01.02.01. Patient identification
All patients are positively identified with two patient identifiers prior to initiating a procedure, test, or treatment
Importance of patient identification
- Patient identification is the process of “correctly matching a patient to appropriately intended interventions and communicating information about the patient’s identity accurately and reliably throughout the continuum of care” (p. 4).1
- Patient identification encompasses not only the physical identification of the patient but also technologies abled to enhance the accuracy of patient identification, such as barcodes, referential matching software, biometric identification technologies and radio frequency identification.2
- Patient identification errors are preventable and can occur in every healthcare setting, including diagnostic imaging.2,3
- Patient identification errors can be classified into three categories: i) incorrect patient identification (e.g., misidentification of name, documents and health card), ii) incorrect body part identification (e.g., imaging or treating right side of body versus left side), and iii) use of biological materials from the wrong patient (e.g., inappropriate analysis of pathological specimens).4
- Root causes for patient misidentification can include2:
- time pressure
- insufficient training and awareness
- duplicate medical records
- lack of communication between departments
- inadequate safety procedures
- over-reliance on own identification systems
- Failure to accurately identify patients raises safety and quality of care concerns across the care continuum, from diagnostic testing to treatment.1,3
- In one such critical incident, “the wrong patient was taken to the radiology department for a magnetic resonance imaging exam with general anesthesia. The patient was intubated and sedated before the error was caught” (p. 7).1
- Lack of accurate patient identification can affect clinical decision-making, treatment, patient outcomes, and patient privacy. Also, there is a risk of duplicating tests unnecessarily and increased organization costs.1
- Inaccurate data resulting from a patient misidentification can cascade into a multitude of internal and external systems and databases such as laboratory, radiology and health information networks, potentially leading to laboratory, imaging, and medication errors as well as wrong-site surgeries.1
Patient identification in practice
- An MRT must assume responsibility for ensuring that each patient is appropriately identified prior to performing any procedure, test or treatment.5
- It is the primary responsibility of each healthcare worker to check the identity of a patient and match the correct patient with the correct care before that care is administered (e.g., diagnostic procedure).6
- Accreditation Canada cites, as a required organizational practice (ROP), that at least two person-specific identifiers are to be used to confirm a patient receives the procedure, test or treatment intended for them.7
- An ROP is defined as an essential practice that organizations must have in place to enhance patient safety and minimize risk.7
- In order to receive accreditation, organizations are assessed for compliance during on-site surveys, therefore MRTs must act in accordance with applicable standards from Accreditation Canada and organizations must ensure MRTs are trained and comply with the process.7
- Patient identification is done in partnership with patients and their families by explaining the risks related to patient misidentification and asking them for the two identifiers.6,7
- The identifiers obtained need to be specific to the patient:
- Patient’s full name and date of birth constitute two valid identifiers.6,7
- Medical record number, accurate patient photograph, home address, health card number, client barcode and patient wristband are also valid identifiers.7
- Identifiers that are not person-specific, cannot be used. For example, the use of a room number would not be considered an example of a unique patient identifier.8
- When patients and families are not able to provide information, other sources of identifiers can include wristbands, health records, or government-issued identification.7
- Two identifiers may be taken from the same source.
- MRTs must verify the patient identifiers against all requests to ensure the procedure, test or treatment is provided to the correct patient.6
- MRTs should obtain patient identification information using open-ended questions where the individual is required to state the information rather than it being provided to the individual.9
- For example: “What is your date of birth?” as opposed to “Is your date of birth January 1, 1950?”
References
- ECRI Institute. Patient Identification: Executive Summary. Published online August 2016. Accessed January 5, 2022. https://www.ecri.org/Resources/Whitepapers_and_reports/PSO%20Deep%20Dives/Deep%20Dive_PT_ID_2016_exec%20summary.pdf
- Riplinger L, Piera-Jiménez J, Dooling JP. Patient Identification Techniques – Approaches, Implications, and Findings. Yearb Med Inform. 2020;29(1):81-86. doi:10.1055/s-0040-1701984
- Kim T, Howe J, Franklin E, et al. Health Information Technology–Related Wrong-Patient Errors: Context is Critical. Patient Saf. 2020;2(4):40-57. doi:10.33940/data/2020.12.3
- De Rezende HA, Melleiro MM, Shimoda GT. Interventions to reduce patient identification errors in the hospital setting: a systematic review protocol. JBI Evid Synth. 2019;17(1):37-42. doi:10.11124/JBISRIR-2017-003895
- Canadian Association of Medical Radiation Technologists. National Competency Profiles. Accessed January 5, 2022. https://www.camrt.ca/certification-4/current-competency-profiles/
- World Health Organization. Patient Identification. Patient Saf Solut. 2007;1(2):1-4.
- Accreditation Canada. Required Organizational Practices: 2020 Handbook. Published online 2020. Accessed January 5, 2022. https://src.healthpei.ca/sites/src.healthpei.ca/files/Accreditation/Accreditation_Canada_Required_Organizational_Practices_Handbook.pdf
- The Joint Commission. Two Patient Identifiers – Understanding the Requirements. Published October 19, 2021. Accessed January 5, 2022. https://www.jointcommission.org/standards/standard-faqs/ambulatory/national-patient-safety-goals-npsg/000001545/
- Ortiz J, Amatucci C. A case of mistaken identity: Staff input on patient ID errors. Nurs Manag (Harrow). 2009;40(4):37-41. doi:10.1097/01.NUMA.0000349689.98615.6d
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