Boston, MA - September 18, 2006 - Researchers at Brigham and Women's Hospital
(BWH) and Harvard Medical School, evaluating the use of bar coding technology
for storing and dispensing medication from the hospital pharmacy, found that
the rates of medication dispensing errors and potential adverse drug events,
which are dispensing errors that can harm patients, were substantially reduced
when bar code scanning technology was used in the dispensing process. The findings
appear in the September 19, 2006 issue of the Annals of Internal Medicine.
Shortly before bar code technology was installed, the researchers observed the dispensing of 115,000 medication doses from the hospital pharmacy to measure the rate of dispensing errors. During that time, pharmacy technicians and pharmacists manually retrieved medication doses from several storage areas and relied on visual inspection alone to verify the retrieved doses before dispensing the medications to the patient care units. With the implementation of bar code technology in the Fall of 2003, every dose of medication was affixed with a bar code, and these barcodes were scanned in an additional step to ensure that the right medications were being dispensed. Following barcode technology conversion, the researchers observed the dispensing of nearly 254,000 doses to re-measure the rate of dispensing errors.
By comparing the error rates before and after the implementation of bar code technology, the researchers found that the rate of dispensing errors targeted for reduction by bar code technology fell by 85 percent. The rate of potential adverse drug events (or dispensing errors with the potential to harm patients) also fell by 63 percent.
However, the study also notes that the way the bar code technology is set up may affect its ability to reduce errors. The research team examined three configurations of bar code technology implemented in the hospital pharmacy. In two of these configurations, all medication doses were bar code scanned during the dispensing process. In the third configuration, only one dose was scanned if several doses of the same medication were being dispensed. In the two configurations that required pharmacy staff to scan all doses of medications, dispensing errors were reduced between 93 and 96 percent and risk of potential adverse drug events was reduced by 86 to 97 percent. The configuration that did not require scanning of every dose achieved only a 60 percent reduction in dispensing errors and saw nearly a 2.5-fold increase in risk of potential adverse drug events.
"Overall, the use of bar code scanning technology appears to have a significant impact on the rate of dispensing errors that were serious enough to potentially harm patients," said Dr. Eric Poon, HMS assistant professor of medicine, associate physician in the Department of General Medicine at Brigham, and Women's Hospital and lead author of the study. "We saw that bar code scanning dramatically reduced the likelihood that the wrong medications or wrong doses of medications would be dispensed from the pharmacy to the nursing units. For a hospital like the Brigham and Women's Hospital, which dispenses about 6 million doses of medications a year, we project that this technology is preventing about 13,000 dispensing errors every year, of which about 6000 would have had the potential to harm patients. However, like other forms of information technology in healthcare, the effectiveness of bar code scanning technology depends on the way it is used. Our findings suggest that in order to reap the maximal benefit from this technology, every medication dose should be scanned before it reaches the patient."
The study was supported by a grant from the Agency for Healthcare Research and Quality.