The Science Journal of the American Association for Respiratory Care

2010 OPEN FORUM Abstracts

IMPACT OF THE ELECTRONIC HEALTH RECORD (EHR) ON MEDICATION SAFETY AND ASSOCIATED PERFORMANCE IMPROVEMENT.

Brent D. Kenney, Anthony Elliott, Kathryn Estebo; Respiratory Care, St. John’s Hospital, Springfield, MO

Background: St. John’s Hospital as part of a larger health system implemented a complete electronic health record (EHR) in January thru April of 2009. This EHR has an electronic medication administration record (MAR) coupled to barcode scanning of the patient’s wristband. Prior to implementing the current EHR the hospital used another proprietary electronic MAR. The Respiratory Care barcode compliance was consistently > 90% with this system prior to implementation of the current EHR. The hospital goal had originally been > 90%. We asked ourselves if the barcode compliance would change with the introduction and use of the new system. Method: Previously collected data on barcode compliance was reviewed to look at the numbers of RCPs who met the hospitals goal of > 90% compliance. The EHR established data collection and reports similar to what we collected previously. We began a Quality Excellence project to identify any change in medication barcode compliance, and to ensure that steps were taken to maintain or improve previous barcode compliance levels. We chose to look at all RCPs performing medication administration and identify barriers to successful and safe medication administration. Results: Data from July of 2008 identified 96 RCPs participating in medication administration with 4 RCPs having barcode scanning compliance < 90%. After implementation in July of 2009, that number had risen to 17 RCPs < 90% out of 100 total RCPs for an increase of 325%. We identified barriers to successful barcode scanning compliance, accomplished by rounding in the hospital and from feedback from RCPs. Additionally we began to communicate weekly to the Supervisors of the RCPs with compliance < 90%, informing them that their co workers were not compliant. As of April 2010 the number of RCPs with barcode compliance < 90% was back to pre EHR levels of 4 RCPs < 90% compliant out of a total of 95 RCPs. Conclusion: The implementation of an EHR has potential implications for patient safety and medication safety. RCPs must be educated about their role in medication safety. Communicating expectations and holding individual RCPs accountable for barcode compliance as part of medication safety are essential for success. Removal of barriers, providing adequate equipment, dialogue with other departments, and holding RCPs accountable all contributed to getting back to acceptable barcode compliance levels for the Respiratory Care department. Sponsored Research - None RCPs Barcode Compliance < 90%