The Pharmaceutical Journal
Vol 270 No 7233 p131
25 January 2003

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American Society of Health-system Pharmacists summary

Bar-coding can improve medication safety

According to a recent survey, 43 per cent of hospital respondents in the US are considering the introduction of bar-coding, but this needs to be 100 per cent, said Dr Kasey Thompson (director, Centre on Patient Safety, ASHP). At present only 1 per cent of US hospitals have bar-coding fully implemented in all areas, he added. In a session devoted to presentations about the Pathways for Medication Safety project (a joint initiative involving the American Hospital Association, the Institute for Safe Medication Practices and several other agencies), Dr Thompson described critical issues concerning the implementation of bar-coding to improve medication safety.

Bar-coding has been successfully used in other industries for many years and it would help hospitals to meet JCAHO requirements for accurate patient identification. Nevertheless, organisations have recognised that some preparation is required before the implementation of bar-coding. A multidisciplinary panel of health care experts have collaborated to devise a modular tool to help institutions to assess their readiness for "bedside bar-coding". The first module of the tool is designed to raise awareness of current issues with bar-coding technology and explores its role in the health care context.

"We have investigated success stories and failure points and described the benefits and challenges of [bar-code] implementation," said Dr Thompson.

The second module contains 135 questions designed to explore the organisation's readiness for the process, and helps to identify potential failure points. For example, it includes questions such as, "Do nurses consistently follow existing procedures?" Bar-coding could only work with a unit dose system, claimed Dr Thompson.

The third module contains an outline of the implementation process and several additional documents. These include a template for a specification to be sent to a technology vendor, a worksheet to estimate cost-savings associated with the implementation of bar-coding and a "failure modes and effects analysis" (FMEA) for a bedside bar-coded drug administration system that demonstrates anticipated failure points and their causes. More information is available at the website www.medpathways.info, he added.

One hospital pharmacist who had used the tool commented that it was useful because it had forced him to examine the practicalities of implementation. Another said that it had showed that they were not ready for the technology and had "put the IT team in its place".

Asked if bar-coding would be an outdated technology by the time of implementation, Dr Thompson said that other technologies such as radio-frequency tagging would also evolve but that bar-coding would continue to have a place for many years.