Patient Safety and Medication Management in Operating Rooms

From left: Amrita Gujral, Pharmacy Manager, Ann Itwaru, Surgical Services Manager, and Jacqueline Stokes, Project Management Lead, show the new equipment inside one of Headwaters Health Care Centre's operating rooms.


As one of the first hospitals in Ontario, Headwaters Health Care Centre in Orangeville has recently transformed and improved patient safety by streamlining its medical management system. This transformation included the adoption of BD Pyxis™ Anesthesia Station ES (PAS) and the Codonics Safe Label System (SLS) in Headwaters' Operating Rooms (ORs).

The PAS gives anesthesiologists quick and secure access to medication for a patient during a case. The SLS uses barcode technology to read information from a drug container and electronically verify it against the hospital's pharmacy-approved formulary database at the point of care. In addition, full-colour labels customized to the needs of each site's formulary meet global patient safety and quality standards, such as The Joint Commission.

“With the integration of PAS and SLS, we are taking a proactive approach to enhancing patient safety in our ORs," said Amrita Gujral, Manager of Pharmacy at Headwaters Health Care Centre. “With real-time medication verification and labelling, we reduce the risk of medication errors and safeguard patient well-being during surgical procedures."

The recently introduced technologies not only bolster patient safety but also support staff and physicians by automating medication management processes and streamlining workflows. As a result, Headwaters' OR may see a reduction in the need for manual interventions, allocates resources more effectively, and ensures that staff can deliver timely and attentive care to every patient, even during periods of high demand. Since data is derived from these systems, it also provides an additional layer of insight into medication usage patterns, enabling Headwaters to make even more insi​ghtful clinical decisions. 

With the introduction of any new technology or system, change management is a key consideration.

“As early adopters of these technologies, we've been asked to share lessons learned with our hospital peers. We're continuously learning from our change management journey, especially as we navigate innovation hurdles and support all users with adoption," said Jacqueline Stokes, Project Manager.

The implementation required robust stakeholder engagement at administrative and clinical levels, coupled with rigorous operational management and extensive training to ensure seamless integration and potential risk mitigation protocols. Yet, the hospital's unwavering commitment to patient safety and quality care spurred the team to navigate challenges inherent in early adoption.

“One year ago, Headwaters embarked on a hospital-wide transformation to automate our entire medical management system," says Cathy van Leipsig, Vice President of Corporate Services and CFO at Headwaters Health Care Centre. “Since patient safety is further advanced by real-time medication data capture and workflow improvements, our clinical decisions have been sharpened. Motivated by patient safety and quality care improvements, the team showed courage and passion to navigate the challenges common to early adopters."

​Ultimately, Headwaters' change management resiliency symbolizes more than just a technological upgrade. It signifies a deep-rooted commitment to pushing boundaries and reshaping patient care. By embracing transformation, Headwaters is advancing its mission to achieve even greater levels of safety, quality care and patient experience within Ontario's healthcare landscape.