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优化高级配药处的工作流程。

Optimising workflow processes in an advanced medication dispensary.

机构信息

Inpatient Pharmacy Services - Foothills Medical Centre, Alberta Health Services, Calgary, Alberta, Canada.

Inpatient Pharmacy Services - Foothills Medical Centre, Alberta Health Services, Calgary, Alberta, Canada.

出版信息

Res Social Adm Pharm. 2018 Nov;14(11):1072-1079. doi: 10.1016/j.sapharm.2017.11.015. Epub 2017 Nov 27.

DOI:10.1016/j.sapharm.2017.11.015
PMID:29203407
Abstract

The workload measurement of an inpatient hospital dispensary is critical to improve efficiency in the face of limited budgets. This single-centre pilot study used work sampling to observe and identify areas to improve efficiency of dispensing prescribed medications at one tertiary level acute care teaching hospital. Workload sampling was conducted at a 1096-bed hospital in Calgary, Alberta, Canada. The dispensary services the entire hospital, 24 h per day, seven days per week. Pharmacists are solely involved in clinical screening. The hospital uses a tech-check-tech practice. The observer was a registered pharmacist who collected data in the dispensary over two-hour blocks during November 14-24, 2017. A pre-made data collection sheet was used to record observations. Pharmacists duplicated tasks performed by dispensary technicians, such as ensuring STAT orders were delivered or identifying floor stock medications. Assistants inconsistently organised orders for filling. The assistant delivering STAT medications was difficult to find. Not all STAT medications were delivered first on a scheduled delivery route. Overall, areas for improvement in the dispensary process may include reinforcing the pharmacist clinical duties, establishing clinical competency baseline, supporting the full scope of practice of registered technicians, and consistent training of assistants, and clarifying communication processes.

摘要

面对有限的预算,提高住院医院药房的工作效率至关重要。这项单中心试点研究使用工作抽样法来观察和确定提高一家三级急症护理教学医院配药效率的方法。工作量抽样在加拿大阿尔伯塔省卡尔加里的一家拥有 1096 张病床的医院进行。该药房每天 24 小时、每周 7 天为整个医院提供服务。药剂师仅参与临床筛选。该医院采用技术检查技术的做法。观察员是一名注册药剂师,他于 2017 年 11 月 14 日至 24 日期间在配药室内每两小时进行一次数据收集。使用预先制作的数据收集表记录观察结果。药剂师复制了配药技术员执行的重复任务,例如确保 STAT 医嘱的送达或识别楼层库存药物。助理配药人员在安排的送药路线上不一致地组织订单。总体而言,配药流程的改进方向可能包括强化药剂师的临床职责、建立临床能力基线、支持注册技术员的全部实践范围、对助理进行持续培训以及明确沟通流程。

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