Why barcode medications?Why barcode medications?

Admin Rx at the Admin Rx at the Medical University of South CarolinaMedical University of South Carolina

More people die in a given year as a result of medical errors than from motor vehicle accidents (43,458), breast cancer (42,297), or AIDS (16,516).

Kohn, Corrigan & Donaldson, “To Err is Human”, Institute of Medicine, 1999

Why barcode medications?Why barcode medications?

Nationally 2 of every 100 admissions experienced a preventable adverse drug event, resulting in increased hospital costs of $4,700 per admission.

This is $2.8 million annually for a 700-bed teaching hospital.

Kohn, Corrigan & Donaldson, “To Err is Human”, Institute of Medicine, 1999

Why barcode medications?Why barcode medications?

Where do medication errors occur?Where do medication errors occur?

Transcription

6%

Dispensing 4%

Administration34%

Ordering 56%

Bates, Cullen, Laird, et al. “Incidence of Adverse Drug Events and Potential Adverse Drug Events.” JAMA, 1995, 274, 29-34.

• Right drug 75% improvement• Right dose 62% improvement• Right patient 93% improvement• Right time 87% improvement• Missed meds 70% improvement

*Johnson, Carlson, Tucker, & Willette Using BCMA in VA Medical CentersJournal of Healthcare Information Management-Vol 16, No.1

Why barcode medications?Why barcode medications?*Barcode Medication Administration (BCMA) in VA Medical Centers*:

• 8,000,000doses dispensed

• 549,000errors prevented

• 0documented errors

*Eastern Kansas Health Care System (VA) 1994-2001*:

Why barcode medications?Why barcode medications?

• 0 documented errors?

On what does this depend?

• How do we define “error”?

• Doing BCMA the right way

Why barcode medications?Why barcode medications?*Eastern Kansas Health Care System (VA) 1994-2001*:

• How do we define “error”?

failure of a planned action to be completed as intended (an error of execution)

or the use of a wrong plan to achieve an aim (an error of planning)

• How we define a med error at MUSC?

deviation from what the prescriber intended

er·ror

Kohn, Corrigan & Donaldson, “To Err is Human”, Institute of Medicine, 1999

Why barcode medications?Why barcode medications?

Admin Rx at MUSCAdmin Rx at MUSC

Doing BCMA the right way

• Will we alter the wrist scanning process for– Isolation patients– Emergency Department– Surgery– NICU, nursery

• Details of dispensed medications– Half pill ordered, half pill delivered– Insulin, topicals– IVF with additives

How we catch medication errors- How we catch medication errors- a closed loop system:a closed loop system:

eMeds (Pharmacy)

Clin DocAdminRx

CPOE (Computerized Provider Order

Entry)