Teamwork
Brings Bar Coding, Patient Safety Improvements to Bellin
Health
(4/3/2008)
When it comes to improving patient
care through technology, bringing caregivers together behind
a common goal is essential to ensure success. MEDITECH
customer Bellin Health Care (Green Bay, WI) has found a way
to recognize those departments and providers which exemplify
exceptional teamwork in pursuit of patient safety, through
its annual internal VIP Recognition Awards. This year's
recipient team included nurses, pharmacists, I.S. staff, and
others who joined together to implement MEDITECH's bedside
medication bar coding technology to eliminate errors from the
care process.
"To enhance patient safety at our hospital, we knew it
was going to take a major commitment from many different
departments and caregivers," says Randy Ronsman,
director of information services at Bellin. "We're the
first hospital in Green Bay to undertake a bar coding project,
so we wanted to make sure we did our research as well as get
end-users involved from the start, so that we could gather
ideas and gauge our success from multiple perspectives. It
was a cross-functional team that really stood out and worked
well together."
Taking
A Collaborative Approach to I.T.
Knowing that medication bar coding technologies would most
strongly affect nurses and pharmacists, the hospital made
sure to recruit leaders from both areas for the project,
working closely in conjunction with the I.T. staff. "First,
we identified the people who seemed to be thoughtful leaders
in their departments, staff who were highly respected by
their peers," says Ronsman. "They understood the
importance of not only learning and utilizing the new tools,
but also communicating their enthusiasm to others and acting
as role models for the entire staff."
Even though nurses were the
ones who would be using bedside medication bar coding,
leaders at Bellin believed that pharmacists also needed to
take a prominent role in the project. "Pharmacists were
involved from the very inception of the project, looking at
the current processes and helping to conduct a detailed
analysis of where we wanted to go and how the changes would
affect patient care," says Pharmacist Mike Stiller. The
analysis included determining the best and most effective way
to package and bar code individual medications, examining the
steps in medication delivery to determine any potential flaws,
and modifying billing methods to take advantage of the new
technology. The team also addressed issues using a similar
team-oriented approach.
"We took a collaborative approach to problem solving all
the way around," adds Ronsman. "We brought I.T. to
the table for the job of attaching bar code readers and
setting up carts, while Pharmacy created readable bar codes
for our products, and Nursing took charge of the go-LIVE
schedule. Everyone had an important role to play."
 |
Going
the Extra Mile for Patient Safety The kick-off for bar coding took place over the course of three weeks, in the post-surgical area of Nursing, where a wide variety of care is administered. During that time, pharmacists and nurses worked together to integrate the site's MEDITECH system with its newest technology. "Our pharmacists learned the Nursing system first, so they would be able to assist nurses as they began bar coding," says Ronsman. Cindy Suplinski, RN, says that having extra staff available during the first few days LIVE was a huge help in making the implementation go smoothly. "We had more nurses and pharmacists on hand during those first days, so nurses who were learning to use bar coding could concentrate better and not worry that patient care was suffering at all," she says. "We all did whatever we could to make sure that nurses wouldn't feel overwhelmed." On the Pharmacy side, Stiller believes that the patient safety benefits made the extra steps involved with implementation and training worth it. "Bar coding definitely involved more work at first, with making sure all of our medications and supplies had clear, readable codes. Having a high speed packager helped us with efficiency, but it wasn't a necessity. We had good solid systems already in place," he says. "The thing is, we understood the importance of eliminating medical errors, and that was our priority. It's not a process that starts and stops with Nursing; we all have to do our part, and help each other." |
Keeping
Staff Focused and Motivated
But the true test for Bellin came when bar coding reached
wider audiences, going LIVE in the Maternity, Pediatrics,
Rehab, Medical, Orthopedics, and finally, Critical Care areas.
Keeping the staff motivated and focused on their patient
safety goals was a priority for the project's leaders.
"When we first began using medication bar coding, we had
an outstanding scan rate, over 90 percent," says
Suplinski. "But over time, that number has dropped a bit,
so we've really had to take action to actively encourage
compliance. We still monitor scan rates on a weekly basis, so
we always know what's going on and who's doing well with it."
One of the ways Bellin recognized nurses with high scan rates
was to post their names on the department bulletin board, as
well as post the department scan rates on the hospital's
Intranet. "Everyone who achieves a 95 percent scan rate
is one of our 'bar coding superstars,'" says Suplinski.
"It's clear everyone wants to perform as well as their
peers; some weeks we nearly run out of room on the board,
there are so many superstars!"
The Nursing department also created a brochure for patients,
explaining the new bar coding procedures and patient safety
benefits. "We're giving our patients the expectation for
safe, efficient care. If their nurse doesn't scan their
medication, we want them to ask 'why not?' It's always a good
thing to have patients more engaged in their care processes,"
Suplinski says.
Serving as a Model
for the Hospital Community
Now that several months have passed since the initial
implementation, Bellin is seeing its dedication and teamwork
pay off. "On only the second day of using bar coding, we
caught an error when a nurse tried to scan the wrong dose of
a patient's medication," says Suplinski. "Catching
medication errors before they happen is the whole reason we
undertook this project. Even if patient care takes a few more
minutes, we know we're providing safer care in the long run."
She notes that bar coding has actually resulted in an average
ten minute decrease between medication administration and
documentation.
Ronsman believes that the technology has also helped to
improve Bellin's charge capture rates. "Before bar
coding, our misdocumentation rates for IV antibiotics was
around seven percent," he says. "If there's no
documentation, there's no charge. I estimate we're gaining
back about $200,000 in lost revenues."
After making such great strides with medication bar coding,
Bellin hopes to roll out the functionality to other areas of
the hospital, including Surgery and Anesthesia. "The VIP
Award didn't just recognize great work by our team, it also
sent a message to the rest of the organization," says
Ronsman. "We want everyone to know the team approach to
new technologies does work, patient care can be safer, and
challenges can be overcome."
MEDITECH
Medical
Information Technology, Inc.
MEDITECH Circle
Westwood, MA 02090
781-821-3000
www.meditech.com