Evaluating the impact of implementing an electronic barcode and image capture workflow system in an oral liquid repackaging area

Abstract Purpose To assess the impact of barcode scanning and image capture technology on clinically significant medication preparation errors and medication waste in oral liquid repackaging workflows. Methods A quality improvement initiative was conducted at an academic medical center to assess the impact of implementing barcode scanning and image capture technology on the oral liquid repackaging process. The primary objective was to evaluate the impact of technology on medication preparation errors. The secondary objective was to evaluate medication waste. Preparation errors were tracked during pharmacist verification before and after implementation of the third-party technology. Clinically significant medication errors were defined as wrong drug, beyond-use date, volume, or label errors. Medication waste, defined as medication that was prepared but not administered, was evaluated using electronic health record data. Error rates were calculated per 1,000 syringes prepared, and a Poisson rate test was used to assess statistical significance. Results A total of 108,611 doses were prepared during the preimplementation period while 63,684 doses were prepared after implementation. The number of clinically significant errors decreased from 747 to 132 events. Wrong drug errors declined from 160 to 5 events (P 0.01), wrong volume errors decreased from 294 to 55 events (P 0.01), and wrong beyond-use date errors were lowered from 281 to 67 events (P 0.01). Wrong label errors did not show a statistically significant change. The wrong drug error rate decreased from a peak of 2.97 to 0 per 1,000 syringes. Hazardous medication waste was reduced by 8% following workflow adjustments. Conclusion Implementation of barcode scanning and image capture technology was associated with a significant reduction in clinically significant medication errors and a modest decrease in medication waste.