Complexities and capabilities of Scan4Safety in NHS hospitals: a qualitative study of a national demonstrator site

Background: Data standards and barcoding technologies are implemented in hospitals to uniquely identify objects, people and locations, streamline the management of supplies and inventories, improve efficiency, reduce waste and improve patient safety and quality of care. The UK Department of Health & Social Care Scan4Safety demonstrator programme (2016-2019) had six hospitals adopt global data standards to address these aims. This study examined the implementation of Scan4Safety at one NHS demonstrator site to understand the hospital experience of adopting these standards, barcoding and related technologies. Methods: Exploratory case study design, informed by information infrastructure theory, at one Scan4Safety demonstrator site. Semi-structured interviews were conducted with internal and external stakeholders, analysed thematically together with thematic analysis of documents related to the Scan4Safety programme. Results: The NHS Trust Scan4Safety team was interviewed, together with senior roles in procurement, inventory, recalls management, nurses and surgeons (n=15), and senior roles in other demonstrator sites, NHS supplies, as well as GS1 - the organization responsible for the standards (n=4); 67 documents were analysed. Key enablers for Scan4Safety included: allocated funding, government role/regulation, executive buy-in/wide stakeholder involvement, patient focus, agile/adaptive approach and data linkage. Challenges were both internal and external, mainly pertaining to data quality, work-as-done, and trade-offs. Mechanisms of anticipated positive outcomes, and potential risks were also identified. Conclusions: Linked standards for identification of patients, products, places, and procedures, across supplies and hospital processes, constitute a wide-ranging information infrastructure with the potential for significant value to patients and the whole health system.