SOUTHINGTON - On the second floor of the Hospital of Central Connecticut at Bradley Memorial, registered nurse Jennifer Warren is caring for her patients in an entirely different way.

On Wednesday morning, she waved a small, PDA-like device above the identification bracelet of Donald Lee, a 77-year-old Cheshire resident who was awaiting a hernia operation. The device scans a bar code on the patient's ID bracelet, making sure he's receiving the correct medication at the proper time.

The bar-code system is designed to reduce medication mistakes, among the leading medical mishaps, and the approach should be familiar to anyone who has checked out an item at the grocery store.

But there's a significant difference. At the grocery store, the scanner checks the bar code on the box of Cheerios. At the hospital the scan is checking the equivalent of a bar code on every Cheerio in the box.

That should make it clear that implementing such a system is a major commitment of work and expense. The Hospital of Central Connecticut invested about $6 million in the project and its staff, particularly nursing and pharmaceutical, has had to learn some new skills.

The Bradley campus went live with the new system Monday. The New Britain General campus will start using it today.

"We wanted to start small and make sure everything worked," said Linda Frigon, director of patient care services, who noted that a medication error had been averted on the system's first day. A nurse scanned the bar codes of a medication and patient, and the portable workstation told the nurse that was the wrong medication.

"I think the system has been working really well," Frigon said.

The technology puts the hospital at the forefront of a trend that hospitals across the state are looking at very closely, said Leslie Gianelli, director of communications and public affairs at the Connecticut Hospital Association, which represents the state's acute-care hospitals. The association has set up a committee to examine the approach, she said.

The first step toward the bar-coding and scanning system took place when Southington's hospital merged with the Hospital of Central Connecticut at New Britain General in 2006. A revamped approach was needed to get computer systems speaking the same language. The hospital's Cerner Millennium computer system puts all patient information into one database.

That left the hospital poised to put together electronic systems that managed medication records and patient identification.

"We knew it would be a huge investment and present major challenges," Frigon said. "But we saw it as a major patient safety initiative."

In order for the system to work, the commitment has to be total, which means that every medication dosage must be bar-coded. The hospital pharmacy had to develop a way of producing accurate bar codes, said Pharmacy Director David Girouard.

"There's still a huge amount of work to do this on a pharmacy level," he said. An additional pharmacist and technician were added to the pharmacy at New Britain General, but no increased staffing was required in Southington, Girouard said.

On Wednesday morning, pharmacy technician Cynthia Hubbard was feeding pills into a machine that packages them individually and stamps a bar code.

"We really believe that all this work is worth it, because medication errors are a big issue," said Frigon. "We believe we'll be cutting down on the number of errors."

Lee, the patient waiting for the hernia procedure, also has diabetes, and takes eight different medications a day, some more than once a day.

Warren keeps track of all this on a portable workstation that includes a computer and attached scanner, and shelves containing the medications for all of her patients. Before, all this information was on paper. Now she can make sure all that information matches the bar code on the identification bracelets of her patients.

"I like it, I think it will prevent a lot of mistakes, but it's an adjustment," said Warren, who has been a nurse for 10 years. "We all have to get used to this."

To help with the transition, the hospital trained what it calls "super users," one for each shift, on the electronic medication administration record system. The hospital also set up an information services command center to monitor the transition.

A backup system, set up in case of power failures, prints out a snapshot of the database every two hours. For New Britain General, that snapshot is a file of nearly 1,800 pages, while Bradley's is a few hundred.

jkurz@record-journal.com

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