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Flaws in the barcoded technology used to reduce medication administration errors identified
Date:7/1/2008

ned patient's medications on one tray. Ross Koppel, Ph.D., Center for Clinical Epidemiology and Biostatistics at the University of Pennsylvania School of Medicine and the Sociology Department at the University of Pennsylvania, emphasized that "It's not that staff are lazy or careless, it's that the system does not work as well as it should. If the refrigerated medication is two floors and a long hallway away, you're not going to wheel your 87 year old patient to the fridge. You make a copy of her barcode. And while you do that, you help another two patients who also need refrigerated medications."

"Bar-coding is still under development," says Koppel. "Administrators and vendors may expect it to be fool-proof, but users know it's not. It's a very promising technology that still requires constant refining and careful observation of on-the-floor workflow to get it right."

The researchers found that in the pressurized, "can-do" culture of today's hospital, nurses compensated for the imperfect technology and workflow by devising 15 types of workarounds. The study also presents typologies of workarounds, BCMA "causes," and the kinds of errors associated with each.

Every day BCMAs save lives and stop errors, says Dr. Koppel, and the published study documents thousands of medication errors avoided via these systems. In addition, the article also lists many recommendations for identifying the problems and mitigating workarounds. Four of the study hospitals reduced the number of overrides dramatically by following these recommendations.

"The causes of workarounds are neither rare nor secret," added Koppel. "They are hidden in plain sight, obscured by, among other things, a blind faith in technology and the urgent needs of patient care. Clever as they are, workarounds are the unintended consequence of a technology in need of continuing and in situ evaluation."

Professor Ross Koppel's research on healthcare information t
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Contact: Marc Kaplan
marc.kaplan@uphs.upenn.edu
215-662-2560
University of Pennsylvania School of Medicine
Source:Eurekalert

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