Jahn Michelle A, Caldwell Barrett S
a School of Industrial Engineering , Purdue University , West Lafayette , IN , USA.
Ergonomics. 2018 Jan;61(1):69-81. doi: 10.1080/00140139.2017.1353136. Epub 2017 Jul 13.
As the expansion and utilisation of community pharmacy systems increases, so does the risk for an adverse drug event to occur. In attempts to mitigate this risk, many community pharmacies implement health information technology (IT); however, there are challenges in integrating the wider systems components necessary for a successful implementation with minimal unintended consequences. The purpose of this paper is to introduce a Community Health Integration through Pharmacy Process and Ergonomics Redesign (CHIPPER) framework, which explores the multiple angles of health IT integration to support medication delivery processes in community pharmacy systems. Specifically, CHIPPER identifies the information flows that occur between different parts of the system (initiation, upstream, midstream and downstream) with varying end-users and tasks related to medication delivery processes. In addition to the justification and presentation of the CHIPPER model, this paper reviews several broad applications for CHIPPER and presents two example studies that demonstrate the CHIPPER framework. Practitioner Summary: Most medication delivery in the US occurs through outpatient-based community pharmacy practice. Community pharmacies are challenged by inconsistent and incomplete information flow and technology integration between providers, pharmacy practitioners and patients. This paper presents a framework for improved healthcare systems engineering analysis of pharmacy practice, with case study examples.
随着社区药房系统的扩展和使用增加，发生药物不良事件的风险也随之上升。为了降低这种风险，许多社区药房采用了健康信息技术（IT）；然而，要将成功实施所需的更广泛系统组件进行整合，并将意外后果降至最低，仍面临挑战。本文旨在介绍一种通过药房流程和人机工程学重新设计实现社区健康整合（CHIPPER）的框架，该框架从多个角度探索健康IT整合，以支持社区药房系统中的药物配送流程。具体而言，CHIPPER识别了系统不同部分（起始、上游、中游和下游）之间发生的信息流，这些信息流涉及不同的最终用户以及与药物配送流程相关的任务。除了对CHIPPER模型进行论证和介绍外，本文还回顾了CHIPPER的几个广泛应用，并展示了两个实例研究以阐明CHIPPER框架。从业者总结：美国的大多数药物配送是通过基于门诊的社区药房实践进行的。社区药房面临着供应商、药房从业者和患者之间信息流不一致和不完整以及技术整合方面的挑战。本文提出了一个用于改进药房实践的医疗系统工程分析框架，并给出了案例研究示例。
