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MobileAsset: The Right Prescription for Truxtun Radiology Medical
Truxtun Radiology Medical Group (TRMG) offers the very latest in diagnostic radiology services. Founded in 1988 in Bakersfield, California, Truxtun opened its doors with only one radiologist and a total of five employees, yet today it stands as the largest radiology center in the area. Presently, with over 150 employees, four buildings on the main campus, and two remote sites, TRMG serves over 600 patients each day. Key to their success is the state of the art equipment, which allows for speedy and accurate diagnoses, as well as rapid reporting of diagnostic information, making it possible to initiate treatments sooner. In fact, adding to the long list of high quality diagnostic equipment, TRMG recently installed a new 64 slice multi-detector CT system that is unsurpassed in image quality and speed. TRMG is committed to providing not only the best diagnostic radiology services, but also the best in patient care.
The Technical Problem
While the expansion and growth at TRMG enables the company to provide the very latest in diagnostic services, the increase in valuable diagnostic tools and equipment creates added asset tracking demands. Chris Freels, the IT manager, found the traditional spreadsheet method to be not only time consuming but inaccurate. “When dealing with equipment of this nature it is important to have precise data when it comes to location, but even more importantly accurate data on maintenance and repair,†states Freels. The present manual tracking system allows for a huge margin of error resulting in misplaced equipment as well as the possibility of deliberate theft. Moreover, each modality, from the ultrasound units to the x-ray machines, is on a strict schedule for maintenance and repair, and keeping a clipboard history on each unit is time consuming.
Freels’ objective is two fold: to find an automatic asset management system to track basic computer equipment, but more importantly, a method to inventory and monitor the multitude of high-value diagnostic equipment. With time being a critical element in the health care industry, the asset tracking system must offer speed, without sacrificing accuracy, when it comes to providing complete reports on location as well as current maintenance history for each state-of –the art diagnostic unit. Freels began his search for a solution only to find many products were just too difficult to install and customize to the special needs of TRMG. “Implementation was not easy and the data collection process did not allow portability nor compatibility with bar coding that already was on the equipment, states Freels. It was not until he discovered MobileAsset Network that Freels realized there is an easy, cost-effective solution to asset management.
Honeywell streamlines asset management at WellSpan Health
WellSpan Health is a healthcare system with over 600 beds in two hospitals and 60 locations in southern Pennsylvania and northern Maryland. The company has over 8,000 staff members, including doctors, nurses, and administration, operational and support employees. Both hospitals use Lawson’s Mobile Supply Chain Management (MSCM) application for real-time data entry of medical supply inventory.
In 2007, both Lawson and the previous scanner vendor alerted WellSpan that their hardware and software were nearing the end-of-life, and an upgrade would be necessary. The facility decided to stay with Lawson as their MSCM system, but opened up the possibility of using a different model or vendor for their scanning needs.
The Situation:
Since the Lawson upgrade would take approximately one year, there was some time to adjust and test a new hand-held mobile scanning solution. WellSpan was provided with a sampling of recommended devices that were compatible with Lawson’s software and WellSpan staff were given the opportunity to test the devices in their work environment to identify which worked best for their needs.
Brigham and Women’s Hospital use Bar Codes to Improve Asset Management
Challenge: Throughout the U.S., almost one in five medication doses administered in hospitals is given in error, according to a recent Archives of Internal Medicine study. As a pioneer in patient safety, the Boston-based Brigham and Women’s Hospital (BWH) wanted to decrease those odds by creating an automated safeguard for preparing and administering prescription medications. BWH concluded that bar code scanning was the optimal system to improve safety and accuracy at all points. An effective system would require an individual bar code label on all prescription medications, however, only about half of the pharmaceuticals shipped to the hospital were marked with unit-of-use bar codes.
When BWH was planning its systems, the U.S. Food and Drug Administration (FDA) was considering a new rule to require unit-of-use bar code pharmaceutical labeling. The hospital didn’t wait for the FDA to require bar code labels on individual medications, and it did not rely on its suppliers to provide them. Instead, the hospital relied on printers from Zebra Technologies to produce individual two-dimensional (2-D) bar code labels for more than 3.5 million pharmaceuticals per year.
