Some of the barriers to placing technology in hospital

Resolving issues of 'wrinkled barcodes'

Any time a hospital pharmacy introduces new technology into the workflow there will be process changes and barriers to overcome.

"They won't magically standardize the process, so there has to be a detailed workflow analysis that involves end users of that technology and process," says Craig P. Frost, RPh, MBA, pharmacy manager.

1. Equipment can fail." If the barcode scanner isn't scanning, or it's not in the right field of its software, then there's a problem impacting workflow," Frost says.

Sometimes this is a problem that can be prevented through robust staff training, Frost notes.

And after training, there needs to be heavy support during the barcode scanning technology's implementation, he says.

Also, it's a good idea to have a collaborative team available to listen to any workflow complaints and issues that arise, Frost says.

"We have a collaborative team of information technology professionals, pharmacists in a steering committee, so that any issue can be brought up and addressed and followed appropriately," he explains. "You need a guiding team representing all parties to address any type of workflow problem."

2. Nurses develop work-around habits. Often when the new technology doesn't work the way nurses expect or if it belabors a process, the nurse will find a way to work around the technology.

"You need to have assistance for front-end users because nurses more than any other health care worker will find a practical way of getting around anything that prevents them from taking care of their patients," Frost says. "So it's critical to have early on-site support, around-the-clock support during the implementation, to prevent work-arounds and bad habits from developing."

And when a bad habit or barrier crops up, there should be a support person to show the nurse how to resolve it.

3. Wrinkled IV barcodes slow the workflow. "The barcode could be wrinkled on the IV bag, and if the nurses are trained to smooth it out, that is one of those little tricks that really work," Frost says.

The barcode scanner needs a flat, unencumbered surface to read that machine code on the label, he notes.

"So if the label is torn, smudged, wrinkled, or crinkled, there's a chance the scanner cannot detect what the bar code is, and it will stop the workflow," Frost explains.

The pharmacy department is responsible for making certain the IV bag's barcode is not damaged or altered in any way, Frost says.

"And we need to teach nurses to recognize the problem and to know who to call to get it fixed," he adds. "Maybe the IV bag needs to be relabeled."

This is why barcode technology support is critical, he says.

"All of us need to work together to make the technology work," Frost says. "If one of us slips up, it won't work."