BARCODE SCANNING PROJECT
UAB Medicine clinics now have a venue for holding stable patients
requiring admission through collaborative efforts between inpatient and
ambulatory settings. In the past, patients being admitted were held in
the clinics until a bed was available. Currently, with the use of a pre-
existing stability scale already in place for patient transport, patients
are assessed by clinic staff to determine if they are appropriate for the
Ambulatory Admission Holding Area (AAHA). Patients who do not have
a bed assignment and meet the established stability scale criteria are
transported to the AAHA Lounge while awaiting a bed. Patients in this
inpatient area are assessed hourly by nursing staff. In 2015, it was noted that overriding (bypassing) the electronic scanning
of patient armbands and/or lab specimen labels was occurring routinely
on nursing units. Over 16,000 overrides occurred in October 2015,
compromising positive patient identification and specimen integrity.
An interprofessional team was identified to brainstorm a solution
for improving the bar code scanning process. Initially, members of
the team (mostly leaders) did not drive desired changes; in fact, the
number of overrides increased. In August 2016, in an attempt to identify
opportunities for improvement, a new data field was added to the
order section of the electronic order entry system. An expectation was
set for staff to enter a reason each time barcode scanning could not
occur. Data were collected on the “whys” associated with failure to
follow the process. The most commonly cited challenge was “access
to an available computer or scanning device”. The interprofessional
leadership team realized that the lack of availability of equipment was
driving many of the issues related to scanning. The number decreased
from 20,239 in July 2016 to 931 in August 2017. In this example, asking
staff to help identify opportunities for improvement highlights shared
governance and interprofessional collaboration.
MAY
16
15000
ALL HOSPITAL LAB SCANS (INC. BB) FY2015–2017
20000
OVERRIDES
25000
0
5000
10000
This area not only provides a great patient experience in a quiet and
comfortable environment but also provides appropriate oversight for
stable patients awaiting a bed outside of the busy clinic setting.
AAHA LOUNGE
www.uabmedicine.org
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