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How the VA used technology to reduce medication errors

Pharmacy Regulation Resource, April 14, 2004

Colmery-O'Neil Veterans Affairs (VA) Medical Center in Topeka, KS, reported as much as an 85% decrease in wrong-time medication errors after it began using bar coding in the medication administration process in the 1990s, says Jeff Ramirez, PharmD, chief of management and clinical information systems for VA pharmacy benefits management.

Here's what the VA did before putting bar coding in place:

1. Changed administration times. The VA needed to change its standards to accomplish the wrong-time error reduction. Nurses originally had 30 minutes before or after an administration time to give patients medication. The VA changed its medication window to 60 minutes before or after an administration time, allowing nurses more time to get medications to a patient. The bar codes allow nurses to identify the correct drug for the correct patient while making sure the patient receives the drug at the correct time.

2. Got nurses on board. The VA needed to teach nurses how to use the bar-code scanners. The system only works if nurses cooperated and followed the procedures, including reporting when the bar code on a patient's wristband did not function properly, Ramirez says.

3. Evaluated its infrastructure. The VA spent almost $60 million to build bar-coding systems at its 173 facilities nationwide, Ramirez says. That cost includes building a wireless network and acquiring hardware and software for a main server.

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