How e-coding can prevent NHS slip-ups

How can electronic coding help hospitals? GS1 UK's Gary Lynch counts the ways…

A survey we ran recently in conjunction with Nursing Times magazine revealed nurses can spend up to two hours during an average shift trying to locate vital medical equipment such as pumps, drip stands and dressings.

For the NHS, this could mean almost £90m of salary expenditure each year is being spent looking for medical items that could be tracked and located instantly using simple technology, such as the barcodes that have been in our supermarkets for more than 30 years.

GS1 UK, a not-for-profit organisation with promotes data standards for supply chains, has been supporting the Department of Health's (DoH) 'Coding for Success' policy through initiatives with several NHS agencies including NHS Connecting for Health (CFH). The DoH policy recommends that the GS1 System of coding be adopted throughout the healthcare system in England.

Although initial uptake of GS1 standards was patchy, it is now growing steadily. The main challenge for an initiative of this scale is that each NHS trust is responsible for its own decision-making rather than being led by a centralised body. Consequently, each trust has to be convinced of the merits of coding independently.

Evidence in favour of coding is compelling. The technology can have a major impact on reducing inefficiencies with serious consequences. In the healthcare sector this means things like minimising medical errors and counterfeit medication, as well as tracking misplaced equipment.

GS1 UK recently provided evidence at a Health Select Committee's Patient Safety Inquiry into the contribution that technical systems can make to patient safety in the NHS. This evidence included statistics on the serious threat posed by medication errors. For example, more than 30 per cent of all adverse drug events are preventable and appear to be consequences of medication errors during prescription, transcription, processing or administration.

It also demonstrated how coding is a reliable and accurate way of reducing these errors as well as providing details on how it can help to combat counterfeit medical products.

Hospitals that have rolled out coding systems are seeing a variety of benefits. Mayday Healthcare Trust in Croydon, for example, has implemented barcodes and RFID technology for its electronic blood-tracking pilot, tracking blood from ordering through to sampling and transfusion. This helps to ensure that the correct blood is administered to patients.

The trust has also adopted GS1 standards for its passive RFID-enabled wristbands, using unique GS1 codes to help ensure positive patient identification.

The process of blood management is complex, delicate and time sensitive. The provision of expired, inadequately tested or incompatible blood to a patient could be fatal.

Administering the wrong blood type (ABO incompatibility) is the most serious error during transfusions. Between 1996 and 2003 the Serious Hazards of Transfusion scheme reported 221 ABO incompatible blood transfusions contributing to 13 deaths and 75 cases of organ failure. Most of these incidents are due to the failure of final identification checks carried out on patients and the blood to be transfused.

Another hospital embracing e-coding is Wythenshawe Hospital in South Manchester, which is using GS1 standards to uniquely identify, track and trace its trays containing surgical instruments. A unique barcode is used to track each surgical instrument tray through its journey from the operating theatre, to the decontamination centre and back into the hospital. Each activity in this process involves the scanning of the tray's barcode label to ensure full traceability.

Since its implementation, the hospital has found instruments are faster and easier to find, and a tray can be traced back to ensure it has gone through the full decontamination process. Historical information on individual instruments can also be collected and stored electronically for future analysis.

Coding can also address the serious threat posed by counterfeit medication feared to be circulating within the NHS. The authenticity of 70,000 packets of medication was questioned recently when a wholesaler noticed discrepancies on the product labelling.

Simple barcodes and RFID technologies are effective authentication tools that can provide a key to unique information, such as what the medication should be, the manufacturer, the batch number and expiry dates. If the information returned is not a match for the product about to be dispensed, then the pharmacist can be alerted to a potential issue and the suspect medication can be withdrawn immediately.

From saving the time it takes to track surgical instruments, to helping eradicate counterfeit drugs and ensuring that patients receive the correct medication, simple coding technology can have a significant impact on the NHS.

Gary Lynch is chief executive of GS1 UK.