Karel Lauren I, Delisle Dennis R, Anagnostis Ellena A, Wordell Cindy J
Department of Pharmacy, Thomas Jefferson University Hospital, Philadelphia, PA.
Thomas Jefferson University College of Population Health, Philadelphia, PA.
Am J Health Syst Pharm. 2017 Aug 15;74(16):1245-1252. doi: 10.2146/ajhp160193.
The application of lean methodology in an initiative to redesign the formulary maintenance process at an academic medical center is described.
Maintaining a hospital formulary requires clear communication and coordination among multiple members of the pharmacy department. Using principles of lean methodology, pharmacy department personnel within a multihospital health system launched a multifaceted initiative to optimize formulary management systemwide. The ongoing initiative began with creation of a formulary maintenance redesign committee consisting of pharmacy department personnel with expertise in informatics, automation, purchasing, drug information, and clinical pharmacy services. The committee met regularly and used lean methodology to design a standardized process for management of formulary additions and deletions and changes to medications' formulary status. Through value stream analysis, opportunities for process and performance improvement were identified; staff suggestions on process streamlining were gathered during a series of departmental kaizen events. A standardized template for development and dissemination of monographs associated with formulary additions and status changes was created. In addition, a shared Web-based checklist was developed to facilitate information sharing and timely initiation and completion of tasks involved in formulary status changes, and a permanent formulary maintenance committee was established to monitor and refine the formulary management process.
A clearly defined, standardized process within the pharmacy department was developed for tracking necessary steps in enacting formulary changes to encourage safe and efficient workflow.
描述精益方法在学术医疗中心重新设计处方集维护流程的一项举措中的应用。
维护医院处方集需要药房部门的多名成员之间进行清晰的沟通与协调。利用精益方法的原则，一个多医院医疗系统内的药房部门人员发起了一项多方面的举措，以在全系统范围内优化处方集管理。这项正在进行的举措始于成立一个由在信息学、自动化、采购、药物信息和临床药学服务方面具有专业知识的药房部门人员组成的处方集维护重新设计委员会。该委员会定期开会，并使用精益方法设计了一个标准化流程，用于管理处方集的增减以及药物处方集状态的变更。通过价值流分析，确定了流程和绩效改进的机会；在一系列部门改善活动中收集了员工关于简化流程的建议。创建了一个用于开发和传播与处方集增加及状态变更相关的专论的标准化模板。此外，还开发了一个基于网络的共享清单，以促进信息共享以及及时启动和完成处方集状态变更所涉及的任务，并设立了一个常设处方集维护委员会来监督和完善处方集管理流程。
药房部门制定了一个明确界定的标准化流程，用于跟踪制定处方集变更时的必要步骤，以鼓励安全高效的工作流程。
