Field Report

Saving lives, reducing costs

August 21, 2008

The University of Kentucky's Chandler Medical Center, named after former Governor A.B. "Happy" Chandler, is a 473-bed facility and the only Level I Trauma Center in eastern and central Kentucky. The facility is also the only one in the region with a Level III neonatal care unit for infants. With a 100-bed intensive care unit and 17 operating rooms, the center includes numerous medical colleges as well as the UK Hospital, Children's Hospital and the Centers of Excellence.

Barbara Bush, laboratory manager for the centralized lab since 2000 and a 28-year employee, has seen the benefits and challenges that come with growth, and that includes such practices as affixing labels. "We have a very high volume of outpatients, who compose about 40 percent of patient testing. All of the labels used on Vacutainers are affixed by our lab staff – we have never had a problem with placement of labels," she said.

"However," she continues, "on the inpatient side we were experiencing massive relabeling problems. Sometimes up to 90 percent of the tubes had to be re-labeled." Why so many? "The labels were being printed at 60-plus locations and affixed to the test tubes by non-laboratory personnel, who were not as familiar with the extreme need and reason for accurate label placement.

"While care was taken to ensure that the patient name or bar code was visible, non-lab personnel were not aware of how dependent some of the label testing equipment was and is on label orientation. If it's just a fraction askew, the label won't scan," Bush says.

The solution arrived in March 2007. Chandler implemented the v-notch label which was developed under license by TimeMed Labeling Systems, Burr Ridge, IL, USA, to work specifically with Becton Dickinson (BD) Vacutainers.

Since laboratory testing can be a matter of life or death, accuracy is paramount and timeliness can be critical. Removing and reapplying labels, or reprinting and reapplying them, has now been reduced from 90 percent of the in-patient Vacutainers to 10 percent. "We have a program now that has been thoroughly tested and proven," Bush says, "and it works very, very well."

The v-notch label from Timemed Labeling Systems, combined with Becton Dickinson's visual guide technology, ensures accuracy in test tube labeling, even when the labels are re-applied.
Simple in design, the patented visual guide technology developed by BD combined with the TimeMed v-notch label lets the user line up the secondary label's color-coded notch and the color-coded sidebar on the BD primary label on the Vacutainer collection tube. Since many of the TimeMed v-notch labels use a special "glove adhesive," it is possible to adjust and realign the label even if it is initially affixed inaccurately. (Glove adhesive is so called because people handling blood and other samples wear protective gloves and can take the labels from the liner without tearing holes in the gloves.)

"The v-notch label has been a win for us," Bush says, "because now when there is a compliance, education or training issue we can point to the success we have with the v-notch label and our people are then accepting of new ideas and processes."

There have been some other benefits as well. The facility had implemented the Physician Order Entry system prior to switching to the v-notch label, which led to training for the staff on the importance of eliminating misaligned labels. The v-notch label and what it stood for aligned well with this training and as a result there was a definite time reduction in accessioning and sample labeling.

"We also switched to centralized inventory," adds Bush, "which led to a reduction in overall label ordering. Prior to implementing this new inventory system, extra rolls were unknowingly set aside in various cabinets on the floors. More money was spent on additional labels because no one knew the extra rolls existed." Now, all the rolls are stored either in the UK Chandler Materials Management location, which replaces them a roll at a time for the 60 locations within the hospital using the labels, and others are stored in the TimeMed warehouse and brought onto campus as needed.

Success of the program didn't just happen overnight. There were training sessions, posters, even flyers given to staff on payday. Meetings were held with every nursing committee and council in the hospital. And because the staff is always adding new personnel, there was a provision for training and as well as retraining for new employees.

UK's Medical Center is currently undergoing expansion and renovation to meet its growing health care requirements. With some 630 attending physicians and 500 resident physicians, there will be continued growth in laboratory testing as well as the physical structures.

Megan Siears, product manager for TimeMed Labeling Systems, worked closely with UK Chandler on the v-notch application and said that TimeMed now has 20 different v-notch labels in stock for customers who use the Becton Dickinson Vacutainer plus plastic tubes. "These specialty labels are available in two different facestocks at this time," she says, including coated direct thermal and infrared thermal papers.

Siears points out that prior to UK's Chandler Medical Center making the switch to the v-notch label, Piedmont hospital in Atlanta implemented a Beckman Coulter automated system. Teams from the Piedmont lab went to the nursing units to train everyone on the importance of label placement/alignment. Some 2,000 people at a growing hospital are now involved with the v-notch labeling. After nearly three years of use, the hospital is spending less for labels now despite a 14 percent increase in lab tests (over 300,000 more tests) because of the reduction in relabeling test tubes.

TimeMed has carved out a sizeable market share by concentrating on labels used in the healthcare environment. With more than 50 years experience, they effectively utilize a consultative sales force to bring solutions and innovation to the healthcare business and have a shelf stock label program second to none.

Larry Arway worked in sales, marketing and product management at Standard Register for 35 years. He was involved in product design and development, and has worked with major consumer and industrial products companies in North America. He can be reached at

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