E-procurement/GS1 standards
message to suppliers that these are the standards the NHS is going to use, and that we will be building them into our contracts with them.
“Once we have begun standardising data, and can achieve automation in the supply chain – we can start tracking those products. Take the famous PIP breast implant issue, where 30,000 women received faulty products, but the sector didn’t know who they were. Had those implants been barcoded and tracked into the patient notes using GS1 barcodes, we would have had a recall facility to notify the women, bring them in, and do the checks far more cost-effectively. By linking a product to the patient, we can identify the patient, and withdraw the faulty product, far more quickly.”
Time-consuming recalls Without such a system, a healthcare safety recall could entail deploying ‘hundreds of staff ‘walking around shelves removing product. Chris Slater said: “We can now input the GTIN, (Global Trade Identification Number) for an item, and identify which shelf it is on.” Making this work effectively, of course, requires supplier engagement to populate the Trust’s product catalogues with the appropriate GTIN. “However,” said Chris Slater, “if six Trusts can do it, with the spread of all six we should be talking to at least 80 per cent of the suppliers, and probably collecting data on 80 per cent of the products they supply to the NHS.” “We won’t initially track every piece of cotton wool or cannula. We will rather be barcoding the small ‘kits’ of theatre items, and will thus know that within the bill of materials, we have ‘x’ number of different items. The other important element – where it starts to link to estates – is that, under the current DH mandate, the first three standards relate to products, patients, and places. That means every location where we undertake activity – the bed bay, the theatre, the ‘prep’ room, or the side ward, will have a unique GS1 identifier barcode, or GLN (Global Locating number). Currently, within my own Trust’s supply chain system, I have 300 transfer points across our seven hospitals – points where would ordinarily be able to track to. However, take this to the point where we carry out activity, and we then have 25,000 locations, so part of this project involves mapping all those to unique GS1 GLNs.”
Location identifiers
Chris Slater explained that currently there were two principal software systems that held location identifiers – Micad and Planet FM. He explained: “Generally these are used around estates and facilities management as opposed to procurement and the patient. We are now using the information we have within Micad for FM to bring in unique GLNs to map them to
At the Royal Derby Hospital, every patient, healthcare assistant, chief nurse, the theatre or ward staff, the consultant going into the operating room, plus every instrument used, will have its own GS1 number.
those location numbers – these could be rooms, door numbers, or office numbers. We are looking to ensure that we have captured most of the 25,000 locations.” Undertaking this work, the GS1 UK project team in Leeds is working with the Trust’s Estates and Facilities Department. Chris Slater added: “We already have all the locations mapped via the Estates Department for estates management at a granular level. We have also worked closely with Micad, the software provider – recently downloading from the GS1 number bank 50,000 GLNs into our Micad system – and are now mapping the unique Micad references to the GLNs. We will subsequently produce physical barcodes, and affix these to all of those 25,000 locations; generally on doors, at handle level, probably using tamper-proof, non-removable barcodes.
A barcoded patient wristband.
A broad spectrum of staff “Currently, we have IT personnel, procurement staff, estates and facilities personnel, and nursing and clinical teams, involved. Over time staff involved will range from porters, to clinicians.” Mapping the various locations would, Chris Slater said, bring several important benefits. He said: “One very practical example is knowing where our patients are. Ask our medical director what really frustrates him, and he’ll tell you that it is not being able to locate a patient when a doctor is doing a ward round. However, if we scan patients in real-time to a real location, and our patient ‘administration’ system records the data, one look at the system will identify that the patient is, for example, in bay 6 in Ward 7.”
Larger items of hospital equipment could soon have GS1 barcodes/tags applied to help staff locate them more quickly and reduce theft.
Tracking room utilisation The Trust would also be able to track room utilisation more accurately. Chris Slater explained: “All this starts to tie back together into one massive management information database that gives us data on patient flows, products, performance, patient safety, and recalls.”
In future, I guessed implementation of GS1 standards would also help a large NHS Trust better manage availability of large items such as beds? Chris Slater said: “Such large assets are outside the scope of the initial three core enablers, but the same principles will apply. I believe Derby Teaching Hospitals NHS Foundation Trust is linking the barcodes generated in its main hospital to individual endoscopes and other surgical instruments so staff know exactly where each is, and for what procedure, and on which patient, it was most recently used. Should, for example, a subsequent claim arise that
a particular endoscope was defective, staff will be able to track where it came from, and its service history. Equally, the automated theatre supply chain process the Trust is using – based around GS1
Health Estate Journal 27September 2016
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