J Am Pharm Assoc (2003). 2019 Mar-Apr;59(2):222-227. doi: 10.1016/j.japh.2018.12.015. Epub 2019 Feb 8.
The aim of this time and motion study was to evaluate the procedural time and steps of performing an oral hormonal contraceptive pharmacist prescribing service in an Oregon community pharmacy.
A standardized patient seeking oral hormonal contraception visited 13 community pharmacies throughout February 2018 in the tri-county Portland, Oregon, metropolitan area for pharmacist-prescribed hormonal contraception services for a total of 26 patient encounters. An observer was present at each encounter to record the time for each step and the total encounter time. Each pharmacist was asked to perform assessment procedures and prescribing for each of 2 standardized patient presentations: in cohort 1 (n = 13), the pharmacist's assessment resulted in a hormonal contraception prescription written; in cohort 2 (n = 13), pharmacist's assessment detected contraindications and resulted in a medical referral to another health care prescriber.
The average total patient time from arrival at the pharmacy to the generation of either a written prescription for hormonal contraception or referral to another health care provider was 17.9 and 14.1 minutes, respectively. Without accounting for documentation or dispensing the prescription, the average total pharmacist time to perform the service and issue a prescription, or refer the patient, was 7.8 and 5.4 minutes, respectively.
The results indicate that the pharmacist prescribing service for oral hormonal contraception requires a modest amount of pharmacist time. Incorporation of practice into regular workflow appears to have an impact similar to other clinical services, such as immunizations and point-of-care testing. The patient time spent with the pharmacist was similar to other health care provider visits.
本时间与动作研究旨在评估在俄勒冈州社区药房中提供口服激素避孕药的药剂师处方服务的程序时间和步骤。
一名标准患者在 2018 年 2 月期间前往俄勒冈州波特兰市三县地区的 13 家社区药房,总共进行了 26 次患者就诊,以获得药剂师开具的激素避孕药服务。每次就诊都有一名观察员在场,记录每个步骤的时间和总就诊时间。每位药剂师被要求为 2 名标准患者进行评估程序和处方:在队列 1(n=13)中,药剂师的评估导致开出激素避孕药处方;在队列 2(n=13)中,药剂师的评估发现禁忌症,并导致将患者转介给另一位医疗保健开方者。
从患者到达药房到生成激素避孕药处方或转介给另一位医疗保健提供者的平均总患者时间分别为 17.9 分钟和 14.1 分钟。不考虑文件记录或配药,药剂师执行服务并开具处方或转介患者的平均总时间分别为 7.8 分钟和 5.4 分钟。
结果表明,口服激素避孕药的药剂师处方服务需要相当数量的药剂师时间。将实践纳入常规工作流程似乎对其他临床服务(如免疫接种和即时检测)产生了类似的影响。患者与药剂师的就诊时间与其他医疗保健提供者的就诊时间相似。