Solution: Part One - Labeling Pharmacy Medications
As the first phase toward realizing this vision, Aurora determined that the value of any bar coding effort would be directly proportional to the percentage of medications properly labeled. In fact, their goal is to label 100 percent of medications. This objective called for on-demand barcode printing in a wide variety of settings. While some smaller Aurora facilities might demand an average of 6,000 to 25,000 barcode labels per month, larger sites may need to print more than 50,000. Aurora needed printers that were appropriate to the volume demands of their varying sized hospitals. They also placed a priority on finding printers that would integrate smoothly with an existing pharmacy information system from Cerner.
Aurora chose Zebra Technologies after carefully considering general research findings, reports from their information systems vendors, and their own positive experience using Zebra printers to track radiology files. Deploying a combination of Zebra's S600™ and Xi™ series printers, the IDN introduced barcode labeling in the pharmacy at Aurora Sheboygan Memorial Medical Center in February 2003 and soon expanded it to 10 additional hospital pharmacies.
"These are thermal, on-demand printers," says Raschke. "They create dense, high-quality symbols that carry more than enough information. Plus, the output survives the rigors of hospital life, achieving the high read rates necessary to streamline labeling in the pharmacy and scanning on the floors."
As Aurora transitions to a centralized medication re-packaging operation for all hospitals, it will continue to use Zebra printers for those medications and preparations, such as patientspecific IVs, that require unit-dose labels be printed at the local level.
Solution: Part Two - barcoded Wristbands for Accurate Patient Identification
A complementary phase of the initiative required introducing barcoded patient wristbands. Aurora needed durable, easy-to-scan wristbands that would allow caregivers to accurately identify patients at the point of care and verify the "five rights" of medication administration: right patient, right medication, right dose, right time and right route. As part of their commitment to maximizing patient comfort, Aurora wanted the wristbanding program to be as non-disruptive as possible. As poorly-constructed, difficult-to-read wristbands can contribute to an impersonal, institutional atmosphere, this thinking had a major influence on the choice of wristband and symbology used.
Aurora standardized on the two-dimensional Aztec Code symbology because it can encode large amounts of data and it makes scanning less obtrusive. Aztec Code works well on a curved surface and can be repeated around the length of the band for easier access to the reader, requiring less re-positioning by the nurse to get a scan.
For added flexibility, Aurora also incorporated one-dimensional or linear barcodes on their patients' wristbands. These simpler codes would allow clinicians to use existing scanners that already supported glucose readings, specimen collection, and other types of point-ofcare testing.
Aurora chose a print solution from Zebra that included Zebra wristbands as well as the TLP 2844-Z™ wristband printer. To help streamline workflow for staff, the health system is working with Zebra to establish a simple method for printing multiple wristbands at once. In the maternity ward, for example, nurses must print four wristbands—two for the infant and one for each parent. By generating all four labels on the same sheet, staff members can save time, avoid hassle and increase overall efficiency.