Less than a year after launching barcode technology during its system-wide Cerner Millennium® implementation, nursing adoption climbed above 90 percent in the inpatient bedded units - and stayed there.
There's a shift in how medication administration errors are being addressed - and more often, prevented. Case in point: Athens Regional Health Services (Athens Regional) is preventing medication errors and advancing patient safety with barcode medication administration.
Athens Regional launched barcode technology in the emergency department (ED) and inpatient bedded units during its system-wide Cerner Millennium® implementation in May 2014. Less than a year later, nursing adoption climbed above 90 percent in the inpatient bedded units - and stayed there.
In one week alone, barcode scanning uncovered 205 patient mismatches system-wide. Had the system not found them, some mismatches could have caused errors.
"It was a very important request from our quality committee and nursing leadership," explained Marie DiFrancesco, director of applications. "We wanted to move forward with barcoding to minimize administration errors."
Nursing, information technology (IT) and pharmacy leadership embraced this initiative and stressed its importance to patient safety. They required hands-on training and encouraged nurses to voice when medication errors occurred.
After go-live, a nurse reported that the system caught an incorrect multivitamin before it was administered to a baby. More nurses began speaking up as they uncovered potential errors; meanwhile they worked closely with the pharmacy analyst to troubleshoot issues and define best practices.
“I took ownership of analyzing reported errors, resolving issues and educating on the proper workflow,” said Kristie Cunningham, pharmacy analyst.
Athens Regional took a unit-specific approach to embedding the technology and setting attainable benchmarks. The project team visited each unit to understand exactly what nurses needed for their workflows; they narrowed down to the specific type of scanners and positioned wall mounts where necessary.
But the main driver behind Athens Regional's barcoding success was the culture of accountability. Each unit had visibility to its own data. Weekly reports compared each unit's performance and drilled down to individual users.
“Generating detailed reports and explaining the results,” continued Cunningham, “has made the data meaningful and actionable.”
The data transparency instigated friendly competition to collectively strive for excellence. Nursing leaders formed a “100 Percent Club” to celebrate improvement as nurses met – and exceeded – their benchmarks.
"What's been huge is getting the data out there," noted Kaye Dawson, director of nursing informatics. "People believe it’s credible and will use it to determine what attention or further training is needed."
Athens Regional has maintained strong performance for several months. ED adoption rose from a baseline of 23 percent in November 2014, to over its benchmark of 75 percent as of March 2015. Leaders say adoption continues to rise.
Initially, the goal was to have 90 percent barcoding compliance in the inpatient bedded units. Since last fall, it jumped from below 80 percent and is now consistently between 92-94 percent.
“We didn't want to set the goal at 100 percent because we knew it wasn't a perfect science and wanted to continuously improve,” explained Dawson. “We wanted 90 percent to be the standard, and we’ve hit and surpassed that goal.”