Improving Patient ID at St. Joseph’s General Hospital

Case Study: St. Joseph’s General Hospital Improves Patient
Identification with High-Performance Armbands, Standardized Forms

Overview
St. Joseph’s General Hospital is a Catholic healthcare organization serving 25,000 residents in Elliot Lake, Ontario, and its surrounding area. It consists of St. Joseph’s General, a 60-bed community hospital, St. Joseph’s Manor, a 64-bed long term care facility, and The Oaks Centre, an accredited treatment centre. As part of the North Eastern Ontario Network (NEON) health care consortium, St. Joseph’s relies on a shared electronic health record strategy that uses the Meditech hospital information system. All of the data required to run the organization’s day-to-day operations in Elliot Lake is housed in a central NEON database in Sudbury.

Challenge
Every patient arriving at St. Joseph’s General Hospital is registered at a central admission desk, including Emergency, Day Surgery and Outpatient Clinic patients, as well as anyone undergoing a diagnostic test or lab work. To clearly identify patients, administrative staff relied on a manual process to produce small, colour-coded labels on a thermal printer that were affixed to armbands and pre-printed forms. Eight different colours were used to distinguish between departmental areas, as well as to alert clinicians to allergies, patient status and other patient-specific information. In addition to patient demographics, the printed labels contained a barcode with a patient account number.

“One of our main problems was having so many different colours,” says Roger Collett, Manager of IT at St. Joseph’s. “It was doubling our label purchases and even though armbands are fairly low cost, when you start piling up the labels, it can get expensive.”

Clinicians complained that labels placed on armbands and forms were difficult to read due to the small font, and that information would wear off over time. Because some areas of the hospital were without access to the colour-coded labels, the hospital was still relying on old embossed plastic cards distributed to each patient as a backup solution. This ensured pertinent patient information could always be transferred to a form by running the cards through an imprint machine, but it also meant each form looked different, causing confusion and leaving room for error.

“We wanted to standardize our forms as much as possible, but we couldn’t do it straight out of our Meditech system,” says Collett, explaining that the programming involved in formatting forms is cumbersome. “There was no easy way for us to produce consistent forms and to enforce standards.”

Solution – Armbands
After installing a positive patient identification solution from Medirex Systems Inc., St. Joseph’s is now able to centrally print patient labels and armbands on one piece of specially-formulated paper. Medirex’s SuperSoft water and chemical proof armbands are more professionally laid out then the previous labels, and are more legible, both by clinician eyes and by barcode scanners. They also last up to four weeks under rugged and wet conditions.

Relying on expert advice from Medirex, the hospital reduced the complexity of its colour-coded system by deciding to identify two distinct patient populations only – those at risk and those not at risk. Patients who are considered at risk, either due to an allergy or other underlying condition, now receive armbands with a red border, alerting clinicians to check for further information. All other armbands are white.

“Our raison d’être was to find an armband solution that was legible and long-lasting, that could accurately and readily identify patients,” says Pierre Ozolins, St. Joseph’s Assistant Executive Director, Patient Care Services. “What is the benefit of a readable armband? Nobody really knows the value until you have a catastrophic event that could have been avoided.”

Solution – Forms
St. Joseph’s is also implementing Medirex’s integrated print-on-demand, form design and electronic output solutions, enabling the hospital to start the process of forms standardization and eliminating the need to affix labels to pre-printed forms. The Medirex solution serves as middleware, making it easier for the IT team to access pertinent patient information stored in Meditech and to produce barcoded forms that provide a consistent look and feel across departments.

“Medirex eases the workload for us by providing templates based on proven experience in other hospital environments,” notes Collett.

The first forms to be standardized are the inpatient face sheets. Medirex’s Peerstorm Proofing Tool is being used by clinicians to critique and test the new forms in a collaborative manner. Once a design is finalized, St. Joseph’s will use Medirex middleware software to start populating the printed barcode with data and the plan is to include more than patient account numbers in the barcode in the future.

Results
Since implementing Medirex technology, St. Joseph’s General Hospital is well on its way to removing its costly plastic hospital cards altogether and giving clinicians the standard forms they’ve been requesting. It has also found a low-cost, highly durable armband solution to support positive patient identification. Additional benefits include:

Cost Reduction – St. Joseph’s expects to save money in the long run by printing fewer armbands and labels, removing its costly card embossing and imprinting equipment, and by standardizing Medirex’s armbands. The move to electronic forms will add further cost-savings.

Increased Efficiency – The new process for laser printing labels and armbands on a single piece of paper means patients are issued one armband only, with or without a red border to signify “at risk.” Barcodes have a new format that is easily readable by both hospital staff and scanning equipment, improving productivity.

Enhanced Patient Safety – Introducing a positive patient identification system means St. Joseph’s can easily identify who is a patient and who isn’t. The armbands are an integral part of the hospital’s patient safety process. Clinicians scan the armband, confirm a patient’s name and verify critical information – including allergies and other at-risk conditions – as part of a routine safety check process.

Streamlined Patient Information – For the first time, St. Joseph’s has the ability to make forms look the same across departments. For example, patient demographics are always in the top right corner for easy identification, whether the information is on an affixed label or printed directly on the form using Medirex software.

The next step will be to look at automating all of the hospital’s forms, including physician orders and pharmacy processes, says Ozolins. “This is just the start,” he says. “Will we save time by having standardized forms that are easier to read? We don’t really know. What we do know is that standardization leads to better recognition and that means less room for error.”