MANAGING TECHNOLOGY: AN EMPIRICAL INVESTIGATION OF CLINICAL ENGINEERING EFFECTIVENESS

Medical technology is a formidible factor in modern health care delivery, and management of medical technology is an issue of growing importance for hospitals. Clinical engineering is a response to the expansion of medical technology in health care delivery and is an important resource for medical technology management. However, clinical engineering has received little study from a managerial perspective. To what extent does clinical engineering contribute to effective management of medical technology? How can the potential benefits of clinical engineering be realized within a particular health care institution?;Effectiveness was measured as administrative staff perceptions of the extent to which the hospital had achieved specified objectives through management of its medical technology. Performance was measured as the extent to which recommended policies and procedures regarding medical technology had been established, and the extent to which anticipated benefits of effective clinical engineering had been achieved. Objectives were measured as the priority of medical technology management relative to other hospital objectives.;Clinical engineering support was measured as the extent to which the clinical engineering program adhered to recommended standards of clinical engineering practice. Also measured were environmental factors of hospital size and level of medical technology.;Effectiveness and performance were found to be indistinguishable, and the priority of medical technology management was found to have little influence on managerial perceptions of effectiveness. Adherence to recommended standards of clinical engineering practice was found to have a small, positive effect on managerial perceptions of effectiveness. Adherence to these standards was greater in larger hospitals and in hospitals with higher levels of medical technology. Hospitals with effective medical technology management make use of clinical engineering programs which are professionally directed, staffed, and operated and which are established at high levels within the hospital's organizational structure.;A causal model of clinical engineering effectiveness was developed and evaluated with empirical data from 90 not-for-profit community hospitals with 300 or more beds. Effectiveness was modeled as performance relative to objectives. Clinical engineering support was modeled as a managerial initiative translating objectives into performance.