How the ACT is eliminating hospital errors

ACT Health has embarked on a clinical systems transformation that will see patients electronically cross-referenced with pathology orders and medication at their bedside in an effort to eliminate errors at the point of care.

The territory's health directorate has completely overhauled how it interacts with patients to banish the paper-based records and processes that are the traditional causes of mixed up blood samples and medications in hospitals.

Despite having made a significant effort to strengthen these processes in recent years, ACT Health wasn't getting the reduction in avoidable errors it wanted. 

So it starting looking at electronic tools to eliminate transcription mistakes.

Chief information officer Peter O'Halloran and team decided to take the bold step of equipping Health's electronic record systems with identification standards.

Patient wristbands and staff ID cards were upgraded to include GS1 compliant barcodes, as were clinical note labels and specimen labels.

It required modifications to eight separate IT systems provided by different vendors to get them to accept the GS1 barcodes.

Now, when a clinician takes a blood sample, they are required scan both their own and the patient's barcodes at the outset, before the specimen label can be scanned and printed. A computer on wheels kitted out with the barcode scanners is used by the patient's bedside.

It means a pathology specimen label can only be printed in the presence of the patient, reducing the risk that the label will be incorrect or misapplied.

"Electronic ordering and collection has eliminated paper order readability and transcription incidents," O'Halloran said.

"Equipping electronic medical record systems with identification standards closes the patient safety loop across the continuum of care."

The approach has initially been implemented for electronic orders in pathology and medical imaging, however it will soon be rolled out for electronic medication management and for the deteoriating patient system.

ACT Health claims it is the first time that electronically-supported positive patient identification meeting GS1 standards has been integrated with clinical systems available at the bedside.

O’Halloran said the health directorate had already recorded a 40 reduction in "wrong blood in tube incidents”. He expects this to reach 100 percent once the project is complete.

The trials of the new approach also showed a big reduction in manual handling, wiping almost eight hours of nursing time off per day per ward.

Implementation of clinical systems across all wards of Canberra Hospital will be complete by June next year.

This project has been named a finalist in the healthcare category of the iTnews Benchmark Awards 2017/18. The full list of finalists can be found here.