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The Patient Journey

The Patient Journey. The Patient Journey. Blood Bank. Medication Administration. Laboratory. Radiology. Healthcare Estates. Porters. Admissions. Sterile Services. Patient Transfers. Admissions. Patient Identification is KEY Currently Hand written wristbands

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The Patient Journey

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  1. The Patient Journey

  2. The Patient Journey Blood Bank Medication Administration Laboratory Radiology Healthcare Estates Porters Admissions Sterile Services Patient Transfers

  3. Admissions • Patient Identification is KEY • Currently • Hand written wristbands • 8.6% of hand written wristband contain incorrect data • 5.7% are illegible to some degree • No patient identification

  4. And yet the patient is the key component of any treatment Hospital Information System (HIS) OR Scheduling System Pharmacy LAB E.R. System Blood Bank Workflow: Process Automation (server based front end applications) Peripheral Devices Patient

  5. Where do errors occur? • Mismatching patients with their care • Given wrong medication • Wrong blood type administered • Pathology samples mixed up • Wrong part of body operated on / removed during surgery

  6. Medication Treatment Sample ID Blood Products Solution = Positive Patient ID • Track patient at every stage of their treatment • Medication administration • Blood Administration • Sample Management • Treatment • X-Ray, surgical etc. • Non-medical • Meal orders, patient billing Bar coded Patient Wristband

  7. Benefits of Positive Patient ID • Wristband can have text and barcode (even RFID) • Patient name • Patient ID number (to ref EPR) • Blood type • Allergies • Primary physicians • Pre-printed colours for visual aids

  8. Benefits of Positive Patient ID • Risk Reduction • Automation of data entry and verification • Error rate for barcode data entry is less than 1 in 3million scans • Improved Processes • re-designed to include scanning of patients, samples, drugs. • Eliminates bad working practices • Electronic Audit Trial

  9. Benefits of Positive Patient ID • Cost Savings €€€€ • Reduction of errors = reduction of costs to rectify errors • average cost per Adverse Drug Event €2,257 (*FDA) • £2billion cost to NHS in extra bed days due to errors • Trial at VA hospital showed 86.2% error reduction using point-of-care scanning for medication • More Efficient • Carillon Health System reported savings of 2.75hrs per 12-hour nursing shift after starting to use barcodes as part of their medication administration *Federal Drug Administration

  10. Wristband solution from Zebra • Bar coded patient wristbands • Thermal Transfer • Z-Band 4000 • Direct Thermal • NEW Z-Band Direct • NEW Z-Band QuickClip • Smart Wristbands (13.56Mhz) • Bar code printers from Zebra • 2824-Z, 2844-Z – ward based solution • S600 / Z4M - Admissions • Network / Printer Management key

  11. Direct Thermal ribbon-less printing Durable image with resistance to alcohols, solvents, water and soaps 1-Piece Wristbands Self adhesive closure with security slits for immediate adhesion and tamper-evidence Band Colour White, custom colours available Z-Band Direct™

  12. Direct Thermal ribbon-less printing 2-Piece Wristbands Secure clip fastening, must be cut to be removed Durable image with resistance to alcohols, solvents, water and soaps Band Colour White, custom colours available Coloured clips option Z-Band QuickClip™

  13. Smart Wristbands™ • 13.56Mhz RFID wristband • Read/write capabilities • Non-line of sight ‘scanning’ to read band • Nurse can read wristbands through bed sheets and clothes • Direct Thermal • Ribbon-less printing • 2-Piece Wristbands • Snap closure: tamper proof, secure locking

  14. Thermal Transfer resin ribbon required Latex free, waterproof, smear and abrasion resistant One-Piece Self adhesive closure Band Colour White, custom colours available Z-Band 4000

  15. The Wristband Family Available to order NOW! Convenient and Cost Effective – Stocks in place now.

  16. Desktop Printer Range 2”, 4” widths available Small and Compact Easy to use Connectivity USB, serial, parallel Internal / external Ethernet ZebraLink New media guide Option for Wristbands Ensures registration and print quality Media Guides Wristband Printers

  17. Case Note / X-Ray ID • Bar code labels for records, X-rays • Accurate storage and tracking • RFID??

  18. Medication Administration • Prescription labelling • In pharmacy • At bedside • Trials at Glasgow Royal Infirmary with mobile printer on W-LAN

  19. Electronic Prescription • Barcoded wristbands to ID patients • Handheld computers used by doctors to write prescriptions at patients bedside • Wireless network for immediate data transfer • Medication delivery verified for right patient, right medication

  20. The ‘5’ Rights Identify the RIGHTPatient Confirm the RIGHTMedication Confirm the RIGHTDosage Confirm the RIGHTRoute And the RIGHTTime The Benefits Reduced errors Reduced costs associated with errors More rapid and accurate documentation Bar coding and medication administration

  21. Product Issue Pre/type testing Recruit Administer (bedside) Screen Donor Collect & prepare Medical reason For Transfusion Monitor & Evaluate Inf Dis tests Patient Sample High Error Processes Blood Transfusion Process *New EU Blood Directive: 2002/98/EC

  22. EU 2002/98/EC • Directive 2002/98/EC of the European Parliament and of the Council of 27 January 2003 • Chapter V • Article 14 • Traceability “1. Member States shall take all necessary measures in order to ensure that blood and blood components collected, tested, processed, stored, released and/or distributed on their territory can be traced from donor to recipient and vice versa.”

  23. ID Patient – Wristband (BC / RFID) • ID Blood Bags • 1y / 2y labels • Patient ID ID Samples - Bar code Solution…

  24. Laboratory Sample ID • Bar-coding of patient samples • Accurate recording of key details • Patient name, DOB, Doctor • In Ward • At Bedside • At GP Surgeries

  25. GP surgeries in Scotland LP 2824 printer supplied to each local doctor +4000 printers Printer links to doctor’s IT system and prints labels to identify samples being sent to lab for testing Before Only 15% samples carried correct information Now 98% samples contain accurate information Case Study

  26. Solution Specimen Container Bar-code printer (lab and portable) Bar-code scanner Application Software Right Specimen Right Container Right Quantity Right Time Right Patient Right Lab Tests Right Results Bar code enabled specimen collection

  27. Healthcare Estates • Healthcare Supply Chain • Stock management, identification • Service & Maintenance • Asset Identification and tracking

  28. Sterile Services • Surgical equipment tracking • 2D direct marking / Bar-coded label to track • Surgical equipment at item level • Surgical kits

  29. Porters: Mobile Data • Real time allocation of jobs • Schedule Management • Porter becomes multi skilled • Audit trail

  30. Patient Transfers • Track transfer of patients from one hospital to another • Requirement to log data through all stages of collection and delivery • Mobile Terminal for data collection (GPRS,WLAN, Bluetooth) • Mobile Printer for receipt of delivery

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