Solution: BWH implemented a system using bar code scanning to track and record pharmaceuticals from the time they are processed in the pharmacy until they are administered to the patient. Bar codes are also applied to patient wristbands, employee ID badges, prescription orders and lab samples to facilitate automated tracking and error-free information recording.
Raising the Bar for Positive Patient Identification
The Challenge
The concept of ‘positive patient identification’ is much talked-about in the
medical world, and is a fundamental requirement for correct patient care. This phrase covers all types of verification and identification practices which effect patients, hospitals and procedures. Using patient ID wristbands goes a long way to ensure the correct drugs are assigned to the correct patient – as handwritten wristbands can be misread, easily damaged or even lost.
Previously ward nurses would have to hand write all patient wristbands using information from the patients medical history. By eliminating this manual process, the hospital would save time for medical staff, allowing them to focus on other aspects of their jobs.
It was also important that the key patient demographics were taken from the hospital information system to avoid the risk of transcription errors.
Effective barcodes
According to Helena Roddy, Haemovigilance Officer, Portiuncula Hospital:
“We wanted to implement a blood tracking system to assist with compliance to the EU Blood Directive. The first step in this process was to introduce barcoded patient identification wristbandsâ€
“Implementation and support were also key†Roddy continued. â€We needed a solution which required minimal maintenance and expense.â€
The hospital chose a Zebra solution of printers and wristbands for use with all its adult patients and installed six LP 2844-Z printers throughout the hospital as well as working with hospital staff to design the wristband. This design was key to its success, and had to contain the patient’s name, date of birth, sex, and hospital number.
Bar Coded Wrist Bands are Healthy Solution to Hospital’s Tracking Procedure
Challenge: South Central Regional Medical Center needed to keep up-to-date with technology to provide their patients the utmost in care. They needed a system that would allow them to verify the patient’s identity before performing any procedures in the facility.
Solution: The Medical Center installed Zebra® Stripe® thermal transfer printers to print Z-Band™ wristbands. All wristbands are printed with the patient’s name, identification number, date of birth and gender. This same information is also embedded in a bar code along with the patient’s accounting charge number. The wristbands are clearly readable, easily scannable and more durable than traditional methods.
Application: Various departments throughout the hospital also use the bar code printers. For example, from a nursing station, a doctor issues orders specifying which tests need to be performed on which patients. This generates bar coded labels on the Stripe printers in Hematology. The hematologists take the labels to the patient floor and scan the patient’s wristbands to verify the patients’ identity. When a specimen is collected, it is labeled at bedside to ensure positive identification. The labeled samples are brought back to the lab where the various tests are performed. Once the tests are completed, the scanner releases the patient information into the hospital computer to update the patient’s chart.
Pioneering Radio Frequency Tagging for Positive Patient Identification
In 2004 and 2005 alone, the UK’s NHS (National Health Service) faced over £400 million (about $616.2 million) worth of clinical negligence claims. One of the key causes being patient misidentification. The National Patient Safety Agency states this causes 19% of all hospital errors.
UK Government estimates that errors associated with mistaken identity costs the NHS approximately £2 billion (about $3.1 billion) in extra bed days. Similarly, the NHS continues to come under attack for inefficiency. Despite this, many hospitals have been unable to improve accountability with any significant results. Operation delays are one of patients’ top complaints. Currently there is an estimated 80 minutes per day wasted due to slowness in getting patients to theatre on time.
The Birmingham Heartlands Hospital is part of The Heart of England NHS Foundation Trust. It is one of the largest in England serving half a million people and caring for 574,000 patients a year. In this busy hospital environment, information accuracy is essential for providing the best possible patient care. Determined to reduce errors and improve efficiency, The Birmingham Heartlands Hospital needed to develop a new system for managing patient identification through the operation process.
