Automating Healthcare
Solving business problems with savvy automation

Code Cart Tracking

Business problem
Anyone who has spent much time in acute-care hospitals is familiar with "Code Blue," the term used in many hospitals for a patient requiring immediate rescuscitation, most frequently as the result of a respiratory or cardiac arrest. "Code carts" are kept throughout the hospital, ensuring that vital equipment and supplies are always readily available. Keeping these carts fully stocked with up-to-date supplies and equipment is a major challenge. We needed a process to:

  • identify everything that should be on each cart,
  • track expiration dates where applicable, and
  • help manage the updating process.

First, fix the process
Before automating anything, the underlying process needed an overhaul:

  • No standardization of carts (and contents) into categories
  • Poor documentation of contents
  • Inconsistent documentation of cart usage
  • Inconsistent process for restocking contents

Several process issues were addressed at the same time that automated code cart tracking was implemented, with the following steps:

  • Assign each cart its own ID
  • Assign each location its own ID
  • Secure each cart with a uniquely identifiable lock
  • Standardize cart components, including expiration dates
  • Ensure that all necessary items are stored together
  • Rearrange carts to ensure consistency and ease of access
  • Standardize equipment (defibrillators and AEDs)
  • Simplify carts by removing non-essential items
  • Streamlined restocking of carts by simply swapping with central supply for a fresh drawer or cart

Automating the process
The top priorities for automating the process were:

  • Easy-to-use process to identify and track every item in every cart
  • Automated reminders whenever items approach an expiration date

The tracking process is very simple. Just select a cart and edit the cart or its contents. The default screen shows a list of all carts by name (shown below).

Alternatively, a location may be selected, and only the cart(s) in that department will be displayed (shown below).

Selecting a cart displays the full details. All information can be edited and saved (click the image below to see the full details for the selected cart).

[Click the image above to see the full size image]

A selection of reports is available for clinical and central supply managers (see list below).

Full Report
The full Excel report provides a complete list of all items in all carts, including expiration dates where applicable (click the image below to see the full size image).

[Click the image above to see the full size image]

Full Report
The printable report is rendered as a Web page to make it more easily printable. It is otherwise identical to the Excel report above (click the image below to see the full size image).

[Click the image above to see the full size image]

Report by Expiration

Exception reports are essential for managing any process. Code Cart Tracking provides four variations of a report listing items with near-term expiration dates (shown below).

The report is simply a list of items (click the image below to see the full size image).

[Click the image above to see the full size image]

Change Reasons Report

An audit trail documents the reason why each item was replaced, and the Change Reasons report lists all data (click the image below to see the full size image).

[Click the image above to see the full size image]

Managing the building blocks
Code cart tracking is built with several essential sets of data:

  • Code carts
  • Cart containers
  • Cart types
  • Locations
  • Items
  • Item change reasons

These lists are maintained by central supply staff, using several forms.

First is the list of carts. Each cart is configured by selecting a hospital-specific cart type and a location (shown below).

Each cart has a set of "containers" located in specific places on the cart (shown below).

Each cart also has a list of items. This list is updated by selecting the item name, then selecting the cart container, and finally inputting the quantity for that item (shown below).

The list of locations is a basic building block (shown below).

The list of possible inventory items is another basic building block (shown below).

Finally, a list of reasons for replacing any item (shown below).

Cart Maintenance
Anytime a cart is used or opened, all components are reviewed for expiration dates in the next 90 days, and a new, unique lock is installed.

Automated Reminders

  • On the first of each month, an automated reminder is e-mailed to central supply staff, listing all carts with any item expiration date within the next 31 days.
  • A daily reminder is e-mailed to central supply staff for any cart with any item expiration date on that date or earlier (expired).


  • Cart maintenance is excellent, by all accounts.
  • Two Joint Commission inspections have found no issues with code carts since implementation of this process.

Lessons learned

  • The most successful applications are those which solve an urgent problem and have a motivated sponsor in operations. This process met both criteria and has been very successful for several years.

Posted 25 November 2008


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