Bar Coding for Patient Safety in Northern Michigan

Five partnering hospitals in northwest lower Michigan collaborated to create a system of health care that involves an integrated computer network. This network not only offers a single repository for the storage of all patient information, but it also allows the sharing of technology that can enhance patient safety. Goals and initiatives at all hospitals were focused on reducing Adverse Drug Events and medication errors. These events and errors occur at several places along the medication chain, including ordering medication, transcribing physician orders, dispensing medication, and administering medication. A solution to this serious problem, therefore, must consider all of these phases. Plans have been completed to address errors at the dispensing, ordering and transcribing phases through computerized pharmacy and CPOE (Computerized Physician Order Entry) applications, but these approaches do nothing to correct the 34 percent of errors that occur at the end of the medication chain, namely its administration by nursing staff. The bar coding system that we installed fills this lapse and provides an important safeguard for hospitalized patients. It ensures that the right medication in the right dose is given to the right patient at the right time by an administrator who is qualified and authorized to give it. It offers alerts regarding potential drug interactions and allergic reactions. It provides a permanent record of the patient's medication history, accessible by health care providers at any site within the partnership. It tracks "near misses," so that more errors can be avoided in the future. It saves many of the thousands of dollars that are spent in repairing the damage done by each medication error, leads to better health outcomes for patients, and improves the health of our communities. The bar coding application, offered by the vendor Cerner, was installed in all six hospitals sequentially over a period of 2-1/2 years.