CASE STUDY: Sherwood Forest trust rolls out barcoded patient wristbands in line with new guidance

The solution was implemented with very little disruption to the daily operations of the Trust and at no risk to patients using its services.

Background

Sherwood Forest Hospitals is the main NHS trust providing healthcare services for people in and around Mansfield, Ashfield, Newark, Sherwood and parts of Derbyshire and Lincolnshire. It looks after 76,000 inpatients as well as 30,000 day case patients and has recently opened a flagship £320m redevelopment scheme at King’s Mill Hospital.

The trust already had a limited barcoded patient identification system in place before the implementation, but there were a number of limitations that the new solution was designed to address.

Meeting standards

Sherwood wanted to comply with the National Patient Safety Agency’s (NPSA) Safer Practice Notice 24 - the Department of Health’s Coding for Success policy recommending the use of GS1 standards - and the Information Standards Board’s Advanced Notification calling for the use of GS1 barcoded wristbands by July 2011.  Its compliance with these requirements meant the hospital could further improve patient care.

However, with its existing system, the trust could not produce patient wristbands that met all of the criteria. For instance, the guidelines stipulate that a 2D barcode should be printed on each wristband, which wasn’t possible with the existing solution. Due to the limitations of the technology, some of the wards and departments, including the paediatric and maternity unit, couldn’t make use of barcoded wristbands at all.

The paediatric unit couldn’t use the existing barcoded wristbands because it wasn’t possible to print all the required information (including a 2D barcode) onto the smaller wristbands used in the maternity and children wards.  It meant wristbands in the unit were handwritten, which created a number of issues. It was difficult to read many of the wristbands because they were so small and the staff wrote large amounts of information on them. On the maternity unit, there is often a need to add more than the core information, for instance, where there are twins or triplets. There were also problems with the bands getting wet, causing them to peel off or the text to run.

The solution

Sherwood Forest Hospitals opted for a new barcoded wristband solution developed by Herbert Healthcare called Interceptus Wristband. The GS1 UK-certified solution produces wristband templates that conform to DH guidelines and therefore GS1 standards on how to lay out the information. The solution also provides integration between the trust’s Patient Administration System (PAS) and the wristband printers. Herbert also helped to identify a material for the paediatric wristbands that was flexible and soft enough for a baby, and also suitable for displaying the required information and coding.

Efficiency benefits

The trust has already experienced a number of benefits since the implementation. It now has 100% wristband coverage, including in the paediatric and maternity units, where the new solution can create smaller wristbands that contain all the required information. In the wards that used the former wristbands, the end users did not notice any difference, according to questionnaires. However, particularly in the paediatric unit, many end users have been impressed with how much information can now be fitted in such a small place and how much clearer it is. The new solution has, as a result, significantly reduced the risk of patients being misidentified on the wards and receiving incorrect treatment.

The implementation means the trust now meets the NPSA and DH guidelines well in advance of the required timescales. The solution also enables the trust to set up its own wristband templates should guidelines or circumstances change. The project team anticipates that in time there will be cost benefits to the wards because processes will be speeded up and certain checks that are performed will be amended or cut out. When future applications are rolled out, there are expected to be a number of further efficiencies.

Reducing disruption

It was critical the new solution was implemented with as little disruption as possible to the trust’s daily operations. For instance, a prolonged downtime to implement the solution in areas such as theatre or surgery would have caused chaos. The IT project team worked closely with Herbert Healthcare to ensure the implementation happened without preventing clinical and administrative staff from doing their important work.

The second challenge was making sure that staff, whether administrative or clinical, were appropriately trained in using the new solution. The Nottinghamshire Health Informatics Service (NHIS) project delivery team spent a considerable amount of time with staff to ensure they were comfortable with using the technology.

Conclusion

The solution took around four weeks to implement and as little as half a day of downtime to roll out in each ward. Now there is 100% coverage, the NHIS project team is planning to develop new applications connected to the system. The IT project team will soon begin an e-Prescribing pilot and there is a clear intention to roll out further complementary applications in future.

Commenting on the deployment, Michelle Peet, IT project manager at Nottinghamshire Health Informatics Service, said: “Our improved system of positive patient identification not only enables us to have 100% wristband coverage across the trust and meet current and future national coding guidelines, but also means we are in a very strong position to implement future applications that have even more benefits for the safety of our patients and the efficiency of hospital services.”