The Alternatives

Two further technologies are being investigated to prevent wrong site surgery, the use of bar codes and radio frequency (RFID) tags. Both have the potential to integrate into existing hospital patient administration systems. They have a number of disadvantages however.

Cost

Both systems have a large initial cost outlay. All clinical areas of the hospital will need to be equipped with barcode printers and scanners or RFID programmers and readers. These will need computers to drive them with the attendant risks of security. All of the equipment will need to be maintained, maintenance contracts will be needed and software upgrades and bugs are likely. All of this is very expensive. The patient safety band in comparison costs pennies rather than many thousands of pounds.

Equipment Failure

Computers can crash. All of us have been infuriated by this event. In RFID and barcode systems computer failure means that the protection that you have paid for is no longer present. The patient is no longer protected by the system and the risk of error returns. The patient safety band is low tech and equipment failure is highly unlikely.

Propagated Error

All clinicians will give examples like 'the letter says cystectomy (bladder excision) but should have said cystoscopy (bladder inspection)' we have all seen letters which state that the pathology is on the right when it is on the left. Indeed we have all been in a car where someone has said turn left but meant turn right (and usually won't admit it and swears blind that they didn't). RFID and barcode systems usually use data entered at the time of outpatients. Any errors at this stage will be propagated right up to the operating table.

Interaction

Research from the USA pin points the most frequent reasons for wrong sided procedures to be lack of communication. Using the patient band system will result in two doctors consulting with the patient separately to identify the nature and site of the procedure, this by it's very nature fosters communication. By using electronic systems such as RFID or barcode there is a tendency to rely on the technology.

Clinical Negligence Scheme for Trusts

When your hospital is inspected the care of your patients in the journey through theatre is one aspect of the monitoring process. It is suggested that after discharge the patients band is stored in the notes using the already present perforations. This will greatly aid the documentation of compliance with NPSA recommendations on the avoidance of wrong sided surgery. It is much more difficult using RFID or barcode to demonstrate that the checks have been performed by two doctors and confirmed by the patient.