North Kansas City Hospital

Sean Tucker

The Joint Commission (TJC) National Patient Safety Goal (NPSG.01.01.01) for hospitals emphasizes the importance of improving the accuracy of patient identification as their top priority. Required elements include using two patient identifiers when administering medications, transfusing blood, collecting blood samples and other specimens for clinical testing, and when providing treatments or procedures. Health Information Management (HIM) systems have developed numerous technologies to improve Positive Patient Identification (PPID) using barcode scanning at the bedside. This typically queries the system for patient demographic information that matches the barcode scanned on the patient armband. Barcode scanning produces high-reliability identification to reduce human error in high-risk scenarios.

North Kansas City Hospital (NKCH) is an acute care facility with 451 licensed beds and 550 physicians representing 49 medical specialties north of the Missouri River in Kansas City, Missouri. Nestled down next to Cerner Oracle’s previous World Headquarters, the hospital was the company’s second client. Discussions around using the Cerner technology to improve patient safety called CareAware Connect began in 2012 with the implementation taking almost a decade. The hospital identified several goals for the project including enhancing user experience, reducing alert fatigue, improving Point of Care efficiency with barcode scanning, and unifying physician and clinician communication.

In 2023, North Kansas City Hospital began an implementation rollout of the technology starting with the Phlebotomy Management and CareAware Patient Flow applications for capacity management. Both programs utilize PPID scanning of patient armbands to improve patient identification and safety. The technology is uploaded either on to a third-party barcode scanning smart phone shared device or a personal device with the downloaded applications. For NKCH, each department was provided with the shared Smart Phone devices and desktop terminals. While the physicians used the Bring Your Own Device (BYOD) applications on their personal smart phones.

"After implementation, NKCH has seen a significant reduction in misidentification errors during specimen collection "

The phlebotomy application allows for our Laboratory Assistants to assign floors that show pending orders based on priority of collection status. Upon identifying the patient orders in the system, the employee can scan a mobile wireless printer to print the barcoded labels at the bedside. This ensures that labels do not travel between rooms to prevent mislabeling. The program uses two sets of scanning ID, the patient armband and the barcoded labels associated with the orders, to assure accuracy.

Capacity management is utilized by the transportation team within the facility to manage patient movement and throughput. Upon assigning a task, the transporter barcode scans the patient armband to assure PPID and verify the location to where they need to be transferred. Upon arrival, the system is updated to show the new location for that patient. Both applications, in addition to improving NPSG number one for patient identification, improve workflow efficiencies and workload balance. Staff were quick to implement and buy in to the technology.

After implementation, NKCH has seen a significant reduction in misidentification errors during specimen collection. Additionally, there has been a noticeable increase in efficiency of patient throughput and a balanced approach to workload across departments. Next steps for the project will include the Voice and Messenger applications to improve communication across the organization. This will reduce the need for other mobile hardware devices to communicate internally and allow for direct connections to anyone assigned as a provider to individual patients. All emergency codes and alerts will be sent through the system, reducing the need for pagers. Camera capture allows for nursing and providers to upload images to patient records at the bedside. And finally, our providers will be able to monitor telemetry remotely on the handheld. All of which go live later this year.

In our efforts to becoming a high-reliability organization and reducing our patient misidentification errors to zero, barcode scanning technology at the bedside is critical towards that goal. When solutions can improve safety without the inhibition of decreased efficiency, these are win-wins for healthcare systems.

NKCH was awarded Most Wired Hospital in 2022 by the College of Healthcare Information Management Executives.