Scanning Barcodes In The Operating Room: Safer Procedures .

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Scanning barcodes in the Operating Room:Safer procedures, more satisfiedpersonnel. The Greek Army's GeneralMilitary HospitalMr. Sotiris Tsiafos – Tsiaras, Military Pharmacist, OR Traceability Project Manager at 401 AthensGeneral Army Hospital, Greek ArmyOctober 18, 2018

Welcome and thank you for attending! Welcome to our GS1 Healthcare October 2018 webinar.Thank you to our guest speaker Mr Sotiris Tsiafos-Tsiaras, Military Pharmacist, ORTraceability Project Manager at 401 Athens General Army Hospital, Greek Army Some housekeeping for today:-All attendees will be on mute-If you have questions during the presentation, please type them into the questions area andthese will be monitored then answered at the end of the call After the webinar:-Within a week, the recording will be posted to: http://www.gs1.org/healthcare/hpac webinars-All previous webinars are also posted to this location, so please feel free to use this resourceand share the link GS1 20182

GS1 Healthcare Global and the Healthcare WebinarsFocus is on thought leaders and adopters of GS1 Healthcare Standards fromthe global clinical provider environment. Their final goal is to improvepatient safety, cost efficiency and staff productivity through implementationof GS1 standards.A forum for sharing anddiscussionIdentification of projects andcase studiesA source of expertise andadvice About the practical realities of implementation of GS1Standards in the care giving environment in regards tothe impact on clinical care and patient interaction That support the adoption of GS1 Standards inhealthcare providers and retail pharmacies For publication, presentation and sharing To those involved in GS1 standards development, thewider Healthcare stakeholder community and seniorexecutives/decision-makers to gain their buy-in andsupport for implementation of GS1 Standards GS1 20183

Some specific GS1 Healthcare ActivitiesWebinars Monthly webinars open to allstakeholders interested in learningabout GS1 standards implementationin the care giving environment. http://www.gs1.org/healthcare/hpac webinarsAwards Twice per year Provider Best Case Study Award Provider Recognition Award The prize is travel / accommodation toattend the next GS1 Healthcareconference http://www.gs1.org/healthcare/hpacGS1 Healthcare also holds two global conferences per year. The nextconference will be in Bangkok, Thailand from October 30 – November1st, 2018.We expect significant Healthcare Provider participation on the agenda. GS1 20184

Presenting todaySotiris Tsiafos-TsiarasMilitary Pharmacist,Pharm. BSc, Logistics MScOR Traceability Project Manager401 Athens GeneralMilitary Hospital GS1 20185

401 Athens General Military Hospital GS1 20186

Our Hospital: Facts & Data Largest Military Hospital in GreeceNATO Role 4 Hospital540 beds, up to 1075 11 Operating RoomsCardiac Catheterization & Vascular EmbolismLaboratoryCardiac surgery dept. In 2017: 15.700 inpatients, 220.000 outpatientsMore than 4.000 surg. operations 7.000.000 annual spend on medical devices GS1 20187

Decision to use GS1 Standards Need to:- Improve Operating Room supply chain operations- Enhance patient safety in the ORGreek Army's Medical Supplies Centre isusing GS1 standards in warehouse operationssince 2015 with very good results ! GS1 20188

Decision to use GS1 Standards“How GS1 standards will improve hospital’s operations ?”Proof of Concept: A pilotWhere ?What ?How ?Operating RoomExpensive items – stock managementHigh–risk medical devices, implantsUsing AIDC technologies and manufacturer’sbarcodes GS1 20189

A Great Challenge ! Nurses/Staff knew nothingabout barcodes Suppliers' limited knowledgeof GS1 standards Barcode scanning notimplemented in hospital’sclinical software Resistance to change (?) GS1 201810

Initial Assessment - Findings Proprietary hospital-only items coding scheme. No GTINs stored in the system Manual registering of items (Excel item Catalogues) No LOT/BATCH or Serial tracking (patient safety!) No detailed stock visibility – losses due to expiration GS1 201811

Initial Assessment - FindingsError-prone, time-consuming processes !Valuable time lostInaccurate stock dataTraceability ?Expired items - losses GS1 201812

Initial Assessment - FindingsMedical Devices used in the OR: 90% barcoded85% GS1 (GS1-128, GS1 Datamatrix)5% HIBCC2% otherApplication Identifiers:(01) GTIN(17) EXP(10) LOT(21) SERIAL GS1 201813

Implementation StrategyEarly StagesDEFINE SCOPE TARGETINFORMSTAKEHOLDERS Which items? How manyORs? Desiredoutcomes Form aprojectworkgroup Explainobjectives ContactsuppliersEDUCATEPEOPLE GS1 Basics Barcodebenefits Hands-ontrainingBUILD A DEMO(optional) “Quick &dirty” Show benefits Get feedback Gain support GS1 201814

