Wednesday, September 12, 2007

Barcode This

I hate bad reporting. Even worse, I hate the way that uses bullet points that have little or no basis in the full article. Where does it say that patients are to be stamped with barcodes? The closest is this line:

"In the US veterans' health system, basically every patient has a barcode on the normal hospital wristband as well as their name and date of birth," he said.

For your information, Dr Wakefield, this is common practice throughout many hospitals in Australia and New Zealand. Perhaps Queensland is lagging behind? Mind you, the barcode is quite useless unless you have an army of staff wielding barcode scanners prowling the hospital. It's generally much easier just to check the name, hospital number and date of birth against the operating list, x-ray request slip, drug chart etc. It also doesn't stop people putting the wrong label on the wrong patient (and no, two wrongs do not make a right).

Wrong side, wrong site, wrong procedure or wrong patient surgery is a serious issue, and is not helped by sensationalist reporting. It is also not prevented by single step "solutions" like patient barcodes (which actually make identification more difficult rather than easier). Just like in aviation safety, errors are avoided by multiple layers of protection (The Swiss Cheese Model), and acceptance that responsibility for safety lies amongst all hospital staff, as well as patients themselves. Air crash investigators do not point fingers at individuals, and neither should health safety committees.

Barcodes for patients to stop medical bungles
By Janelle Miles
September 12, 2007 07:37am

  • Patients to be stamped with barcodes
  • 31 wrong operations performed last year
  • Patient misidentification main problem
HOSPITAL patients in Queensland are to be stamped with barcodes in a move to prevent operations being performed on the wrong body parts.

Last financial year 31 mistaken procedures were performed, including three cases of the wrong tooth extracted and two operations on the incorrect part of patients' spines.

In another instance, a person's left tonsil was removed in error and a separate patient had botox injected into the wrong body part.

Queensland Health's Patient Safety Centre senior director John Wakefield presented the figures to a Royal Australasian College of Surgeons state meeting near Cairns.

They represented a huge increase on 2005-06 numbers, when six such cases were recorded, but Dr Wakefield said the centre had been actively encouraging public hospital staff to report incidents.

"You might think: 'Oh gosh, how do these things happen?' " he said.

"But as medicine has become more complex and we get people through the system quicker, there's more opportunities for mistakes to be made.

"It usually happens in very busy hospitals. A major Brisbane hospital when I was working there three years ago had 22 operating theatres. That's a surgical factory."

Dr Wakefield said although the mistakes were rare, with more than 800,000 patients admitted to Queensland public hospitals in 2006-07, they were all preventable.

"For the vast majority, there was very little harm but we regard all these errors potentially as leading to serious harm," Dr Wakefield said outside the meeting.

"We're unearthing a problem, a risk in our system, which we've got to fix."

An analysis of the cases found patient misidentification was a significant cause of the problem.

Dr Wakefield said Queensland Health planned pilot projects to eliminate the problem, including a study into the benefits of barcoding patients.

"In the US veterans' health system, basically every patient has a barcode on the normal hospital wristband as well as their name and date of birth," he said.

"It's a big technical investment but we'd like to explore that.

"It doesn't just protect against patient misidentification, it protects against the wrong drug being administered as well."


The Gasboy said...
This comment has been removed by the author.
The Gasboy said...
This comment has been removed by the author.
The Gasboy said...

Sorry - major typos - and I'm anal.

I wonder what makes it acceptable for lawyers to step back and allow a no fault investigative inquiry model to be adopted when aeroplanes fall out of the sky... yet when it comes to medical mishaps we stick steadfastly to the adverserial model. (Perhaps lawyers don't like going down in a ball of flames)

As it has been widely acknowledged, medical mishaps are generally a result of systematic errors rather than individual mistakes, much like aircraft crashes. Yet, medical errors (if you could call it that) kill and harm far more than aeronautical disasters annually even including the September 11 events... but we (lawyers, politicians and administrators) insist on sticking with an archaic system where it is more advantagous to cover-up the truth than to explore all the facts.