Bar Codes Cut Drug Errors in Study

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Using bar codes can help reduce hospital drug errors, a study shows. The study was done at Brigham and Women's Hospital in Boston. The hospital is affiliated with Harvard Medical School. Under the hospital's new system, each patient's wristband has a bar code. So does each container of medicine. Prescriptions are put into the patient's electronic chart. Before nurses give medicines, they scan the bar codes for the patient and the drug. The system tells them if it's the wrong medicine or if they are giving it too soon. Nurses also get alerts if a dose is overdue. Researchers looked at hospital units that used the new system. They were compared with units that still used a system without bar codes. Errors dropped "dramatically" in units with the new system, a researcher said. Errors related to timing of medicines fell 27%. Other errors dropped 41%. The New England Journal of Medicine published the study May 6.

What Is the Doctor's Reaction?

No patient wants to feel like a number. But would you rather feel like a grocery item?

Increasingly, patients in the hospital are labeled with bar codes for easy scanning. That's right. The next time you're in the hospital, you may be scanned several times a day. It works just like the supermarket cashier scanning a box of cereal. While that may sound a bit depersonalizing or even creepy, it's for your own good.

Hospital personnel scanning your bar code can ensure they are taking you to the right test at the right time. A nurse hooking up your intravenous medicines can double-check that the drug and dose are correct and intended for you. And the food delivery person can make sure you're not getting something on your food tray that might be bad for your health.

Bar-code technology can even put an end to patients getting "lost" in the hospital. (Believe it or not, this can be a problem in large, busy hospitals.) Just as companies like Fed-Ex or UPS can track your package, hospitals can know where patients are at any given moment by the use of bar codes and scanners.

A new study provides evidence that bar-code use for patients in the hospital can reduce medicine-related errors. It compared medicine error rates before and after a large teaching hospital started using patient bar codes. Errors decreased dramatically after these bar codes were put into use.

• Drug treatment errors, including incorrect medicine dosage, fell by 41%. The rate was 11.5% before the change and 6.8% afterward.


• Transcription errors -- mistakes in recording the doctor's order -- occurred with 6% of orders before bar-code use. They were completely eliminated after bar codes were adopted.


• Medicine errors that could have caused serious harm fell from 3.1% to 1.6%. That's a reduction of more than half.


• Timing-related errors, when a drug is given at least an hour earlier or later than intended, fell by 27%.

This research makes me wonder why all hospitals aren't using bar codes for patients. I strongly suspect that bar codes also could improve other quality measures, such as how many patients get the wrong test or the wrong meal. We already put ID tags on all admitted patients and those in the emergency room. Adding bar codes to those ID bracelets would seem to be a small change. But it would allow scanning to improve quality of care.

What Changes Can I Make Now?

If your hospital does not give bar codes to every admitted patient, suggest it. You can contact a hospital official or your doctor. Or drop a note in the hospital's suggestion box.

In the meantime, you can make other changes to reduce the odds that a drug error will happen to you.

• Know what medicines you take and the purpose of each one.


• Keep each of your medicines in its original, labeled bottle. Or, if you put a few medicines into a single container, make sure you can identify each pill by its color, shape and markings.


• Keep an accurate, updated list of all medicines. Make sure your list includes all non-prescription medicines, vitamins and supplements that you take. Give the list to each of your doctors at every visit.


• Let your doctors know about any medicine allergies or major side effects you have had in the past.


• Ask your doctor, nurse or pharmacist if you don't recognize a medicine or aren't sure what you're getting while you're in the hospital.

Keep in mind that your medicines may not always look the same. Drug makers may change the appearance of a drug. Your doctor may change your dose. Or a generic drug may be substituted for your brand-name prescription. Each of these can lead to a change in your medicine's appearance and cause confusion. So, double-check with your doctor or pharmacist if your medicine looks different to you.

What Can I Expect Looking to the Future?

I think bar-code technology will become more common in the future. It's likely that more and more hospitals will provide bar codes to patients when they're admitted. Outpatient pharmacies also are likely to use bar codes in the future. This will help them to confirm that the right medicine is going to the right patient at the right time.