Photo (l to r): Megan Hawkins, PharmD and Abby Skoglund, RN
JEFFERSON, Iowa – A simple observation led to a meaningful improvement in patient safety at Greene County Medical Center. That observation, “100% is not good enough.”
Megan Hawkins, Pharmacy Director, and Abby Skoglund, Director of Acute Care and ED, recently received recognition for their work improving Medication Administration Record (MAR) barcode compliance at the Compass Healthcare Collaborative 2026 Patient Safety Conference. Their project, “MAR Barcode Compliance: When 100% Isn’t Good Enough,” highlighted how teamwork, communication and problem-solving can make care safer for patients.
Barcode scanning of patients and medications helps ensure the nursing team is documenting the “Five Rights” of: drug, dose, route, time and person. While Greene County Medical Center already had strong compliance in the upper 95th percentile, Hawkins and Skoglund saw an opportunity to continue improving. “When you look at the numbers, even a small percentage can represent quite a few missed opportunities,” Hawkins said.
The biggest improvements came from understanding the challenges nurses faced at the bedside. Skoglund worked directly with her team to identify barriers, including equipment issues and medication labeling concerns, and partnered with pharmacy to find solutions. “We talked to every nurse and asked what their barriers were to not scanning,” Skoglund explained. “From that, we found things we could help fix.” Hawkins and Skoglund also noticed their scanning report was rounding to the nearest whole number, so 99.6% was being reported at 100%. “That is when we decided 100% was not good enough if scans were still being missed,” Skoglund said.
The results have been significant. Missed patient scans decreased from 97 in the first quarter of 2023 to just 2 by the end of the third quarter of 2026. Missed medication scans went from 147 missed to just 6. The process has since expanded beyond acute care to additional areas throughout the medical center. “This wasn’t a win for Abby and me,” Hawkins said. “It was a nursing and pharmacy team effort. They embraced it, took ownership and made sure their patients were safe.”
The project earned Greene County Medical Center recognition at the conference, a trophy and a $500 award to support future patient safety initiatives. “We were surprised to win, but we are glad that we did something that will really have a positive impact on patient safety,” Skoglund said.
This accomplishment reflects the commitment of the entire Greene County Medical Center Team to continuously improve care for every patient. For Hawkins and Skoglund, the recognition was never about the award, it was about the people behind the work and the patients who benefit from it. “Our goal is to make sure our patients are safe,” Hawkins said. “And it is our Team that makes sure this happens.”