#handwrittenmars

So, if you didn’t already know from my profile, I work in a prison.  That being said, I am unable to photograph my facility or our detainees.  This, however, is a fabulous depiction of what ‘med line’ looks like.  To elaborate, a med cart, topped with a jug of water, drinking cups, and a book of MARs is rolled into each housing unit, twice daily.  The detainees line up, get their cups of water, their meds and carry on with their days.  The problems with this system are numerous.  I will focus on two:  Identification of detainees and legibility of MARs.

As you might imagine, this process is lengthy.  We are a facility of 500+ at this time and have an ever-changing staff (people don’t like to be incarcerated---even ‘on the clock’).  Med line procedures dictate that the nurse/med tech on med line check each ID, and match it to the MAR before administering meds.  Sounds quite obvious, right?  Here’s the issue...there are many people that have similar names....sometimes the same name...and sometimes they live in the same housing unit....ugh.

Now, while the name issue is quite challenging at times, there is also the issue of the half hand-written (by multiple staff---some of us have horrible penmanship), half computer generated (only as good as those entering the orders) MARs.  Needless to say, this can be quite taxing on an employee, as they are trying to ensure they are delivering the right meds, in the right amount, to the right person at the right time.  Oh, yeah, under not so fantastic lighting (save this issue for another post).  

In my opinion, this issue could be solved with automation.  A simple program in which the detainee could scan his badge, subsequently having his name, picture and current meds and allergies appear.  It could drastically reduce the incidence of the wrong person getting meds, or the right person getting the wrong dose or at the wrong time.  A system in which the person is identified and the meds are summoned would, from the SCAMPER model, demonstrate ‘Combine’, as we are taking two tasks and making them one. 

Taking the hierarchy of needs into consideration, our current system is stuck at ‘functionality’ at best.  It doesn’t even climb one rung to ‘reliability’, as the errors are quite common, indicating flaws.