Newell Terry L, Steinmetz-Malato Laura L, Van Dyke Deborah L
Operational Improvement Department at Spectrum Health Hospital Group in Grand Rapids, MI, USA.
J Healthc Qual. 2011 Mar-Apr;33(2):15-22. doi: 10.1111/j.1945-1474.2010.00104.x.
The inpatient medication delivery system used at a large regional acute care hospital in the Midwest had become antiquated and inefficient. The existing 24-hr medication cart-fill exchange process with delivery to the patients' bedside did not always provide ordered medications to the nursing units when they were needed. In 2007 the principles of the Toyota Production System (TPS) were applied to the system. Project objectives were to improve medication safety and reduce the time needed for nurses to retrieve patient medications. A multidisciplinary team was formed that included representatives from nursing, pharmacy, informatics, quality, and various operational support departments. Team members were educated and trained in the tools and techniques of TPS, and then designed and implemented a new pull system benchmarking the TPS Ideal State model. The newly installed process, providing just-in-time medication availability, has measurably improved delivery processes as well as patient safety and satisfaction. Other positive outcomes have included improved nursing satisfaction, reduced nursing wait time for delivered medications, and improved efficiency in the pharmacy. After a successful pilot on two nursing units, the system is being extended to the rest of the hospital.
美国中西部一家大型地区急症医院所使用的住院药物配送系统已变得陈旧且效率低下。现有的24小时药物推车装填更换流程以及将药物送到患者床边的做法，并不总能在护理单元需要时提供所需的医嘱药物。2007年，丰田生产系统（TPS）的原则被应用于该系统。项目目标是提高用药安全性，并减少护士获取患者药物所需的时间。一个多学科团队成立了，成员包括护理、药学、信息学、质量以及各个运营支持部门的代表。团队成员接受了TPS工具和技术的教育与培训，然后设计并实施了一个以TPS理想状态模型为基准的新拉动系统。新安装的流程实现了即时药物供应，显著改善了配送流程以及患者安全与满意度。其他积极成果还包括提高了护理满意度、减少了护士等待药物送达的时间，以及提高了药房的效率。在两个护理单元成功试点后，该系统正在推广至医院的其他部门。
