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Community Memorial Hospital

Improving Patient Care with


Barcoding
Project Manager,
CMIO: Susan Cody
CFO: Terresa Roulhac
CIO: Harleen Kaur

The Background of CMH


Community - Based provider
Multi Hospital/16 Primary Care Clinics
Senior communities including Home Care &
Hospice
Staffing agency
Many existing commitments
ICD -10 mandates
Interchangeable data sharing and privacy
issues
Lack of non-stop, secure, and reliable IT
services
Infrastructure Issues

Challenges of CMH
Operational expenses continue to increase
Stricter regulatory standards in place
Protection of patient safety
Reducing medication errors
Increase of Integrated network

Uses of barcoding systems


Identifying patients
Tracking equipment
Materials management
Point-of-care technology
Laboratory and radiology
functions
Medication administration

Barcoding for Medication


Administration
Helps satisfy Meaningful Use requirements
for improving quality, safety, and efficiency.
Patient Safety
Ensuring the 5 rights
Right patient
Right drug
Right dose
Right route
Right time

Barcoding for Medication


Administration
Barcoding assures accuracy
Provides drug-drug interaction
warnings
Provides medication delivery warnings
Provides charting to the eMAR at time
of delivery
Provides for expansion of technology
to other departments

Goals for the Barcoding


Project

Improve Patient Safety


Streamline workflow
Reduce costs over the long term
Determine improvement cycles
for future implementation

In Scope
Barcoding for
Medication
Administration

Out of Scope
Reg/ADT
Laboratory
Radiology
Materials
Management

The Project Team


COO, CIO, CMIO, CFO
Physician Lead
Nursing Lead
IT information officer
Pharmacy Lead
Laboratory Lead
End Users

Constraints
Overcoming resistance and training of
staf
Cooperation between departments
Selection of appropriate vendor and
software
Acquiring sufficient and appropriate
hardware
Placement of equipment in departments
Proper utilization of resources

The Proposal
Proposed Timeline
Impact: Cost & Risks
Impact: Benefits &
Opportunities
Alternative impact

Proposal of Timeline
Date
Jun - 15
Jul - 15
Aug- 15
Sep - 15
Oct - 15
Nov - 15

Activity
Projected approval of barcodingsystem
Installation of test barcodingsystem
Trainingfor trainers by vendors
Trainer for all end users
Testingbegins on test barcode system
Staff surveys via email
Approval of completion of rollout to entire hospital
Barcodingsystemgoes live
Patient surveys sent out via email/text

Cost & Risks

Cost & Risks


Other items for consideration
Conventional Version Updates
Software Maintenance
Additional Staf Training
Hardware Maintenance
Includes replacement cost
Risks
Barcode quality
Lack of min. requirements in Policy &
Procedures

The Budget
BarcodingProject Budget Proposal
Training
Handouts
Refreshments
Vendor Training

10$ *10 workshops


200$*10 workshops
500$ *5 workshops

Equipment
Barcode readers
Computer System
Barcode Software
Barcode Printer

395$ *175 readers


4 general station
273$ * 2 Licensure
540$ * 25 printers

$69,125.00
$6,000.00
$546.00
$13,500.00

Miscellaneous
Version Updates
Software maintenance
Hardware maintenance

for q 33 months
yearly price
yearly alloted

$500.00
$10,000.00
$20,187.80

GrandTotal

$100.00
$2,000.00
$2,500.00

$124,458.80

Benefits and Opportunities

Benefits and Opportunities

Alternative Impact

@http://intelligenthospitaltoday.com/rfid-tracking-vs-barcode-scanning-how-to-determine-which-is-essential-for-your-healthcare-environment/

Project Details of Proposal


Project Fit
Evaluation and Measurement
Potential solution
Alternative solution
Contingency solution

Why BCMA?
Where do medication errors occur ?

