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多中心研究评估技术辅助工作流程对小型社区医院静脉输液室效率、成本和安全性的益处。

Multicenter study to evaluate the benefits of technology-assisted workflow on i.v. room efficiency, costs, and safety in small community hospitals.

机构信息

UNC Eshelman School of Pharmacy and UNC Medical Center, Chapel Hill, NC.

St. David's Georgetown Hospital, Austin, TX, and Heart Hospital of Austin, Austin, TX.

出版信息

Am J Health Syst Pharm. 2019 Jun 18;76(13):964-969. doi: 10.1093/ajhp/zxz080.

Abstract

PURPOSE

To evaluate the benefits of technology-assisted workflow (TAWF) compared to manual workflow (non-TAWF) on i.v. room efficiency, costs, and safety at community hospitals with less than 200 beds.

METHODS

Four hospitals in the United States (2 with and 2 without TAWF) were evaluated, and characteristics of medication errors and frequency of each error type were measured across the institutions. The average turnaround time per workflow step and cost to prepare each compounded sterile product (CSP) were also calculated. The results were evaluated using descriptive and inferential statistics.

RESULTS

The TAWF hospital sites detected errors at a significantly higher rate (3.78%) compared to the non-TAWF hospital sites (0.13%) (p < 0.05). The top error-reporting category for the TAWF sites was incorrect medication (71.66%), whereas the top error-reporting category for the non-TAWF sites could not be determined because of the small number of errors detected. Use of TAWF may be associated with a decrease in turnaround time and a decrease in overall cost to prepare a CSP.

CONCLUSION

Significantly more errors were detected in small community hospitals that use TAWF in the i.v. room compared to those not using it. There were differences in error types observed between technology and nontechnology groups. The use of TAWF was associated with faster preparation times and lower costs of preparation per CSP.

摘要

目的

评估在床位少于 200 张的社区医院中,与手动工作流程(非 TAWF)相比,技术辅助工作流程(TAWF)对静脉室效率、成本和安全性的益处。

方法

评估了美国的 4 家医院(2 家有 TAWF,2 家没有 TAWF),并测量了各机构的药物错误特征和每种错误类型的频率。还计算了每个工作流程步骤的平均周转时间和制备每个无菌产品的成本。使用描述性和推断性统计数据评估结果。

结果

TAWF 医院的错误检测率明显高于非 TAWF 医院(3.78%比 0.13%,p < 0.05)。TAWF 医院的主要错误报告类别是药物错误(71.66%),而非 TAWF 医院由于检测到的错误较少,无法确定主要错误报告类别。使用 TAWF 可能与准备 CSP 的周转时间缩短和总成本降低有关。

结论

在使用 TAWF 的小社区医院的静脉室内,与未使用 TAWF 的医院相比,检测到的错误明显更多。在技术和非技术组之间观察到了错误类型的差异。TAWF 的使用与准备时间的缩短和每批 CSP 的准备成本降低有关。

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