Label printers dramatically improve accuracy

According to the Healthcare Commission, the independent body set up to monitor the performance of NHS trusts, healthcare organisations need to have "a systematic and planned approach to the management of records to ensure that, from the moment a record is created until its ultimate disposal, the organisation maintains information so that it serves the purpose it was collected for and disposes of the information appropriately when no longer required."

In a report by the Healthcare Commission, dated 9 July 2006, 106 of the NHS Trusts and PCTs are by their own admission either not complying with this mandate or have insufficient assurance that they are able to comply.

Primary care trusts (PCTs) need to clean up their data in order to comply with the data metrics mandated by the Fujitsu Alliance, the local service provider for the South of England, for the upload of data to the National Care Records System (NCRS) and in order to avoid costly litigation claims due to errors.

Research carried out across a number of health authorities has shown that the amount of duplicate records held on existing clinical systems can be as high as 80%. While expensive administration time is being invested to try and dedupe these records they are being created at a faster rate than they are being corrected, making this a seemingly impossible task.

The main cause for duplications to the clinical systems is generation of poor quality data during the creation of patient specimen sample requesting forms. This results in difficulties experienced by the pathology laboratory in interpreting the information correctly.

Patient records are often not located due to the poor quality of handwriting combined with a lack of NHS number and/or demographic information. This results in a huge waste of pathology time and the creation of a duplicate record on the clinical system.

Issues resulting from poor data

The resulting issues from this situation are not only non-compliance of the core standard C09 outlined above also include a whole host of other issues that impact on personnel and processes from the PCTs all the way down to the patients themselves.

Issues for PCTs, informatics and management:

Risk of costly litigation due to errors.
Inability to cleanse data at a rate that can keep up with duplications.
Increased waiting times for appointments.
Skilled medical staff time is wasted on administration – on average this is 5-6 hours per person per week.
Additional admin time impacts on already pressurised budgets.
Massive cost implication to ensure data compliance for NCRS.

Patient issues:

Additional, unnecessary visits to clinic to have repeat specimen samples taken.
Potential to receive results intended for another patient.
Incorrect results can delay diagnosis of illness and/or result in prescription of unnecessary medication.
Costs are incurred due to having to obtain additional prescriptions due to incorrect diagnosis and incorrect prescribing of medication.

GP issues:

Clinic and appointments over run due to time taken with specimen sample administration.
Valuable GP time spent on administration instead of patient evaluation and diagnosis.
Incorrect results provided to patients due to duplications can result in failure to correctly diagnose illness and, consequently, incorrect treatment.

Practice nurse issues:

Valuable nursing time wasted due to need to attend phlebotomy clinics.
Less time available to undertake clinically relevant tasks.

Practice manager issues:

Need to employ additional phlebotomists.
Difficult to keep patient appointment schedule running on time.
Fewer patients are seen during normal practice hours impacting on breaks and closure times.
Time taken to find patient details for other related administration tasks, such as referral letters, is high increasing the time taken to perform such tasks and delaying patient care.

Pathology issues:

Rarely able to locate the correct record on the clinical system first time due to illegibility of handwriting, missing demographic information and lack of NHS number.
Time wasted attempting to book in requests due to time spent trying to rationalise the record or in creating a new record (which often then becomes a duplicate).
Reduced throughput in the lab resulting in slower turnaround times.

The resulting costs

The costs resulting from the current state of the majority of clinical systems is having a huge impact on the NHS and will continue to do so unless actions are taken to clean patient record data and then prevent it from being duplicated at source.

Typical examples of the resulting costs of poor data are:

“1,200 people die each year in England and Wales as a result of medication errors, costing the NHS £500m a year”
A Spoonful of Sugar: Medicine Management in NHS Hospitals: Audit Commission

“The root cause of 27% of medication errors is poor information availability”
Building a Safer NHS for Patients: Improving Medication Safety, DH

The time taken to cleanse and merge the average number of duplicate records created in a typical PCT over a twelve month period is just over three months, based on eleven staff working evenings and weekends with a resulting cost of £25,000.

Label printing offers a quick and cost effective solution

Faced with these issues, software specialists QuickTrace developed LabelTrace, a system providing GP surgeries with the ability to print patient details directly from the clinical system to clearly identify sample requests.

The whole process takes seconds and saves valuable GP and nurse time, previously wasted handwriting labels. It also ensures that the labs have the correct information instantly available enabling greater throughput of samples and eliminating the need to check and merge records or to create new ones.

LabelTrace works with all popular primary care administration systems. It is a proven solution in daily use by over 8,000 GPs and nurses across the UK. The investment for this solution is around £1,500 per practice and payback is typically achieved within six months.

In addition to the significant time savings enjoyed by the practices and labs, LabelTrace delivers a major boost to the Information Quality Assurance Programme (IQAP) by ensuring that clean data remains clean and the task of de-duplicating patient records for the NCRS remains manageable.

Reference sites

NHS Argyll & Clyde
Somerset Health Informatics Service
NHS Lanarkshire
Southern Health & Social Services Board, Northern Ireland
Levern Medical Group
Dr Mills & Partners, Bradford
Dr Micallef & Partners, Bradford
St Andrews Surgery, Tonypandy, Wales
Craigavon Labs, Northern Ireland
East Quay Medical Centre, Bridgwater

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