Radio tagging to avoid misidentification
“We wanted to take advantage of the latest technology to implement new patient safety standards and improve the efficiency of our operating theaters,†said consultant surgeon David Morgan. “We rely on patients’ wristbands to give us the right information to provide every aspect of their treatment from administering medication, transfusing blood to carrying out surgical procedures. Given its critical role in patient care, any system we developed had to based around the RFID wristband.â€
Heartlands Hospital worked with Zebra to develop a new process that used technology to drive patient safety and efficiency. The resulting solution combines Radio Frequency Identification (RFID) tagging with real-time process software using PDAs and Zebra® printers and wristbands. When admitted, the patient is photographed and given a printed wristband with an embedded RFID tag. The patient’s digital image is part of the patient record identification through the operation process.
Baylor Health Care Standardizes Par Management
The company: Baylor Health Care System
The Baylor Health Care System of Dallas-Fort Worth has served its North Texas community for more than 100 years. Baylor provides a full range of inpatient, outpatient, rehabilitation and emergency medical services through owned, leased, or affiliated hospitals and surgical services at short-stay hospitals. Founded as a Christian ministry of healing, Baylor continues its mission as a non-profit with a focus on innovation and research.
The challenge: Standardized, efficient enterprise-wide inventory management
The Baylor Health Care System is committed to providing advanced health care options, treatments, and procedures to its patients. Baylor also provides strategic technology for departments to support that care.
“Materials and supply chain departments at our hospitals use Lawson software for inventory management, managing the pars in each of our facilities,†said Terry Worsham, Project Leader, Supply Chain Informatics, Baylor Health Care System. “However, some were using outdated handheld technology and some were doing these functions manually. So when it came time to upgrade our Lawson MSCM system, we saw the opportunity to standardize the equipment and processes across all of our hospital facilities,†Worsham said.
Baylor has over 400 pars spread across 12 hospitals with approximately 27,000 items in its Lawson catalog. Improving efficiency and reducing the costs of delivering supplies to end users were two key goals of standardizing the inventory system.
Baylor Supply Chain Informatics also wanted to implement a solution that would streamline support. The Informatics team was providing on-site support for the old hardware at each hospital, and this was inefficient in terms of staff resources and time.
The solution: Motorola enterprise digital assistants (EDA) running Lawson software
The Baylor Supply Chain Informatics team, IS team, and materials managers from Baylor hospitals did hands-on evaluations of several mobile computers including the Motorola MC70 EDA.
“Lawson told us that they recommended the Motorola MC70. We also talked with other Lawson clients, and a lot of them preferred the MC70,†Worsham said.
“We tried out several alternatives, and in the end we liked that the MC70 was so feature rich,†Worsham explained. “The scanning capabilities and the size and weight of the MC70 make it easy to use and the keypads are easy and functional. Unlike some of the devices we considered, the MC70 offers choices like the optional pistol grip. We liked that the MC70 enabled us to offer our employees choices, too,†he stated.
Rudy Martinez, Business Analyst II, Supply Chain Informatics, at Baylor Health Care System emphasized the value of the ruggedness of the MC70. “When I did demonstrations at the facilities, the first thing the employees asked was ‘is it durable?’ We actually dropped an MC70 on the floor—the employees were scared, but the mobile computer was fine, not even a scrape,†Martinez said.
Southwestern Vermont Medical Center Turns to 2-D Bar Codes at Bedside
Challenge
An early adopter of healthcare IT, Southwestern Vermont Medical Center (SVMC) began implementing bar coding for bedside medication verification in 2007 as part of its organization-wide initiative to enhance patient safety.
SVMC—which operates a 99-bed flagship facility along with rehabilitation, long-term care, hospice and home care, advanced cancer treatment, and primary care services—received funding support for this initiative through the Agency for Healthcare Research and Quality (AHRQ). Even though the incidence of errors was rare at SVMC, the project aims to decrease the potential for medication transcription and administration mistakes through the use of bar coding and e-MAR technologies.
According to Charles Still, senior systems analyst at SVMC, the key to a successful implementation lies in helping nurses and clinicians verify patient identification and medications with the greatest possible ease and reliability. “We reviewed both bar code symbologies and print technologies thoroughly in light of the needs of our patients, clinicians and the hospital mission,†says Still. “Each symbology has its own pros and cons.
