Gentry A F, Fudge K A, Wellman G, Sherrin T P, Sturek J K, Thompson R L
Riverside Methodist Hospital, Columbus, OH.
Top Hosp Pharm Manage. 1991 Jul;11(2):18-30.
A comprehensive program has been developed to evaluate prescribing practices in diverse drug therapy categories and in all areas of the institution. Input for topic selection comes not only from the pharmacy department, but also from QA, medical staff, and nursing. The development of monitoring criteria and review of the results by the P&T Committee, Medical Executive Committee, and other key medical staff members, promotes ownership of the program by the medical staff. The benefit of this ownership is active support for the program and participation in peer review. Overall, the results of this cost-effective program include limited use of broad spectrum antibiotics, select prescribing of high-risk drugs, and focused educational efforts to improve quality of patient care. The primary goal for the future of the program is to develop criteria and documentation mechanisms for reporting measurable clinical outcomes. In making the transition, it is important to use the success and impact of the current program as the foundation. This is particularly true for the concurrent monitoring program and its immediate feedback mechanism. The major challenge will be evaluating negative clinical outcomes and developing corrective actions as well as documenting the positive outcomes and the avoidance of negative outcomes of the current program. To meet this challenge, the DUE program must be integrated with all other institutional QA programs. Although a difficult task, this is a significant yet necessary step in the right direction for assuring optimal patient care.
已制定一项综合计划，以评估该机构各个领域不同药物治疗类别的处方行为。选题的意见不仅来自药房部门，还来自质量保证部门、医务人员和护理人员。药事与治疗委员会、医疗执行委员会及其他关键医务人员制定监测标准并审查结果，这促进了医务人员对该计划的主导权。这种主导权的好处是对该计划的积极支持以及参与同行评审。总体而言，这个具有成本效益的计划的成果包括广谱抗生素使用受限、高风险药物的选择性处方以及为提高患者护理质量而开展的有针对性的教育工作。该计划未来的主要目标是制定用于报告可衡量临床结果的标准和记录机制。在进行转变时，将当前计划的成功和影响作为基础很重要。对于并行监测计划及其即时反馈机制来说尤其如此。主要挑战将是评估负面临床结果并制定纠正措施，以及记录当前计划的积极结果和避免负面结果。为应对这一挑战，药物使用评价计划必须与所有其他机构质量保证计划相结合。尽管这是一项艰巨的任务，但这是朝着确保最佳患者护理方向迈出的重要且必要的一步。
