In April 2008, Baystate Medical Center (BMC), a 653-bed teaching hospital in Springfield, MA, began implementation of its Bar Code Point of Care technology to positively impact medication administration in reducing errors.
In the early pilot programs, BMC reported a 50% bedside scanning rate for all medications and a medication error rate of 1.2 errors per 1,000 patient days.
Following the implementation of an organization-wide bar code scanning process in September 2008, BMC improved its medication scanning rates to 87%—90%. The medication error rate also decreased to 0.3 errors per 1,000 patient days, a 75% reduction.
Implementation and pilot programs
Planning and implementing a bar code scanning system at the bedside was a major undertaking for BMC because the patient safety-focused process is designed to significantly reduce medication administration errors.
"What is so impactful about the whole process is that all departments—with the exception of some emergency departments—are fully bar coded," says Gary Kerr, MBA, PharmD, director of pharmacy services at BMC. "The central pharmacy has been re-engineered to support the outputs necessary to drive and sustain medication bar codes."
BMC started small, with a six-month pilot program that involved three nursing units. It was during this six-month pilot program that Kerr and Mark Heelon, PharmD, medical-surgical director at BMC, committed themselves to learning everything about the bar coding process.
It became clear early on that there were numerous obstacles when scanning a patient every time he or she received a medication, from packaging to process. Examples of identified scanning challenges included large-volume IVs, medications without bar codes, medications with reflective packaging (e.g., suppositories), and computerized physician order entry (CPOE) mismatching products or administration times of medications.