In so doing, the hospital becomes one of the nation's first to use bar code scanning for all the steps in the blood transfusion process.

"Even though the hospital staff are already doing an outstanding job of providing safe blood transfusions, this will provide an important extra mechanism for safety. We are taking an excellent system and moving it to the highest level that can be achieved with current technology," said John Kemp, M.D., director of Laboratory Services at UI Hospitals and Clinics.

The pioneering system was thoroughly evaluated over many months as a prelude to today's full implementation. The key to the process is that a unique patient specific bar code number is constantly checked by re-scanning in each of the several steps of the transfusion process. The user is informed immediately not to proceed if bar codes do not match at any point.

"This is part of a larger program to deploy the best possible patient identification system throughout the hospital," Kemp said. "This system will eventually encompass all patient medication administration and specimen collection procedures."

The next step in the bar-code implementation program will begin in May when a team of nurses, pharmacists, and information systems staff launch a pilot project to scan bar codes on all medications given at patients' bedsides. After the system passes scrutiny on a single patient care unit, it will be deployed in other inpatient units in procedure areas over a period of months.

"This system will target reductions in medication administration errors, which is a large step forward in improving patient safety," said Paul Abramowitz, PharmD, director of the Department of Pharmaceutical Care and assistant dean of the UI College of Pharmacy.

Linda Chase, R.N., associate director of Nursing Services and Patient Care, noted that supermarkets have used scanners and bar codes for decades. "So have industry and government," she said. "We are among a growing number of health care organizations who see great potential for using this same technology as a way to ensure patient safety."

The concept holds such great promise that UI Hospitals and Clinics received an $800,000 grant from the federal Agency for Healthcare Research and Quality to develop and implement the bar code system for blood transfusion procedures. Loreen Herwaldt, M.D., an infectious disease specialist from the Department of Internal Medicine, and Lee Carmen, director of Health Care Information Systems, are principal investigators for the grant.

The bar code system includes:

• unique software developed by the hospital's computer specialists
• wireless computers that use radio waves instead of wires or cables and bar code scanners on moveable carts
• bar-coded patient wristbands

Data collected from an 8-month pilot study conducted last year indicate the bar code system is four to 10 times more likely to detect any discrepancies in the blood transfusion information tracking process at earlier points than current manual paper-checking methods, according to Jeff Vande Berg, a program associate in the Clinical Outcomes and Resource Management office at UI Hospitals and Clinics.

Herwaldt said the system allows the hospital to identify problems more quickly and supports research related to quality and safety.

Carmen said bar coding "definitely improves communication among nurses, physicians, pharmacists, and other health care providers and further enhances patient care through improved information management."

UI Hospitals and Clinics staff transfuse more than 34,000 blood products annually. The system's introduction required the training of some 1,800 nurses, anesthesiologists, perfusionists, phlebotomists, and DeGowin Blood Bank personnel.

"By adopting the system now, we are ahead of the curve in almost every respect," Chase said. "It underscores the culture of safety that we aspire to at UI Hospitals and Clinics and makes us national leaders in using bar code technology toward this end."

For more information:

Loreen Herwaldt, M.D.