"Safety first.” This famous adage is often quoted, but not all healthcare providers actually take it to heart. In fact, in this era of reimbursement cuts, technology adoption, and structural reform, losing sight of this tenet has become all too easy. This is unfortunate because improving patient care and safety are the main reasons most of these changes are being implemented in the first place.
Memorial Hermann is one health system that hasn’t lost any of its focus on patient safety. In fact, setting the gold standard in this area drives just about every initiative undertaken by the provider. Memorial Hermann has a long history of excellence when it comes to patient safety. The fact that the health system won the NQF (National Quality Forum) National Quality Healthcare Award back in 2009 is proof. This award acknowledges outstanding quality and safety improvements in healthcare, and once a provider receives the honor, it can never win it again.
Patient safety is one of the main pillars of care at Memorial Hermann. Bedside patient ID, medication administration, and specimen collection are central to this initiative.
![]()
"Safety first.” This famous adage is often quoted, but not all healthcare providers actually take it to heart. In fact, in this era of reimbursement cuts, technology adoption, and structural reform, losing sight of this tenet has become all too easy. This is unfortunate because improving patient care and safety are the main reasons most of these changes are being implemented in the first place.
Memorial Hermann is one health system that hasn’t lost any of its focus on patient safety. In fact, setting the gold standard in this area drives just about every initiative undertaken by the provider. Memorial Hermann has a long history of excellence when it comes to patient safety. The fact that the health system won the NQF (National Quality Forum) National Quality Healthcare Award back in 2009 is proof. This award acknowledges outstanding quality and safety improvements in healthcare, and once a provider receives the honor, it can never win it again.
One of the key ways Memorial Hermann is currently driving continued patient safety improvements is by perfecting its bedside patient identification, medication administration, and specimen collection processes. Using bar code technology to validate patients, drugs, doses, and specimen orders is helping to close the loop on these processes and eliminate adverse drug events and specimen collection errors. In this Q&A, John Barr, the Consulting Systems Architect of Technical Solutions at Memorial Hermann, provides insight into this ongoing project.
Q: When did the bedside bar coding initiative begin at Memorial Hermann?
![]()
A: We started with a positive patient ID/medication administration project back in 2006 and completed the framework in 2007. Today, between 85 percent and 95 percent of all the drugs administered at Memorial Hermann go through a bar code verification process. In other words, a bar code wristband is scanned to verify the patient’s identity, and a bar code label on the medications is scanned to ensure the drugs and dosage line up with what was ordered. All of this information is reconciled and recorded in our Cerner EHR/clinical delivery system. We recently decided to extend this solution to specimen collection as well.
Q: What specimen collection problems are you looking to address with bar coding?
A: In the past, physicians would tell nurses what types of specimens they wanted collected from a patient (e.g., blood, sputum, urine, etc.). The nurses would write these orders down on Post-it notes, put them in their pockets, collect the requested specimens from the patients, and then return to the nurses’ station to complete the required labels before sending the specimens down to the lab. The problem was that nurses were often collecting specimens from five or six patients at one time. When collecting various specimens from multiple patients, if you’re not labeling the specimen at the exact time you’re collecting it, you can easily confuse them.
As a result, we sometimes ran into instances where lab results got mixed up. For example, Mr. Jones who was in for the flu came back with a positive test for cervical cancer. These mix-ups are not only embarrassing but also potentially dangerous to the patient. Moreover, these errors would generate more costs for us. For instance, when a lab error occurs, we have to run more tests to correct our mistake, and we’re not going to pass these costs on to the patient. It became imperative for us to verify specimen collection at the patient’s bedside in much the same way we administer medications.
Q: What technologies do you leverage to support your bedside bar coding efforts?
A: We currently use a combination of Honeywell Dolphin 9900 handheld computers and Honeywell 4600g bar code scanners. The 4600g scanners are generally tethered to wireless mobile carts or COWs (computerson- wheels) by Howard Medical, while the handheld computers are stand-alone devices. For our specimen collection efforts we are also leveraging the Intermec PB22 mobile label printer to generate specimen labels at the patient bedside. All of these components integrate with our Cerner EHR/ clinical delivery system.
Q: Did you encounter any challenges when extending this solution to specimen collection efforts?
![]()
A: Change is rarely received with open arms. Initially, our nurses felt like we were giving them more to do and bogging down their workflow. There was a little push back as a result. However, when we painted this initiative under the guise of patient safety, they were more than willing to make the change for the sake of our patients. We also took some time to identify influential nursing liaisons and champions to help support our rollout of the new bar code process and drum up support from the nursing staff. In the end, many of the nurses are actually finding the new specimen workflow to be more efficient.
Q: Can you describe the new specimen collection workflow and its benefits?
A: Well, they’re not jotting down notes on Post-it notes anymore and carrying them in their pockets. With the new solution, nurses don’t have to remember anything. They simply walk into a patient’s room with their handheld computer or wireless mobile cart or access the mounted computer terminals available in some patient rooms to pull up the specimen collection orders requested by the physician for a certain patient. This process is initiated by scanning the patient’s bar code. They then click on a tab on the screen that says “Pending Collections,” draw the appropriate specimens, and hit enter to print out a label to affix to the specimen container. All of this is done right at the patient’s bedside.
![]()
As a result of our new bar code specimen collection process, we are eliminating lab mix-ups and improving patient safety. Moreover, our nurses are finding that they are now able to spend more time in the room with patients and are able to get more accomplished in a shorter amount of time.
Q: Are there any additional ways you are considering expanding bar coding at Memorial Hermann in the future?
A: One initiative potentially on the horizon is applying bar coding to track anatomic pathology samples. This could be anything from a blood slide to a lab analysis of a tumor biopsy. I’m not certain where this initiative falls on our roadmap, but it’s definitely on our radar.
"Safety first.” This famous adage is often quoted, but not all healthcare providers actually take it to heart. In fact, in this era of reimbursement cuts, technology adoption, and structural reform, losing sight of this tenet has become all too easy. This is unfortunate because improving patient care and safety are the main reasons most of these changes are being implemented in the first place.
A: We started with a positive patient ID/medication administration project back in 2006 and completed the framework in 2007. Today, between 85 percent and 95 percent of all the drugs administered at Memorial Hermann go through a bar code verification process. In other words, a bar code wristband is scanned to verify the patient’s identity, and a bar code label on the medications is scanned to ensure the drugs and dosage line up with what was ordered. All of this information is reconciled and recorded in our Cerner EHR/clinical delivery system. We recently decided to extend this solution to specimen collection as well.
A: Change is rarely received with open arms. Initially, our nurses felt like we were giving them more to do and bogging down their workflow. There was a little push back as a result. However, when we painted this initiative under the guise of patient safety, they were more than willing to make the change for the sake of our patients. We also took some time to identify influential nursing liaisons and champions to help support our rollout of the new bar code process and drum up support from the nursing staff. In the end, many of the nurses are actually finding the new specimen workflow to be more efficient.
As a result of our new bar code specimen collection process, we are eliminating lab mix-ups and improving patient safety. Moreover, our nurses are finding that they are now able to spend more time in the room with patients and are able to get more accomplished in a shorter amount of time.
