I.T. Behaving Badly

Randy Osteen, associate CIO at Christus Health, Irving, Texas, agrees that if a system doesn't fit well with the nurse's workflow, the system will usually lose unless managers step in to mediate. For example, the "right patient" part of medication bar-coding is supposed to be accomplished by scanning a bracelet that's firmly attached to the patient. Sometimes those bracelets get wet and hard to read; sometimes the patient is asleep or uncooperative or in the bathroom. Nurses may find ways to get the patient scanned anyway. "If you see a bunch of patient barcodes taped to a medication cart, or stuck to the head of the bed, you know something's going on," Osteen says.

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