“With my background in family medicine, emergency medicine was not difficult to learn, but in the early 1980’s we were terrified when an acutely ill or injured child came into the emergency room. There were no tools to treat a child then and everyone struggled.” Dr. James Broselow, founder of eBroselow, admits he never set out to save the world, but recognized the need to develop a reliable tool to help solve preventable patient death, the third leading cause of death in the United States today. Much like the Broselow Tape, Dr. Broselow’s SafeDose Scan, improves preventable patient death and significantly reduces medication error amongst the pediatric patient population. SafeDose Scan is a valuable solution for medication safety, emergency medicine, and improves the quality of our healthcare system as a whole.
PSMF: Introduce yourself and how your career in pediatrics started.
BROSELOW: My name is James Broselow. My career initially started as a family doctor. In 1983 I started moonlighting in the emergency department and enjoyed it, so I switched careers and started working full-time at a small community hospital. The community hospital was not very busy, so I had the time and opportunity to study my new role in emergency medicine. It was not long before I became comfortable treating adults in the emergency department…but kids were different. I don’t remember ever being as nervous as I was when I faced my first critically ill child. There was so much on the line and everyone else was just as nervous as I was! I clearly needed help, or a “tool” of some kind. Not long after, the Broselow Tape and Color-Coded Crash Carts were born.
PSMF: How did the development of your concept the, Broselow Tape, begin?
BROSELOW: I was convinced the answer was some kind of tape measure that measured dose rather than length, but I had to prove that it actually worked. So, I set out to do a case study using several pediatric offices in rural North Carolina to test my ideas. The first step was to make a prototype tape. I used the height and weight table from my Nelson’s text book as a reference. My neighbor, a CPA who had a computer at the time, turned my table into length zones. Then, I sent the data I had collected to Lenoir-Rhyne University, our home college in North Carolina, and the head of statistics took the data on as a course project. When PALS (Promoting Active Learning and Service) faculty did a large national study, the data I had submitted had held up. The evidence that length could predict emergency doses in children was there, which laid the foundation for the Broselow tape. Soon after, I partnered with
Bob Luten, a PALS faculty member, and Allen Hinkle, a pediatric anesthesiologist. We proved that length could also predict equipment size and ultimately used that concept to develop the matching coded color- crash carts.
PSMF: As inventor of the Broselow tape, what influenced your decision to take your innovation and use it to develop an electronic drug dosing and tracking system?
BROSELOW: I kiddingly always say, “I didn’t invent the Broselow tape, the Broselow tape invented me!” I had learned an important lesson; I learned that it was possible to standardize one small, but important, aspect of emergency medicine. The tape opened up many opportunities, and ultimately led to the start of my new company, eBroselow. eBroselow is focused on using technology to expand safety, way beyond the limitations implicit in writing information in a small box, on a tape measure. To really scale the tape concept, it had to go digital. The need for technology came in because human error is inevitable. Every study out there proves it.
PSMF: How did your idea to turn the Broselow Tape into an easy to use a web application, SafeDose Scan, initially take shape?
BROSELOW: The analogy I use to explain the concept behind SafeDose Scan starts at the Supermarket. If properly trained, a supermarket’s staff knows food pricing and what is on sale, yet they never do math or memorize the prices. They simply scan the can of soup and there it is… transparent to everyone. Why not apply that same concept to safeguard medication administration? A device, that to a similar degree, scans a barcode, does math for you, and never makes an error? It is used every day in supermarkets, why don’t we have a logical solution in healthcare that does the same? Now let me ask you a question, when a child’s life is on the line, would you rather do the math in your head or use a scanner that spits out an accurate dosage within seconds?
PSMF: You received second place in last year’s 2016 Patient Safety Innovation Awards for identifying an area in dire need for improvement and creating a product that has positively changed the quality of medication administration and the treatment of pediatric patients, what’s next?
BROSELOW: I have to say, the work I have done is only a microcosm of what the Patient Safety Movement Foundation is doing. The Movement has brought together an engaged and multi-faceted group of passionate individuals who are all after the same end goal; to provide safe, high quality and resilient care to patients and reach zero preventable deaths by 2020 (0X2020). We can solve preventable patient death with simple tools and information we already have. My focus is to support the Patient Safety Movement Foundation’s efforts in my role as a Patient Safety Movement Foundation Ambassador for Pediatrics. In this role, I plan to spread awareness on simple, existing tools that offer valuable solutions to eliminate errors and avoidable death. I encourage healthcare systems and all stakeholders to make use of these existing best practices and to join us on the journey to zero.