February 2003
Volume 27 No. 2

Hi-tech ID wristbands boost safety, efficiency

New policy details procedure for missing patients

New Cellular Therapeutics Lab boosts SHC's bone marrow transplant capacity

Emergency Medicine faculty promotes specialty halfway around the globe

Revised policies mean cell phones, laptops can be used in some areas

Physicians can take simple steps to improve patient safety



Hi-tech ID wristbands boost safety, efficiency

A new bar-coded ID wristband that automatically links clinical data with patients' medical record numbers is boosting patient safety and health-care efficiency at Stanford Hospital. Based on the promising results the hospital has seen after a few months of use, Lucile Packard Children's Hospital is gearing up to use it as well.

With the technology, patients admitted to the hospital receive wristbands that contain their medical record number in bar-code form. The bar code is read electronically by diagnostic devices such as glucometers, which allows the test results to be automatically linked back to the patient. When the patient's wristband is scanned, the data is downloaded to the hospital's clinical laboratory where it is joined to other test results in the patient's record. By automating this process, the wristband eliminates errors that occur when medical record numbers are entered by hand.

The effort began in December 2001 when new glucose meters with bar-code readers were installed at the hospital. The patient ID error rates were high at first because the medical record numbers were still being input manually. Lab staff were spending up to two hours a day correcting mistakes, while nurses were spending up to five hours a week fixing problems, said Connie Taylor, patient care policy and procedures coordinator at Stanford Hospital.

"It's a human error thing," Taylor said. "When people are working fast, it's like typing with no auto-correct. It's very difficult. We had to fix the system first."

That fix involved automating how medical record numbers were entered into the test devices, giving rise to the ID bracelets. The project involved not only the clinical laboratory but also nursing, patient admitting services, medical records, IT and materials management.

As of Oct. 1, 2002, the bar-coded wristbands are being used for all patients in the hospital's inpatient nursing units, the emergency department, the Ambulatory Surgery Center, the Ambulatory Treatment Unit and the Cath/Angio Lab.

Nursing staff were trained to use handheld glucose meters with a bar-code scanner and download the data at a docking station, which then transmits the data to the clinical laboratory. The new system has virtually eliminated the transposition errors that occurred when staff entered the medical record numbers manually.

"It was a pretty exciting project. The nurses embraced it because they saw real benefit from it," said Taylor. "It made their jobs easier because it's a lot less work to scan a bar code than to enter information manually." The changeover to the bar-code system, she said, "has been perceived as very positive."

Sandra Trotter, quality manager for the clinical laboratories at SHC and Packard Children's Hospital, said the wristbands also work with a portable device called the i-Stat 1, which analyzes various blood-chemistry tests.

Before the i-Stat 1, when a physician ordered a potassium test, for example, it took 30 to 45 minutes to get the result. With the new bar-code-compatible device, Trotter said, the result comes back in just two minutes. That, in turn, allows physicians to quickly decide whether to send a patient to the ICU or to surgery.

While bar-coding technology has long been used by the retail sector, hospitals have begun applying it only in the last few years, and Stanford is one of the few hospitals using bar-code technology for patient identification. Charles Dibble, assistant director of patient admitting services, sees tremendous potential for the technology as more departments purchase equipment with bar-code reading capabilities. "Right now we're using it in the lab," he said. "In the future, it could be used by pharmacy, radiology, EKG or transfusion. The possibilities are almost endless."