Cost Associated with Medication


Errors

Project Fit
Increased efficiency of the healthcare operations
C3 Model (Better communication, coordination and
cooperation )
C3 process with pharmacists, nurses and physicians

Pilot Testing
BCMA Technology & Associated
workflow will be tested in smaller units
Fixing glitches & ensuring sufficient
technical support available
Rollout to larger & complex units of the
organization
Plan-Do-Study-Act (PDSA) for process
improvement

BCMA Implementation
Approach

PhaseI
PhaseII
PhaseIII
PhaseIV
PhaseV

Planning
DesignandQualityAssurance(QA)
Training
Go-live
PostImplementationMonitoring

New Workflow

Addressing Constraints
Resistance and training of staff

Steering committee will be formed and weekly meeting will


be held with open discussions on concerns. Nurses will fully
view BCMA systems before implementation.
Training sessions will be provided.

Cooperation between departments

Nursing/pharmacy staff will be fully involved in selecting


hardware e.g. mobile medication carts and scanners.
Kick-off meetings for decision-making to address needs
across the continuum of care.
Software that will provide full integration of the EHR and
BCMA
Continuous updating of medication configuration.
One spare fully equipped medication carts, scanners in the
event there is a hardware failure will be provided.
The wristbands that can resist water damage, soiling,
stretching will be selected to minimize the need for
replacement.
Designating an IT entity to support staff, as units go-live.
Processes will put in place such that IT dept. routinely
monitors the hardware
The workflow standardization across the inpatient services
Pilot testing to address any issues and concerns the new
technology of the workflow.

Selection of appropriate vendor and


software
Acquiring sufficient and appropriate
hardware
Working of equipment
Proper utilization of resources

Contingency Plan
Electronic file of medication
history of patients
Printing medication history in
case of a technical difficulty of
the BCMA
Tabletop drills for demonstration
purposes.

Concluding Remarks
54%-87% reduction in
medication administration errors
More integrated healthcare
delivery system
Increased patient safety
Increased revenue

THE END

References
Agrawal, A., & Glasser, A. (2009). Barcode Medication. Retrieved from:
http://www.org/files/HIMSSorg/content/files/jhim/23-4/JHIM_Fall_Agrawal.pdf
Barcoding hospital data capture solutions. (n.d.). Retrieved from:
http://www.barcoding.com/hospital-acute-care-facility-data-capture-solutions.shtml
Barcoding Sales and Inventory Control. (n.d.). Retrieved from: http://www.kcsi.ca/
barcoding_adv.html
Barlow, R. (2013). Raising the bar on tracking products, people, equipment. Healthcare
Purchasing News. Retrieved from: http://hynonline.com/inside/2013-10/310-PSBarcode.html
Brusco, J. M. (2012, July). Incorporating barcoding into the perioperative setting.
AORN Journal, 96(1), 86-88. http://dx.doi.org/10.1016/j.aorn.2012.04.026
Cummings, J., Ratko, T., & Matuszewski, K. (2005, September/October). Barcoding to
enhance patient safety [Article]. Patient Safety & Quality Healthcare. Retrieved
from http://psqh.com/sepoct05/barcodingrfid1.html
Duffy, V. (2009). Analyzing the Effects of a BCMA in Inter-Provider Communication. In
Digital human modeling second international conference, ICDHM 2009, held as part
of HCI International 2009, San Diego, CA, USA, July 19-24, 2009; proceedings (p.
749). Berlin Springer.

References
Lan, M., Zhu, L., & Zhou, Q. (2013, February 19). Medication administration errors
made by nurses reflect the level of pharmacy administration and hospital
information infrastructure. Journal of Clinical Nursing, 23(5-6), 894-895. http://
dx.doi.org/10.1111/jocn.12495
Nachrieb, J. (2013). Raising the Bar on Barcode Risk. Retrieved from: http://
www.rmmagazine.com/2013/10/01/raising-the-bar-on-barcode-risk/
SG20 Healthcare 2d Imager. (n.d.). Retrieved from:
http://www.intermec.com/products/SG20HPHC/
index.aspx
Zebra HC100 Wristband Printer. (n.d.). Retrieved from:
http://www.barcodesinc.com/zebra/
hc100.htm