Increasing the use of Barcode Medication Scanning Technology in nursing staff

Medication errors can lead to a significant impact on clinical outcomes. Barcode Medication Administration (BCMA) technology was rolled out across Imperial College Healthcare NHS Trust in 2019, but uptake has been much lower than desired, with some wards only using the technology to scan 10% (or less) of scannable medication.
The Change Lab undertook a large piece of qualitative work to understand the barriers to using the technology. This involved interviewing nursing staff and patients across three wards at Charing Cross Hospital in London.
This identified barriers including:
- Lack of leadership and accountability
- Poor ergonomics of the BCMA trolley
- Low perceived time-efficiency

This qualitative work was used to inform two intervention design workshops with key stakeholders and frontline users, rating intervention ideas according to potential feasibility and impact.


Potential interventions were co-designed over a series of workshops. The co-design group included: Frontline staff, subject matter experts, Behavioural Scientists and Designers.

Through this process we generated over 100 ideas, which were evaluated and designed using behavioural science frameworks and the behaviour change wheel.
Shortlisted designs were re-reviewed and refined using impact and feasibility criteria - ensuring our final intervention was likely to create behaviour change, and also be suitable for scale.

This led to the development of a feedback intervention with two components, utilising three behavioural science constructs: the messenger effect, gamification and gain-framing.

We trialled our intervention on five wards, using the remainder of the hospital as a control. The intervention was live for 18 weeks, and a difference in difference analysis demonstrated a 23% increase in scanning rates as a result of our intervention.