The Patient Journey

AdmissionsRadiologyMedicationAdministrationPatient TransfersPortersSterile ServicesLaboratoryBlood BankHealthcare EstatesThe Patient Journey

AdmissionsPatient Identification is KEYCurrentlyHand written wristbands8.6% of hand written wristband contain incorrect data5.7% are illegible to some degree

No patient identification

Hospital Information System (HIS)OR SchedulingSystemLABPharmacyE.R. SystemBlood BankWorkflow: Process Automation(server based front end applications) Peripheral DevicesPatient

Where do errors occur?Mismatching patients with their careGiven wrong medicationWrong blood type administeredPathology samples mixed upWrong part of body operated on / removed during surgery

Solution = Positive Patient IDTrack patient at every stage of their treatmentMedication administrationBlood AdministrationSample ManagementTreatmentX-Ray, surgical etc.Non-medicalMeal orders, patient billing

Bar codedPatient Wristband

Benefits of Positive Patient IDWristband can have text and barcode (even RFID)Patient namePatient ID number (to ref EPR)Blood typeAllergiesPrimary physiciansPre-printed colours for visual aids

Benefits of Positive Patient IDRisk ReductionAutomation of data entry and verificationError rate for barcode data entry is less than 1 in 3million scansImproved Processesre-designed to include scanning of patients, samples, drugs.Eliminates bad working practicesElectronic Audit Trial

Benefits of Positive Patient IDCost Savings Reduction of errors = reduction of costs to rectify errorsaverage cost per Adverse Drug Event 2,257 (*FDA)2billion cost to NHS in extra bed days due to errorsTrial at VA hospital showed 86.2% error reduction using point-of-care scanning for medicationMore EfficientCarillon 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

Wristband solution from ZebraBar coded patient wristbandsThermal Transfer Z-Band 4000Direct ThermalNEW Z-Band DirectNEW Z-Band QuickClipSmart Wristbands (13.56Mhz)Bar code printers from Zebra2824-Z, 2844-Z ward based solutionS600 / Z4M - Admissions Network / Printer Management key

Z-Band DirectDirect Thermalribbon-less printingDurable image with resistance to alcohols, solvents, water and soaps1-Piece WristbandsSelf adhesive closure with security slits for immediate adhesion and tamper-evidenceBand ColourWhite, custom colours available

Z-Band QuickClipDirect Thermalribbon-less printing2-Piece WristbandsSecure clip fastening, must be cut to be removedDurable image with resistance to alcohols, solvents, water and soapsBand ColourWhite, custom colours availableColoured clips option

Smart Wristbands13.56Mhz RFID wristbandRead/write capabilitiesNon-line of sight scanning to read bandNurse can read wristbands through bed sheets and clothesDirect ThermalRibbon-less printing2-Piece WristbandsSnap closure: tamper proof, secure locking

Z-Band 4000Thermal Transferresin ribbon requiredLatex free, waterproof, smear and abrasion resistantOne-PieceSelf adhesive closureBand ColourWhite, custom colours available

The Wristband FamilyAvailable to order NOW! Convenient and Cost Effective Stocks in place now.

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EMEA Wristband Product Range

MaterialDescriptionSizePrinterFastening / details

Z-Band DirectAdult1" x 11"1", 3"security slit/ self adhesive

Child1" x 7"1"security slit/ self adhesive

Neo-Natal0.75" x 6"1"security slit/ self adhesive

Z-Band QuickClipAdult1.2" x 11"1"clip fastening

Z-Band 4000Adult1" x 11"1", 3"self adhesive

RFIDAdult1.2" x 11.5"1" (R2844Z)clip fastening / 13.56Mhz

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Wristband PrintersDesktop Printer Range2, 4 widths availableSmall and CompactEasy to useConnectivityUSB, serial, parallelInternal / external Ethernet ZebraLinkNew media guide Option for WristbandsEnsures registration and print quality

Case Note / X-Ray IDBar code labels for records, X-raysAccurate storage and trackingRFID??

Medication AdministrationPrescription labellingIn pharmacyAt bedsideTrials at Glasgow Royal Infirmary with mobile printer on W-LAN

Electronic PrescriptionBarcoded wristbands to ID patientsHandheld computers used by doctors to write prescriptions at patients bedsideWireless network for immediate data transferMedication delivery verified for right patient, right medication

Bar coding and medication administrationThe 5 RightsIdentify the RIGHT PatientConfirm the RIGHT MedicationConfirm the RIGHT DosageConfirm the RIGHT RouteAnd the RIGHT TimeThe BenefitsReduced errorsReduced costs associated with errorsMore rapid and accurate documentation

Blood Transfusion Process*New EU Blood Directive: 2002/98/EC

EU 2002/98/ECDirective 2002/98/EC of the European Parliament and of the Council of 27 January 2003Chapter VArticle 14Traceability1. 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.

Solution

Laboratory Sample IDBar-coding of patient samplesAccurate recording of key detailsPatient name, DOB, DoctorIn WardAt BedsideAt GP Surgeries

Case StudyGP surgeries in ScotlandLP 2824 printer supplied to each local doctor +4000 printersPrinter links to doctors IT system and prints labels to identify samples being sent to lab for testingBeforeOnly 15% samples carried correct informationNow98% samples contain accurate information

Bar code enabled specimen collectionSolutionSpecimen ContainerBar-code printer (lab and portable)Bar-code scannerApplication Software

Right SpecimenRight ContainerRight QuantityRight TimeRight PatientRight Lab TestsRight Results

Healthcare EstatesHealthcare Supply ChainStock management, identificationService & MaintenanceAsset Identification and tracking

Sterile ServicesSurgical equipment tracking2D direct marking / Bar-coded label to track Surgical equipment at item levelSurgical kits

Porters: Mobile DataReal time allocation of jobsSchedule ManagementPorter becomes multi skilledAudit trail

Patient TransfersTrack transfer of patients from one hospital to anotherRequirement to log data through all stages of collection and deliveryMobile Terminal for data collection (GPRS,WLAN, Bluetooth)Mobile Printer for receipt of delivery

EPR Electronic Patient RecordBarcode will typically be the patient number Colours are used to show allergies these are available as custom products.Studies show that where barcoding and data collection have been incorporated into software systems, staff can no longer cut corners as the software will require them to complete a stage/ process before they can move onto the next step. This eliminates bad working habits that can build up over time.If you can reduce the errors you can reduce the costs associated with fixing them. Drug errors represent ~25% of errors made in hospitals, if hospitals can reduce this by ensuring that they have the right patient every time they administer drugs this will have a dramatic impact on costs. Also introducing scanning / automation into processes via software can save staff time as patient checks can be speed up.Key feature is the introduction of a Direct Thermal wristband material. Zebra have had a TT wristband solution for a few years but the intrduction of a DT solution means that nurses have a ribbon-less solution the no longer have to spend time loading ribbon into the printer!The wristband range is expanding to include adult,child and neo-natal sizes and will include both self-adhesive and clip fastening products.In summary the hospitals must now track blood from Vein to Vein