David Garrido Jaén; Ignacio Bermejo Bosch*; Xavier Andrade Celdrán; Cristina García Bermell; Fernando Gómez Sendra*; Andrés Soler Valero; Rosa Mª Porcar Seder; Inés Mª Pereira Carrillo

Instituto de Biomecánica (IBV)
* IBV’s Healhcare Technology Group, CIBER in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN)

The management of a biomechanical assessment service can be described as the process of integrating the elements of both the laboratory and its environment, with the main objective being to improve the effectiveness and efficiency of its processes.

The support activities of the Instituto de Biomecánica (IBV) intended for laboratories who use biomechanical assessment techniques, aim to maximize the use and consolidation of the health services they provide, with particular emphasis on nuclear procedures related to its organization, strategy and development of continuous improvement processes.

INTRODUCTION

In recent years, the Instituto de Biomecánica (IBV) has become one of the centers that act as a point of reference, both nationally and internationally, in the development and transfer of advanced technology solutions for the application of biomechanics in the field of health and quality of life. It is particularly worth noting its implementation in the areas of occupational health, physical injury assessment and rehabilitation, where the proliferation of professionals and specialized laboratories have contributed to the creation of a new clinical specialty: biomechanical assessment.

Given this distinguishing element and in order to ensure the consolidation, growth and dynamism of this new medical intensification, the IBV has developed since 2003 a series of support activities specifically intended to optimize the clinical and organizational use of both human and material resources in laboratories. Particular emphasis has been placed on the needs of the main players in the industry, such as the mutual insurance companies that collaborate with the Social Security (MCSS), benchmark hospitals in physical medicine and rehabilitation, as well as various companies in the health sector that assess physical consequences and injury.

From an organizational perspective, it is worth noting that the services provided within a biomechanical assessment laboratory, like any other professional activity in the health sector, are carried out within an economic, legislative and social framework which is regulated by the healthcare policies of each organization.

The characteristics of these policies, under which healthcare resources are managed, have a direct effect on how the assessment services are delivered and the use of the healthcare provided by their clients.  As in any organization, the issues related to the funding and the budget available are certainly among the factors that most influence the operation of a biomechanics laboratory services. Both variables have a direct impact on the human and material resources around which such services are structured and developed.

However, the economic factors are not the only ones that come into play when designing, developing and managing laboratory services. Other aspects related to organization, planning, innovation and continuous improvement of the processes involved, have a direct impact on the optimization of the human, material and technological resources available. In the case of biomechanical assessment laboratories, their management should ensure that the strategies to be followed are defined, with particular emphasis on:

• Determining the economic and care objectives that make the operation of the laboratory viable and cost-effective.
• Introducing a quality control system for the services provided.
• Developing processes of continuous improvement.

 The importance of each of these aspects in the context of biomechanical assessment laboratories prompted the IBV to develop specific support contents that will meet the needs of the user organizations in order to help them make decisions concerning the management and optimization of these services. Therefore, on a general basis, the main objective of the support services provided by the biomechanical assessment laboratory is to contribute to the viability of the laboratory activities from both the clinical and healthcare perspective as well as from an economic point of view.

Figure 1. Session performed with an adult patient in a biomechanical assessment laboratory set up in a mutual insurance company.

DEFINITION OF THE SUPPORT ACTIVITIES OF THE BIOMECHANICAL ASSESSMENT LABORATORIES

The support services of a biomechanical assessment laboratory must be adapted and shaped considering the particular needs of each user entity as well as the evolution of the laboratory. This degree of maturity of the laboratory is an essential quality to define the starting point of any action plan within the framework of support activities. In this regard, after more than 15 years as a benchmark center in biomechanical assessment, the IBV has identified two scenarios or stages through which all laboratories go before reaching the so-called Optimization period; these stages are:

1. Set up and start up
2. Maturation
3. Optimization

Figure 2. Evolution of the biomechanical assessment laboratories.

The IBV support activities are designed not only to meet the specific needs of each stage, but also to minimize time and costs until reaching the optimization period.

Determining the stage in which the laboratory is requires diagnosing and auditing in collaboration with the departments of biomechanics, quality and medical management of the user entity in order to establish the indicators to be measured and monitored, as well as the overall strategy of the biomechanical service.

1. Support activities associated with the set up and start up stage

In this period, the laboratory and its personnel are characteristically in the early stages of use and training. At this time, both training and advisory services for the specialized personnel are paramount. However, the importance of the process of analysis, selection and design of the organizational model that the laboratory will follow should not be overlooked, as it will determine its operation and future sustainability. Similarly, particular emphasis should be placed on the tasks intended to integrate the biomechanical service into the other clinical services of the entity. Such tasks require establishing operating procedures both for the communication with other units and the integration of the information generated in the laboratory.

2. Support services associated with the maturation stage

In this period, the biomechanics unit and the resources of the service start to consolidate. The challenges faced by the laboratory focus on establishing policies and actions that maximize the use and profitability of the service. Therefore, during this stage, besides maintaining the quality systems established in the initial phase, the necessary actions to optimize the biomechanics service must be implemented. Similarly, both internal and external communication tasks have a significant importance not only to support the validity of the services developed by the unit, but also to quantify the degree of satisfaction among all the agents that interact with the laboratory.

3. Support services associated with the optimization stage

The optimization stage of a biomechanics laboratory occurs with its maturation. In this stage the available resources (both material and immaterial) are used to their maximum. The laboratory is usually consolidated both internally and externally; the tasks linked to the compliance and maintenance of the quality standards and continuous improvement by implementing innovation policies are vital at this moment. Similarly, in this stage the specific needs of each service require unique interventions related to the renovation, maintenance and expansion of infrastructures as well as training of the newly recruited employees.

CONCLUSIONS

Given the innovative nature of the IBV and its very primary purpose as a technology center, support activities are continuously updating and reinventing. In this regard, the IBV has recently implemented an innovation process whose purpose is to identify and define new contents so as to ensure the maximum use of the user laboratories resources. To this end, specific actions are carried out in order to support the key processes linked to strategic formulation, quality assurance of the activities undertaken by the biomechanics units, identification of poor processes and execution of a plan for continuous improvement.

Figure 3. Innovation of the support activities of the biomechanical assessment services.