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CHIME Launches Case Study Series, First to Feature Bedside Medication Verification System

September 4, 2012

Cook Children’s Medical Center in Fort Worth, Texas, has achieved adoption of an electronic bar-coding system that verifies medication delivery is correct before pediatric patients receive it.

Planning and ongoing support and attention to how clinicians are using the technology have resulted in widespread use of the bedside medication verification system. Executives at Cook Children’s report that more than 97 percent of medications and patients are scanned before patients receive treatment.

Cook Children’s story is being highlighted in a case study, “Changing the Culture: One Hospital’s Journey to Improve Care Delivery with Bedside Medication Verification,” developed by the College of Healthcare Information Management Executives (CHIME) and intended to highlight how IT can improve health care delivery and show how providers are successfully implementing technology and to promote sharing of best practices in IT implementation.

Verifying medication doses are crucial in care delivery, and especially so for pediatric patients, because dosages typically vary dramatically, based on the weight of the patient. Either too low or too high of a dose can reduce the effectiveness of treatment or potentially harm the patient through an overdose.

Beginning in November 2010, Cook Children’s implemented a bedside medication verification system to prevent variances in drug administration. Bedside medication verification uses integrated technology to check in real time, before medication is administered to a patient, to make sure the right medication is being given in the right dose to the right patient at the right time and in the correct manner – commonly called the “Five Rights” of medication administration.

Achieving the five rights is especially crucial when it comes to pediatric patients, like those who are Cook Children’s clientele, says JoAnn Sanders, MD, the organization’s patient safety officer and the project sponsor for the bedside medication verification program.

“We can do so much good with medication, but also so much harm when we make medication errors,” Sanders said. “Bar coding takes a lot of the elements of human error away. It ensures that you have the five’rights’ of medication safety and that you verify them before you give any medication.” Bedside monitoring verfication serves as an important tool for nurses and respiratory therapists, providing another layer of safety to augment the critical thinking skills developed in years of training and on-the-floor experience.

To implement the new system, an implementation team was formed with participants from a variety of departments within the hospital, including nursing leaders, the pharmacy department and IT. The team worked together to map out a phased implementation in the 428-bed facility, and then a strategy to use data to encourage the bar-coding system as they treated every patient.

While bearing responsibility for the installation of the technology, Cook Children’s IT department was at the table to enable the project, but not to lead it, said Theresa Meadows, a CHIME member and senior vice president of IS and CIO at Cook Children’s Health Care System. “It wasn’t an IT project,” Meadows said. “It was driven by the clinicians, and that made a huge difference.”

Placing the project as a patient safety initiative under direction, and with the input from the core team cast the project in a different light, Sanders said, and members of the core team sought out feedback for how the project would change care delivery and what would be needed to make it work.

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