The same is true for standard laser printers and thermal printers.We knew our decisions in each of these areas could affect ease of use and reliability of both patient identification and medication scanning at the bedside.â€
Solution
For patient identification and medication labeling, SVMC opted for two-dimensional (2-D) bar codes over linear bar codes. Two-dimensional bar codes—in SVMC’s case, the Data Matrix format—provide more flexibility than linear codes. Still offers three primary reasons for the decision.
First, ease of use is crucial because a cumbersome scanning process can lead to workarounds that jeopardize patient care. Linear symbologies are larger, and therefore harder to scan on a curved wristband. Because smaller 2-D symbols are readable from any angle and can be repeated around the length of the wristband, there’s often no need to disturb a sleeping patient just to get a positive scan. “If a nurse is administering an IV drug late at night, he or she can scan any spot on the wristband, from any angle, and get a positive patient identification,†says Still.
Second, error rates for 2-D symbologies are 10 to 20 times lower than for linear codes. Perhaps more importantly, 2-D images can withstand more wrinkling and damage and still remain readable.
Printing Solutions Improves Patient Security and Efficiency
The Challenge
Patient security is a key medical sector challenge. It includes verifying and identifying everything that can affect a patient during their hospital stay. Good patient security guarantees that the right patient gets the correct diagnosis and treatment. Having an integrated system for marking, identifying and tracking blood tests is a significant step towards being able to guarantee that patients receive their relevant test results. This in turn leads to appropriate treatment at the correct dose.
Previously, when Karolinska doctors sent blood, plasma or tissue to the laboratory, this was a manual process. Laboratory orders labels were printed from a regular laser printer. A whole sheet of labels was needed just to print a single label. This was an unnecessary waste of resources. Additionally the printed labels were not logged into the hospital’s journal system. This resulted in mistakes.
More efficient handling of laboratory tests
Karolinska needed to improve their handling of tests sent to laboratories. Back in 2003, Karolinska Sjukhuset in Solna went from using regular laser printers for blood test labelling, to using Zebra® desktop printers. The system was gradually expanded and now covers all of Karolinska Universitetssjukhuset. A cost effective and safe solution was needed. The Zebra® TLP 2844 desktop printer was chosen as ideal for printing test tube labels, emergency room ID tags and patient records. Today Karolinksa deploys more than 2000 TLP 2844 desktop printers!
A journal system called TakeCare enables Karolinska hospital personnel to follow up on a patient’s health care history, from anywhere in the hospital that it’s held. This greatly reduces the risk for providing the wrong treatment due to incomplete information. Zebra® printers are used for labelling orders for blood, plasma and tissue tests to be sent for analysis. They are also used for patient labels and ID-bands for acute cases. When a doctor orders a blood, plasma or tissue test, he enters the order into the TakeCare system, which in turn generates a barcode and a LID (laboratory identity) number.
Patient ID wristbands dramatically improve patient safety
The Challenge
The National Healthcare Center 10 in Florence is dedicated to safeguarding patients during their treatment at any of its facilities. As a result the Florence authority, together with seven other healthcare centers in Tuscany (Careggi, Empoli, Grosseto and Siena) organized a patient identification campaign which was fully supported by the Regional Center for Clinical Risk Management.
The Regional Center for Clinical Risk Management is responsible for identifying key health service areas that need improving. 2.6% of laboratory errors stem from incorrect patient identification, while 67% of blood transfusion errors are linked to the use of the wrong blood components. Key factors in accident and emergency (A&E) medicine are: unique patient characteristics (e.g. foreign patients with complicated names), time dependent medical procedures, a change of hospital staff during patients’ treatments and the completion of multiple cases during the same surgery session.
Key to all these errors was the inability to correctly identify the treatment. Therefore it was necessary to build and implement a technology solution that could guarantee correct patient identification as well as improve communication between medical staff.
The Solution
Run by Zebra, the project’s first phase focused on clarifying the best instruments for optimizing patient identification. A survey was carried out to identify benefits and challanges to a range of solutions used in other hospitals including: the Gemelli Hospital in Rome, the Niguarda Hospital in Milan and the Manzoni Hospital in Lecco.
