Project Manager, CMIO: Susan Cody CFO: Terresa Roulhac CIO: Harleen Kaur Community Memorial Hospital Improving Patient Care with Barcoding

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

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

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

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

Proposal of Timeline

Cost & Risks

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

The Budget

Benefits and Opportunities

Alternative

Project Details of Proposal Why BCMA? Project Fit Implementation Process Workflow Addressing Constraints

Where do medication errors occur ? Why BCMA?

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

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. Selection of appropriate vendor and software Software that will provide full integration of the EHR and BCMA Continuous updating of medication configuration. Acquiring sufficient and appropriate hardware 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. Working of equipment Designating an IT entity to support staff, as unit’s go-live. Processes will put in place such that IT dept. routinely monitors the hardware Proper utilization of resources The workflow standardization across the inpatient services Pilot testing to address any issues and concerns the new technology of the workflow.

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: Barcoding hospital data capture solutions. (n.d.). Retrieved from: solutions.shtml Barcoding Sales and Inventory Control. (n.d.). Retrieved from: barcoding_adv.html Barlow, R. (2013). Raising the bar on tracking products, people, equipment. Healthcare Purchasing News. Retrieved from: Barcode.html Brusco, J. M. (2012, July). Incorporating barcoding into the perioperative setting. AORN Journal, 96(1), Cummings, J., Ratko, T., & Matuszewski, K. (2005, September/October). Barcoding to enhance patient safety [Article]. Patient Safety & Quality Healthcare. Retrieved from 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), dx.doi.org/ /jocn Nachrieb, J. (2013). Raising the Bar on Barcode Risk. Retrieved from: SG20 Healthcare 2d Imager. (n.d.). Retrieved from: index.aspx Zebra HC100 Wristband Printer. (n.d.). Retrieved from: hc100.htm