Safety is at the forefront of hospitals across the nation. According to a landmark report To Err is Human (2000) by The Institute of Medicine (IOM), between 44,000 and 98,000 patients die every year in the United States due to preventable medical errors, including wrongful administration of medication. Beyond the cost of human life, these errors cost the healthcare industry as much as $29 million per year. This figure takes into account the expenses associated with additional care, loss of income and disability.
To reduce medication administration errors, hospitals around the country are modifying their current medical dispensing systems. Southern Ohio Medical Center (SOMC) is a hospital addressing this concern.
The 222-bed hospital in Portsmouth, Ohio, provides emergency and surgical care, and a range of other health-care services. SOMC employs 2,200 full- and part-time doctors and volunteers, and the center has a medical staff of more than 140 board-certified or board-eligible physicians and specialists and is supported by more than 800 volunteers.
One of the “Best Practices” outlined in the IOM report calls for the healthcare industry to use technology, such as bedside bar coding, to improve patient identification. SOMC quickly modernized its process from relying heavily on a two-cart dispensing system that included laptops on wheels (LOWs) and pharmacy carts, to a system that is more efficient and accurate.
The new solution, the WALLaroo 2000 wall station, features a cabinet mounted outside each patient’s room to temporarily stock the non-narcotic medications prior to dispensing.
SOMC’s IT department was tasked with finding a way to integrate the wall stations with a state-of-the-art access control system equipped with an access-controlled lock and reader. This would help ensure that SOMC’s “Five Patient Rights” were met: the right patient, the right medication, the right dose, the right time and the right route of administration.
“When we started our quest for an access control solution, I looked for two things. First, SOMC needed a solution that would be centrally networked with the current eMAR system, as well as have a main power source. Second, we needed to replace the magnetic strip on employee badges with a more effective technology,” says Dennis Ward, SOMC’s Information Services and Applications manager. eMAR stands for the hospital’s Electronic Medication Administration Record system for centrally managed and powered networked wall stations.
Ward consulted with several security companies, including Accu-Tech, SecuriCo, Microman and HID Global, before choosing SecuriCo’s Securus Web software solution, which operates using an HID EdgeReader coupled with HID’s iCLASS 37-bit 2K Smart Cards and Rutherford Controls’ 3513 Cabinet Lock.
“The SOMC project required both a Web-based software solution and an IP PoE Access Control solution,” says Jim Andrews, SecuriCo’s president. “After Dennis and I reviewed the project requirements and discussed the design options with Accu-Tech and Microman, everyone agreed that the SecurusWeb solution was the perfect fit for the hospital’s unique access control needs.”
Adds Ward: “As I conducted product research in the security information space, I noted that most available solutions were HID-compatible. This is important since the hospital is growing and our security needs will grow, too.”
The Installation and Implementation
Since Ward had never implemented a project like this before, he obtained samples of one of the WALLaroo wall stations, an HID EdgeReader and evaluation software from SecuriCo. Using the samples, he created a prototype that would suit all his access control needs and serve SOMC in the best possible way.
Installed by Microman, the pre-programmed wall units have specifications particular to SOMC. While physical access control is delivered through the EdgeReader and iCLASS cards, the control of the hardware is provided through the Securus Web software. The software controls which individuals are allowed access into each station based on an access level, including the date and time access is allowed. In addition, the application also records how access is added and removed.
The solution enables pharmacy technicians to deliver bar-coded, 24-hour scheduled, non-narcotic medications to the secured wall-mounted stations. Using authorized iCLASS cards, the nursing staff is then able to access and administer the medication according to SOMC’s Five Patient Rights. The contactless cards have proven to be more durable, as the old cards’ magnetic strip frequently wore off.
“Prior to its implementation, [the Pharmacy] would receive many phone calls from nurses regarding misplaced medications,” says Rory Phillips, director of the SOMC pharmacy. “With the traditional medication cart system, there also was potential for mixing up medication meant for specific patients.”
Accuracy for patient medication dispensing has improved significantly thanks to the new solution. Workflow is also more efficient because the amount of time it previously took nurses to go to the medication room and retrieve new medications has been significantly reduced. Additionally, medication is secure and located where the staff expects it to be, while eliminating the need for medication carts; thus making the hospital hallways accessible and less cluttered.
“Having the medications at the patient bedside has helped our nursing staff provide a much higher quality of care,” says Valerie DeCamp, director of SOMC Inpatient Services.
“Our new dispensing system leaves less room for error and allows us to provide our patients with a quicker, safer process for receiving medications,” adds Tim Lacey, nursing shift manager of SOMC Inpatient Services. “The flag system also gives us a more efficient way of knowing when medications have been delivered and can be administered.”
With the original installation of 73 EdgeReaders being a success, SOMC ordered and installed an additional 102 in the hospital’s new North Tower, including 12 on the first floor Heart Care Unit (HCU), 30 on the second floor in the Surgical-Vascular Care Unit (SVCU), 30 on the third floor in the Medical-Surgical Care Unit (MSCU), and 30 more that are located on the fourth floor in the Progressive Care Unit (PCU).
“Since implementing the WALLaroo solution, phone calls have dramatically dropped, there has been significantly less confusion between the pharmacy and the nursing staff and we are able to provide a much safer environment for our patients,” Phillips says.