Analysis of data captured by barcode medication administration system using a PDA; aiming at reducing medication errors at point of care in Japanese Red Cross Kochi Hospital Masanori Akiyama ab , Atsushi Koshio ab , Nobuyuki Kaihotsu c a Todai Policy Alternatives Research Institute, The University of Tokyo, Tokyo, Japan b Sloan School of Management, Massachusetts Institute of Technology, Boston, MA c Japanese Red Cross Kochi Hospital, Kochi, Japan Abstract Preventing medication errors by using a barcode administra- tion system has become prevalent in patient safety. Analyses of data captured by bar code systems provide opportunities to understand the actual situation at the point of care. Our study aims at understanding issues of medication safety as well as investigating measures taken to prevent medication accidents, by analyzing data captured by a bar code system and a per- sonal digital assistant (PDA),. The barcode administration system named Point-of-Act-System implemented in Japanese Red Cross Kochi Hospital was designed to capture every ac- tivity at the bedside. Complete activity data captured by the system, which included injections, treatment and other nursing activity, as well as injection warning data, were used for our analyses. We describe the data and analyze them statistically to find potentially times of risk and to ascertain the relation between busyness and error. The injection warning rate as a whole was 6.1% on average. The results showed there was a negative correlation between the number of injections given and the injection warning rate (-0.48, p<0.05). The warning rate was low during the hours when a large number of injec- tions were administered. The data also showed that a varia- tion in activities being performed has a negative effect on me- dication safety. A bar code administration system is quite an effective way not only to prevent medication error at point of care, but also to improve patient safety through analyses of data captured by such a system. Keywords: Point of Care System, Medication Errors, Administration and Organization, Handheld Computer, Patient Safety Introduction It is widely believed that patient safety is an important issue for health care systems. Many organizations and hospitals have been accumulating information on patient safety and medication errors to improve patient safety based on the data collected. These data is accumulated to provide information on threats to patient safety. Such data are quite useful in un- derstanding the threats and actual situations related to medica- tion errors in hospitals. However, most of this evidence is ba- sically information on medical accidents and incidents, com- piled from voluntary reports submitted by medical workers. This information is not detailed enough to enable the discov- ery of underlying general principles, because accidents and errors are part of the reality in a hospital setting. A complete picture of the situation in hospitals, including details of medi- cal accidents and incidents, is essential to identifying general causes and frequencies of medical errors. However, it is ex- tremely costly to obtain by observational research sufficient data to enable an understanding of all the activities conducted in a hospital, and furthermore, the accuracy of data collected by observation is sometimes defective. Information technolo- gies such as electronic medical records and barcode admini- stration systems at the point of care have the potential to pro- vide new opportunities for us to understand the overall picture of medical activities by digital capturing data on daily medica- tions and patient care in hospital settings. By using informa- tion systems for all patients in all wards, data captured by the systems become useful resources to understanding various phenomena in medical situations and investigating research questions. In terms of medication accidents, the point of care is a potentially risky area in medical activities [1-3]. There- fore, data captured at the point of care is quite effective in understanding medication accidents. One potential candidate system for this is a barcode administration system for safe injections and medication. Barcode medication administration systems prevent medication errors by authenticating the "5 Rights" of medication: right patient, right drug, right dose, right time, right route. Performed at the bedside, the system offers an excellent opportunity to gather data on medications [4-7]. In addition to their contribution to the authentication of the 5 Rights, data captured by barcode administration systems have the potential to provide sources of research to improve patient safety in terms of actual injections and medication da- ta. Our study aims to use and analyze complete data on medical activities captured at the point of care by the system to under- stand all the activities and issues related to medical safety, and to investigate preventive measures for medical accidents to manage healthcare situations. We focused on injections, which MEDINFO 2010 C. Safran et al. (Eds.) IOS Press, 2010 © 2010 IMIA and SAHIA. All rights reserved. doi:10.3233/978-1-60750-588-4-774 774