Post on 12-Apr-2017
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
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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
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
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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 Instruments - After
Information available:• Electronically & Post –event• Dataloggers linked to tracking system
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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
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Process log
Before After
• Paper based • Electronic• Post-event can be
retrieved at the touch of a button
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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