By Gary Tufel
Patient information is presented on the wristband in 2-D bar code and eye-readable formats.
With the ever-increasing demand for enhanced patient safety and reduction of medical errors, Olympus America Inc has designed a new 2-D bar-coded wristband system that enables hospital staff to swiftly and accurately identify patients and standardize procedures. The new system is called Olympus osYris.
In conjunction with the wristbands, specialized PDA technology allows for patient and caregiver identification to be performed at the patients bedside. By ensuring proper identification of patients during blood sample collection, transfusions, and other medical interactions, Olympus osYris helps protect patients while supporting the staff and streamlining workflow, says Stephen E. Wasserman, group vice president, Diagnostic Systems, Olympus America Inc.
Stephen E. Wasserman
Olympus offers several compatible modules in conjunction with Positive Patient Identification (PPI) systems that provide a standard operating protocol for many hospital procedures, such as sample requests, sample collection, transfusions, imaging, and medication management. The product design follows a standardized platform for all hospital staff in the areas of laboratory, transfusion, pharmacy, and imaging. These modules require minimal technical expertise, and when used with a wireless system available in many of todays busy hospitals, they provide updated information at the bedside when care is given.
Heres how the process works. When a patient enters a hospitals admitting area, his or her information, including first and last name, date of birth, gender, and hospital ID number, is entered into the hospitals Patient Administration System (PAS). The wristband is printed with all of this information consistent with JCAHOs 2007 recommendations. On the wristband this information is presented in both 2-D bar-code and eye-readable formats. The Olympus osYris PDAs can also print on the wristband linear bar codes containing the hospital number, which is compatible with some existing systems.
The essence of the process is to positively identify patients at the bedside every time there is a significant interaction with them, Wasserman says. The system minimizes the need for health care workers to disturb patients to obtain information, especially when the patients are unconscious or asleep.
The Olympus osYris systems have been successfully installed in a number of United Kingdom hospitals, including John Radcliffe Hospital, Oxford; Morriston Hospital, Swansea; and St James HospitalLeeds General Infirmary. It is now being introduced in the United States.
Mike Murphy, PhD
Olympus osYris user Mike Murphy, PhD, professor of Blood Transfusion Medicine, University of Oxford, and consultant hematologist, National Blood Service and Oxford Radcliffe Hospitals, says Our involvement has been to work with the company to develop and introduce the product into clinical practice. It prompts the clinical staff through the essential steps of the transfusion process, which is known to be cumbersome, and prone to error, sometimes resulting in patient deaths.
Murphy says that using Olympus osYris results in greater accuracy of the checking process, and thus the safety of the transfusion process. He notes that hospitals need to make provision for adequate training of staff during its implementation.
Optimizing Bedside Order Management and Sample Collection
Phlebotomists and nurses can, in many cases, print a master list of all tests ordered and their tube types for an entire floor or patient care unit, and these lists can be printed in advance of visiting the first patient when they begin sample collection, streamlining the collection process. Then if, for example, three tubes of blood are to be taken from a given patient, they scan the wristband of the patient and print the label for each tube right at the patients bedside. The labels contain the relevant patient information, plus the time and date of the collection. Traditionally, most sample tube labels have been handwritten by phlebotomists, and as a consequence, as many as 40% of blood tubes have been unidentifiable and thus unusable. However, with printed labels, they are accurate and easily read by the laboratory staff. Wasserman says, Many people know that blood tubes are sometimes poorly labeled and controlled, and that improvements are needed. This system makes such improvements, and it is easy to use.
The bedside order management system can either be done in a wired or wireless format via PDA, or written for entry at a central station. Wasserman says that after adopting the Olympus osYris system, one hospital had a 25% reduction in tests, and one hospital said it reduced patient stays by an average of 1.5 days because physicians did not have to wait as long for samples. Delays due to misreading of handwritten labels were eliminated.
Wasserman notes that each hospital patient care unit using Olympus osYris typically has three or four carts, and every cart contains a PDA and a printer. With all key patient interactions, the process is the same: the hospital caregiver first scans their own ID, then scans the patients wristband to record the interaction, patient information, and time.
The Right Product to the Right Patient
Blood transfusions are handled similarly. The nurse begins by taking a blood sample, using the PDA and portable printer at the patients bedside. The correctly labeled sample tube is sent to the laboratory for cross-matching. Once the cross-match is completed and the prescribing complete, the blood has a compatibility label printed in the blood bank. The label contains the relevant patient and blood information, such as the donation blood bag number, along with a 2-D bar code that contains all vital patient information. The labeled blood is then placed in the blood bank issue refrigerator. At the patients bedside, a nurse with a PDA will follow the standard operating procedure (SOP) for the hospital, scanning in his or her own identification, then the patients wristband, and then the blood bag to screen for compatibility. An additional scan of the blood bag donation number is made to ensure the correct label was placed on the correct blood bag. Additional information can be collected on the PDA. This information can be configured to match the hospitals SOP. This gives a complete circle of confirmation, says Wasserman. Afterwards, depending on hospital policy, the nurse checks the patient every 15 minutes and adds information to the osYris system. The same procedure is followed with high-value drugs, such as chemotherapy and intravenous drugs, which can also be labeled.
The labels positively confirm the patients identity, the treatments given, the times they were administered, as well as other information. They also offer the ability to follow up and create a complete history, Wasserman says.
The hardware for Olympus osYris systems is minimal. The PDA and printer are extremely small: 3 x 6 inches for the PDA, and the same 3-inch width for the printer.
Future plans include extending the electronic tracking through every stage of the hospital transfusion process from the delivery of donor blood to the hospital, to the documentation of the transfusion, including any adverse events. A prescribing module is being developed, which may encourage more appropriate use of blood. It is too early to say anything about cost-effectiveness, but if it reduces blood use, there will be cost savings, Murphy says.
Other Olympus osYris Products
Olympus also features another suite of osYris-related products for laboratory workflow management. The primary system, AutoCard, is a document scanning and management system that scans laboratory requisition forms containing orders and electronically files them, making them available to staff members in and around the laboratory electronically on a PC. Since the amount of effort, time, and cost necessary to find lost orders or to rerun tests is substantial, this is an enormous benefit, Wasserman says. AutoTrack provides current information (such as location) on blood samples throughout the laboratory during analysis. AutoFile provides an automatic system for locating laboratory samples once they have been stored.
These lab information systems are seamless; that is, they can interact with hospitals host computers, and with each other, Wasserman says. When we install the systems, we work with hospital information systems and with departmental staff.
On the Horizon
There is now a next stage on the horizon: Olympus is looking at radio frequency identification (RFID), which Wasserman calls the next generation of ID labeling. RFID consists of a small electronic identification chip attached to a product or a patient. He says RFID works even better than bar codes. For one thing, the chips can be read right through blankets, eliminating the need to disturb sleeping patients. Another advantage is that wristbands are cut off patients before surgery; RFID is applied to patients on a piece of paper, like a bandage. RFIDs are smaller and less susceptible to damage, says Wasserman. They also have the potential to provide updated information.
This is one of many ways consumer and medical markets are converging at Olympus, Wasserman says. The 82-year-old company is a $5 billion firm worldwide, and about half its revenue comes from cameras, recording devices, industrial printers, and projectors. But the majority of our business is in health care, says Wasserman. We hold an 80% market share in such areas as colonoscopes and in ear, nose, and throat devices. We are also dominant in the supply of microscopes for clinical and research use.
Gary Tufel is a contributing writer for Clinical Lab Products.