Room for Improvement in Bar Code Administration, Leapfrog Report Finds

April 12, 2018
Almost every U.S. hospital has implemented bar code medication administration (BCMA), but a new report found that only 34.5 percent fully meet all four requirements for deploying the technology effectively.

Almost every U.S. hospital has implemented bar code medication administration (BCMA), but a new report found that only 34.5 percent fully meet all four requirements for deploying the technology effectively.

BCMA systems are designed to prevent medication errors at the bedside. The nurse or other clinician scans a bar code on the patient’s wristband and a matching code on the medication prior to administration, verifying the right patient gets the right medication at the right time. In these cases, a decimal-point error, overlooking patient allergies, a potentially harmful drug interaction, or confusing similarly named drugs could lead to death or serious injury.

Leapfrog’s standard requires hospitals to (1) Implement a BCMA system in 100 percent of the hospital’s medical/surgical, labor and delivery and intensive care units; (2) Scan both patient and medication bar codes in 95 percent of bedside medication administrations; (3) Include all seven decision-support elements identified as best practices by the Leapfrog BCMA Expert Panel; and (4) Implement all five best-practice processes and structures to prevent dangerous workarounds that impede safety of the BCMA system.

The report, based on the 2017 Leapfrog Hospital Survey and analyzed by Castlight Health, found that hospitals are most often not meeting the Leapfrog standard because they fail to use BCMA scanning in at least 95 percent of bedside medication administrations. In other cases, they fail to have all seven recommended decision-support elements in place to guard against medication errors. Conversely, nearly four out of five hospitals have all five of Leapfrog’s recommended processes and structures in place to monitor and reduce workarounds.

“It is encouraging to see almost all hospitals have bar coding in place,” said Leapfrog President and CEO Leah Binder in a prepared statement. “But it only protects patients to the extent it’s used correctly. Unfortunately, hospitals have work to do to maximize the potential of this important technology. The Leapfrog Hospital Survey is clear and evidence-based in its requirements for meeting the BCMA standard, allowing all hospitals the opportunity to make full use of their bar coding systems and implement improvements. In the meantime, patients’ lives are at risk. We encourage hospital leadership to put a priority on meeting this standard.”   

Founded in 2000 by large employers and other purchasers, the Leapfrog Group is a national nonprofit organization whose flagship survey collects and transparently reports hospital performance.

Leapfrog’s other main initiative, its Leapfrog Hospital Safety Grade, assigns letter grades to hospitals based on their record of patient safety.

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