Surprising Commonalities between Defensive Driving and Barcode Medication Administration

In my early 20s I worked as a driver for FedEx. I logged literally thousands of hours behind the wheel delivering and picking up packages. FedEx taught me safety from the first day I worked there until my last. All these years later, I can still rattle off the defensive driving best practices they taught me. I got so efficient at buckling up that I could simultaneously start the truck with my right hand while buckling up with my left. As I got better at that little maneuver, it took no additional time. Of course, implied in all of this is that we had trucks that ran and seatbelts that worked.

Some drivers at FedEx, including myself at first, couldn’t be bothered with defensive driving principles. The excuse? I was too busy trying to meet package-delivery deadlines. Unfortunately, it took two accidents, additional defensive driving training, and the threat of losing my job for me to take those best practices seriously. Thankfully, no one was seriously hurt in my accidents.

Even though neither of the accidents was deemed my fault by the responding officer on the scene—and I didn’t get a ticket for them either—I was still told by FedEx that if I had followed the defensive driving guidelines better I could have prevented both accidents.

Now compare this to barcode medication administration (BCMA). In our recent KLAS study “Medication Cabinets, Carts & BCMA” we spoke with nurses about the impact cabinets, carts, and BCMA have on nursing efficiency and patient safety. One of the questions we asked was, Where do nurses feel most vulnerable to making medication errors? The top response (given 36% of the time) was noncompliance to protocols, which referred primarily to instances when nurses opted out of using BCMA and other safety features. Nurses cited several reasons for not using BCMA, including having emergency situations, being unwilling to adjust workflow, and not being able to scan all of the medications. Clearly, there is still work to do to improve nurses’ ability to scan all medications, but there are still many nurses not using BCMA the way they should.

At the same time, almost all nurses agree that there are patient-safety gains to be had from using BCMA. The general consensus has been that it slows nurses down. It was surprising, then, that the nurses we interviewed spoke so overwhelmingly about its efficiency gains. Note that I said efficiency, not speed. Also of note is that when we asked which technology would likely be purchased next for medication administration, the primary response was new or more robust BCMA. Here’s a callout to the vendors: Let’s make sure and provide seatbelts that work.