Implementation StrategyImplementationDECIDE &DESIGNCHANGES Systems Procedures KPIsPlanning for the futureAPPLYCHANGESEVALUATERESULTSFORM ACULTURE Continuousmonitoring Feedback Training Support MeasureKPIs Operationalefficiency Patientsafety Everydayjob Clearbenefits UserfriendlinessNEXTSTEPS More ORs Other Depts OR SafeLabelingSystem GS1 201815

ImplementationSELECTED ITEMSSELECTED BARCODES Cost & Volume- High cost medicaldevices- High turnover items (e.g.surg. Sutures) Risk & patient safety- Implants- Intra-Ocular Lens GS1 barcodes:- EAN, GS1-128,Datamatrix No HIBCC No other barcodesScanning at the “Point Of Sale” GS1 201816

ImplementationWHERE TO START? Startsmall Be simple- One operating room- Few items- Basic trainingA “quick” Demo first: Cataract surgeries-Few items used per patient“Fast” procedure (20-25 min.)Need for speedNeed for tracking IOL serials GS1 201817

ImplementationNEXT STAGE 3 more ORs (General and neuro- surgery) Anesthesia & Recovery Dept. Cardiac Catheterization Lab. Interventional Radiology Dept. GS1 201818

ImplementationMain types of barcodes used:GS1-128 and GS1Datamatrix ALWAYS SCANcapturing crucialitem data: GTINLOT/BATCH(SERIAL)EXP DATE GS1 201819

ImplementationWhich barcode should I scan? GS1 201820

Key ElementsTrainingUsabilityJustONEbeep ?!SimplicityMaster Data GS1 201821

Personnel EngagementEXPLAIN- Be there when needed- Take feedbackSUPPORT- Ask !!!- Why we do this- Explain plan- BenefitsEDUCATE- Basics- Simple language- No technical jargon!!TRAIN GS1 201822

Procurement – Suppliers engagement Suppliers engaged at the very beginning- Explained project plan and target- Asked for item catalogues- Shared info and case studies – benefits!- Directed to local GS1 MO GS1 201823

Procurement – Suppliers engagementProcurement is our“Right Hand”- New tender/contract terms (coding - labeling)- Advice on National & European legislation- Contact suppliers- Update e-procurement platform GS1 201824

IT Systems & SoftwareISSUESSOLUTIONSNo GS1 AI decodingNo uniform barcodes – various AIs“Item of supply” vs “Item of trade” Own software, in-house development- GS1 only barcodes- At least GTIN (01) LOT/BATCH (10) SERIAL (21) EXP DATE (17)decoding capabilities (BUT NOT ENOUGH !) GS1 General Specifications as a guide “One-to-many” relationship between hospital’s codes - GTINs GS1 201825

IT Systems & SoftwareDesign Principles GS1 201826

IT Systems & SoftwareEngagement of the IT department is crucial, but don’t let them have the last word. GS1 201827

Outcomes - Benefits Accurate dataWhat was used onwhich patient- Exp dates !- Implants trackingPatientsafety !- Stock accuracy –visibilityEfficiency!- Betterforecasting- Fewer losses GS1 201828

Outcomes - Benefits Speed- Fast & correct registration of items in the OR More time with the patient Less paperwork afterwards- Fast & correct stock counting Less time spend in administrative tasks- Significant time gains at the invoicing procedure ! GS1 201829

Outcomes - Benefits Speed 80% less time needed for stock counting 85% less time needed for registering anesthesia setsto patient records(almost 19 hours/month !)Procurements Officer:“Is like having one more person in the office!” GS1 201830

Outcomes - Benefits Safety- For our patients- For our nursesCardiac Catheterization Lab Head Nurse:“I feel safe knowing I have full control over my stock” GS1 201831

Outcomes - BenefitsChange of Culture! GS1 201832

Outcomes - BenefitsHappier people ! Barcodes are great, butour people is the key GS1 standards madetheir life easierOur Vascular Embolism Lab Team Happier staff meansbetter care for ourpatients ! GS1 201833

One last word GS1 201834

One last wordDon’t hesitate, just do it ! GS1 201835

Thank you !Sotiris Tsiafos-Tsiaras,OR Traceability Project Manager401 Athens General Military Hospital, Greeces.tsiaras@gmail.com GS1 201836

GS1 Healthcare webinar:Questions and contact detailsEls van der WildenDirector Healthcare ProvidersGS1Tel 31615545868eMail els.vanderwilden@gs1.orgwww.gs1.org GS1 201837

15.700 inpatients, 220.000 outpatients . Els van der Wilden Director Healthcare Providers GS1 Tel 31615545868 eMail els.vanderwilden@gs1.org www.gs1.org. Title: PowerPoint Presentation Author: S.J.M

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