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提高基层医疗中电子处方的使用率。

Increasing the uptake of electronic prescribing in primary care.

作者信息

Imambaccus Nazia, Glace Samuel, Heath Rory

机构信息

Kings College London, UK.

出版信息

BMJ Qual Improv Rep. 2017 May 25;6(1). doi: 10.1136/bmjquality.u212185.w4870. eCollection 2017.

Abstract

Electronic prescribing is a form of paperless prescribing that is reported to reduce prescription mistakes and increases the cost effectiveness of the process. In England, around 1.5 million prescriptions are generated in general practice daily. Thus by reducing costs and increasing efficiency of this system through electronic prescribing, costs can be driven down. In this Quality Improvement project, a GP practice in London with approximately 3000 patients on record was assessed for its electronic prescribing rates throughout 3 intervention cycles over a period of 2 months. A baseline value of how many patients were already assigned to electronic prescribing was obtained and a period of normal change over a fortnight without any intervention was also assessed (an increase in 15 patients). These values were then used to illustrate any benefits of the interventions completed during the intervention cycles. An introduction of a new electronic prescribing form saw fortnightly uptake rates increase by 20%. The addition of leaflets and posters in the practice produced a decrease of 26% in fortnightly uptake rate. The final intervention included a staff meeting, computer notes to remind staff of electronic prescribing and attaching the new forms to paper prescriptions. This saw an increase in rates of 80% over two weeks. Overall, this project has illustrated that information provision of electronic prescribing needs to be more than just forms or posters. Indeed, the most effective way of improving rates relies on having a driven and motivated staff who are themselves well informed on electronic prescribing alongside adequate information placement for patients to access.

摘要

电子处方是无纸化处方的一种形式,据报道它能减少处方错误并提高流程的成本效益。在英国,全科医疗每天大约会开出150万张处方。因此,通过电子处方降低该系统的成本并提高效率,可以降低费用。在这个质量改进项目中,对伦敦一家记录了约3000名患者的全科诊所进行了评估,在为期2个月的3个干预周期内评估其电子处方使用率。获取了已分配电子处方的患者数量的基线值,并评估了在没有任何干预的情况下两周内的正常变化情况(增加了15名患者)。然后用这些值来说明在干预周期内完成的干预措施的任何益处。引入一种新的电子处方表格后,两周的采用率提高了20%。在诊所内增加传单和海报后,两周的采用率下降了26%。最后的干预措施包括召开一次员工会议、在电脑记录中提醒员工电子处方事宜以及将新表格附在纸质处方上。这使得两周内使用率提高了80%。总体而言,该项目表明,电子处方的信息提供不仅仅是表格或海报。事实上,提高使用率的最有效方法依赖于有一支积极主动且了解电子处方的员工队伍,同时为患者提供足够的信息以便他们获取。

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