Health IT-related issues are well-represented on the ECRI Institution’s 2016 list of “Top 10 Patient Safety Concerns for Healthcare Organizations.” Heading the list: “Health IT configurations and organization workflow that do not support each other.” Other top concerns include patient identification problems and inadequate test-result reporting and follow-up.
Despite fears that health IT can negatively impact patient safety, the proper implementation of advanced health IT solutions has the potential to improve patient safety. The automation of laboratory management solutions, for example, can reduce medical errors, facilitate faster turnaround and treatment, and improve communication across the whole healthcare organization. Indeed, for health systems seeking to improve patient safety across their organization, the laboratory may be an excellent place to start.
Why the lab?
Laboratories play an essential role in the delivering of healthcare and 60-70% of all medical decisions take lab data into consideration. The implementation of safety-enhancing laboratory management solutions can therefore impact the whole health system.
Consider the far-reaching benefits of various lab-automation solutions:
Barcode labeling and scanning
In the U.S., between .1% and 5% of specimens are mismatched during the collection process, though the use of barcode labels can significantly reduce or eliminate mismatching errors. To ensure positive patient identification, barcode labeling systems should support the Joint Commission’s National Patient Safety Goals 01.01.01 requiring the use of two patient identifiers and labeling in the presence of the patient. Labeling at the point of collection can also improve the turnaround time for results; fast turnaround times are critical in many situations and can reduce the risk of delayed or inappropriate treatment.
Barcoding systems can also facilitate specimen tracking through every step of the diagnostic process and maintain a record of collection dates and times and user IDs. Not only does this provide protection from specimen loss or misplacement, it creates an accurate record of specimen collection activities. Collection records allow organizations to assess workflows and address issues that could be impacting turnaround times.
Barcode scanning is especially critical in blood management. Blood transfusions are the highest volume procedure in US healthcare, and, carry a high degree of risk for both infectious and non-infectious complications. Twenty percent of all transfusion errors are a result of patient misidentification or specimen mislabeling, and most hospitals have not deployed automated bedside checks between patients and units prior to transfusion administration. The adoption of barcode technologies, particularly at the bedside, has great potential to enhance patient safety.
Electronic connectivity between the lab and ordering physicians supports patient safety and also enhances workflows. Better connectivity results in cleaner orders, which reduce mismatching errors and improve turnaround times and time to treatment; connectivity also facilitates faster transmission of test results to ordering physicians. In addition, physicians have online access to previous lab results, which minimizes risks associated with over-testing and duplicate testing.
Communication between ordering physicians and lab professionals is also enhanced with lab/physician connectivity. Ordering physicians can more easily consult with pathologists and make smarter decisions about what lab tests are appropriate and which tests are outdated; should they need assistance interpreting test results, they also have easier access to relevant data and/or lab professionals.
The adoption of closed-loop systems for specimen collection can eliminate avoidable mistakes in patient identification and specimen matching and management. Patient identification and label printing occurs in front of the patient, and barcode scanning ensures smooth handoffs between departments. Workflows that are streamlined to reduce turn-around times and appropriate treatments are delivered sooner.
As the ECRI Institute notes, “patient safety is a top priority for every organization, but knowing where to direct patient safety initiatives can be a daunting task.”
However, health systems are well-served to look no further than its lab operations when considering patient safety initiatives, given the broad reach of laboratory operations and the lab’s essential role in providing data that’s critical for patient diagnosis and treatment.