Improving the consistency and efficiency of auxiliary labeling using EHR-integrated color printing technology

Manual application of auxiliary labels to compounded sterile preparations (CSPs) can introduce variability, workflow inefficiencies, and risk for omitted safety information. This article describes the design, implementation, and evaluation of electronic health record (EHR)-integrated color auxiliary labels to improve labeling accuracy, consistency, and operational efficiency in a pediatric institution.

Automated color auxiliary labels were embedded within EHR post-verification labels for CSPs across 3 pharmacy settings. The intervention included printer and label stock selection, standardized label design with prioritization logic, EHR rule development, medication record validation, and phased hardware deployment. Pre- and postimplementation surveys assessed perceptions of labeling accuracy and workflow impact. Operational metrics included estimated technician time savings, supply utilization, and cost analysis.

Automation eliminated a manual labeling step, averaging an estimated 12.5 seconds per dispense, corresponding to approximately 38 technician hours per month (0.22 full-time equivalents). Staff confidence in accurate auxiliary label application improved, with the frequency of low-confidence responses declining from 20% before implementation to 6.1% after implementation. The automated label logic standardized placement and reduced variability associated with manual processes. Implementation required capital investment for color printers and increased the annual label cost by approximately 29%. Postimplementation monitoring demonstrated stable supply utilization, which was below initial projections.

Integration of automated color auxiliary labels within the EHR improved workflow efficiency, enhanced labeling consistency, and increased staff confidence with minimal cost implications. This offers a practical framework for health systems seeking to standardize labeling without major EHR infrastructure changes.