gs1 uk healthcare conference - masterclass presentation - andrew smith

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Benefits of standards in the Irish National Decontamination Tracking System

GS1 UK Healthcare Conference

Andrew Smith, HSSU Manager, St James’s Hospital, Ireland

12/13th April 2016

© GS1 Ireland 2016

Agenda

• Introduction

• Overview of the National HSE programme

• Background to implementing GS1

• The process at SJH

• Benefits and learnings

• Next steps

© GS1 Ireland 2016

In the news…

Track and

Trace?

“Hospital has apologised to 18 families who were wrongly identified as being at the centre of a contamination scare over a

medical scope”

July 2013

© GS1 Ireland 2016

In the news…

Track and

Trace?

“The HSE will contact up to 20 patients who were operated on using instruments which had been used on a patient who has

been diagnosed with CJD disease”

July 2013

© GS1 Ireland 2016

Overview of Instrument Set Traceability

“Systems should be in place to record the decontamination process used on RIMD (tracking)

and link them with service users on which they have been used (tracing)”

HSE Recommended Practices for Central Decontamination Units. Version 2.0, 2011

Project started in May 2008 – 1st “Go Live” site was St. James’s Hospital in July 2011

© GS1 Ireland 2016

Decontamination Track and Trace - Timeframe

Phase 1 Project Kickoff

GO LIVE8 CDUsSJH first

hospital to GoLive

Phase 2 Business Case

(including Endoscopy)

Approval Procurement/

Finance

Phase 2GO LIVE5 CDUs10 ERUs

Phase 2 GO LIVE 7 CDUs 9 ERUs

Phase 2 GO LIVE 8 ERUs

Completion of Phase 2

2008 2011 2012 2013 2014 2015 FUTUREPhase 3

Business case Remaining CDUs and ERUs (10% volume)

- Commercial loan set providers

- Private Hospitals

• Only National Traceability Solution in the world (both trays and endoscopes)

• 90% of volume will be utilising the solution by end 2015 (32 Hospitals)

• Patient Safety was the key reason for implementation :

Clinical imperative to have traceability for high risk procedures

© GS1 Ireland 2016

St James’s Hospital - Overview

Central Decontamination Unit

• Staff: 24

• Theatres: 17

• Sets processed each week:802

© GS1 Ireland 2016

Process overview – HSSU SJH

Decontamination Unit

TheatreLoan Instrument

Sets

© GS1 Ireland 2016

Track and Trace Solution

© GS1 Ireland 2016

GS1 Standards enabling the vision for SJH…

Scanning in some cases but not GS1 yet (WIP)

Scanning GS1 barcodes

© GS1 Ireland 2016

Overview of the GS1 Barcode

Application Identifier indicates this number is an Asset Identifier (GIAI)

ApplicationIdentifier(8004) 5 3 9 7 0 2 1 9 9 9 1 0 0 1 8 3 4(AI) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

SJHPrefix 9DigitNumber(digit17isacheckdigit)

© GS1 Ireland 2016

Registration/Set up process for a new set

Step 1 Register the new set and instruments on the tracking database

Step 2 Assign the Global Individual Asset Identifier barcodes

Step 3 Upload these details with the GS1 code to the MS1 Database

© GS1 Ireland 2016

Overview of the number of procedures year on year in SJH HSSU

Anecdotal evidence:Moved from 5,000

Transcriptions per day in one hospital

Between 2013 to 2015 Increase in workload with less staff

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

2008 2009 2010 2011 2012 2013 2014 2015

Throughput of sets

© GS1 Ireland 2016

Tracking Stations

New Equipment

© GS1 Ireland 2016

Tracking Instruments - Before

Manual Check

© GS1 Ireland 2016

Tracking Instruments - After

Information available:• Electronically & Post –event• Dataloggers linked to tracking system

© GS1 Ireland 2016

Instrument set lists

After• Electronic (file printed when barcode is scanned)• No need to search in cabinet• No confusion on document version

After: Scan barcode and set list printed

Before: Paper based

© GS1 Ireland 2016

Process log

Before After

• Paper based • Electronic• Post-event can be

retrieved at the touch of a button

© GS1 Ireland 2016

Steriliser Cycle

Before After

• Paper based• Subject to

deterioration over time

• Electronic• Post-event can be

retrieved at the touch of a button (forever)

© GS1 Ireland 2016

Tracking in Theatres - After

Electronic • Post-event –

Can be retrieved at the touch of a button

• Linked to instrument tracking system

© GS1 Ireland 2016

Loan SetsMajor challenge for traceability

The Big Challenge !!• Shared among

hospitals (contents always changing)

• Traceability is very challenging

• Can come from a commercial loan set provider or another hospital (often not barcoded)

© GS1 Ireland 2016

Loan set – ExampleWhich loan set would you rather process?

Loan sets with NO GS1 barcodes Loan sets WITH GS1 barcodes

© GS1 Ireland 2016

Loan set Checklists

• Paper based• No certainty that list

matches tray contents

• Electronic, fully legible• Up to date• List can be pulled from MS1

Cloud by scanning the tray

Before After

© GS1 Ireland 2016

Loan set – ExampleWhich loan set would you rather process?

Not GS1 Coded GS1 Coded

Not GS1 Coded• 30 loan sets• 60 reprocesses• Huge paper trail• Manual tracking• Very time consuming• Manual rekeying and

transcription of data

GS1 Coded• 4 loan sets• 8 reprocesses• Huge paper saving• Electronic tracking• Very time efficient• Unique identification of

set (GS1 barcode)

1 Hospital during 1 week in Feb 2015

© GS1 Ireland 2016

Loan set – Example (PEI)

PEI Loan sets with GS1 barcodes

Loan sets from PEI scanned into Wash Room

- No need to rekey information (huge time saving)

- Full audit trail

© GS1 Ireland 2016

Key Benefits of National traceability solution for Instrument trays and endoscopes

• Automatic Tracking of Instrument Sets- No longer need to stick head in the washer

• Much easier to share Loan Sets- Interoperability between hospitals- Lists more accurate and legible

• Tray Checklists printed when scanned- Accurate and right version, no longer need to search

• All records stored digitally- Can be referenced post-event, huge paper saving

• Link between tracking system and theatre- Closes the link between patients and sets reprocessed

• Improved Workflow- Scanning of instrument sets mean team has to communicate and be more

organised• Reporting and management of set inventory- More reports (doing more audits), Enables asset management (retiring unused

sets)

© GS1 Ireland 2016

Key Takeaways and Next Steps

- Critical mass has been reached • 90% utilisation of the tracking solution = real benefits• Some private hospitals are also using the system

- Role of Manufacturers/Loan Set Providers• DePuy Synthes (J&J) Ireland were the first in Ireland to

put GS1 codes on their loan set trays (also a first globally)• Olympus Medical were the first in Ireland to put GS1

codes on their Endoscopes• Need more Manufacturers to follow this lead!

- Next Steps• Implant tracking

© GS1 Ireland 2016

Contact

Andrew SmithHSSU, St James’s HospitalJames’s Street, Dublin, IrelandTel + 353 1 416 2557eMail [email protected]