Pharmacy Services, University of Utah Health, Salt Lake City, UT.
Division of Pharmaceutical Outcomes and Policy, The University of North Carolina at Chapel Hill, Asheville, NC.
Am J Health Syst Pharm. 2019 Feb 21;76(6):360-365. doi: 10.1093/ajhp/zxy071.
This study evaluated employee perceptions of safety culture in 9 health-system-owned community pharmacies using a safety culture survey before and after implementation of a Pharmacy Services Call Center (PSCC) designed to reduce distractions through reduction of phone volume related to refills and prescription readiness.
The Agency for Healthcare Research and Quality (AHRQ) Community Pharmacy Survey on Patient Safety Culture (CPSPSC) was used to collect employee safety culture perceptions pre-post PSCC implementation. A percent positive score (PPS) was calculated for each of 11 CPSPSC composite questions and for 1 overall rating of patient safety question based on AHRQ-suggested analytic procedures. Pre-post PSCC implementation, PPSs were compared using a chi-square test.
Overall, the lowest composite PPS (Staffing, Work Pressure, and Pace) and the highest composite PPS (Patient Counseling) ranked the same in both survey periods. Of the nine PSCC pharmacies, statistically significant (p < 0.05) PPS improvements occurred in 4 composites including Teamwork (11.9%), Communication About Mistakes (18%), Staff Training and Skills (20.6%), and Staffing, Work Pressure, and Pace (11.8%). PSCC pharmacies also reported a 9.3% (NS) improvement in overall rating of pharmacy patient safety post PSCC implementation. Separate analysis of pharmacist responses was consistent with pharmacy level results, but technician results differed slightly in overall rating of safety perceptions.
Presence of the PSCC appeared to increase pharmacy employees' perceptions of safety culture in the community pharmacies, an integral part of overall patient safety.
本研究通过一项安全文化调查评估了 9 家医疗系统拥有的社区药店员工对安全文化的看法,该调查在实施药房服务呼叫中心 (PSCC) 前后进行,旨在通过减少与 refill 和处方准备相关的电话量来减少干扰。
使用医疗保健研究和质量署 (AHRQ) 社区药房患者安全文化调查 (CPSPSC) 收集实施 PSCC 前后员工安全文化感知的相关数据。根据 AHRQ 建议的分析程序,针对 11 个 CPSPSC 综合问题中的每一个以及针对患者安全问题的整体评分计算出一个正分率 (PPS)。使用卡方检验比较 PSCC 实施前后的 PPS。
总体而言,最低的综合 PPS(人员配备、工作压力和节奏)和最高的综合 PPS(患者咨询)在两个调查期间排名相同。在九家 PSCC 药店中,有四个综合项(团队合作、错误沟通、员工培训和技能以及人员配备、工作压力和节奏)的 PPS 有统计学意义的提高(p < 0.05)。PSCC 药店在实施 PSCC 后,对药店患者安全的整体评分也提高了 9.3%(无统计学意义)。对药剂师反应的单独分析与药店层面的结果一致,但技术人员对安全感知的整体评分略有不同。
PSCC 的存在似乎增加了社区药店员工对安全文化的看法,这是整体患者安全的一个组成部分。