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医院药剂师的时间分配:一项工作抽样研究。

How Hospital Pharmacists Spend Their Time: A Work-Sampling Study.

作者信息

Wong Daniel, Feere Andrea, Yousefi Vandad, Partovi Nilufar, Dahri Karen

机构信息

, BSc(Pharm), ACPR, is a Clinical Pharmacist with the Royal Columbian Hospital, New Westminster, British Columbia.

, BSc(Pharm), ACPR, is a Clinical Pharmacist with the Abbotsford Regional Hospital and Cancer Centre, Abbotsford, British Columbia.

出版信息

Can J Hosp Pharm. 2020 Fall;73(4):272-278. Epub 2020 Oct 1.

Abstract

BACKGROUND

The expanded scope of pharmacist practice allows for increased comprehensive care and improved patient outcomes at the cost of increased workload and time demands on pharmacists. There are limited descriptive metrics for the time that pharmacists spend on various activities during the workday. An evaluation of the time spent on different activities would allow for potential optimization of workflow, with a focus primarily on devoting more time to direct patient care activities.

OBJECTIVE

To quantify the amount of time that hospital and clinic-based pharmacists spend on clinical activities, including direct and indirect patient care, and nonclinical activities.

METHODS

An observational fixed-interval, work-sampling study was conducted at 2 hospitals, Vancouver General Hospital and Richmond Hospital, both in British Columbia. Trained observers followed individual pharmacists for a set period. The pharmacists' activities were recorded in 1-min increments and classified into various categories.

RESULTS

In total, 2044 min of activity, involving 11 individual pharmacists, were observed. Clinical activities accounted for 82% of total time, 12% (251 min) on direct patient care activities and 70% (1434 min) on indirect patient care activities. The most common direct clinical activity was conducting patient medication history interviews (73 min; 4% of total time), and the most common indirect clinical activity was assessment and evaluation (585 min; 29%). The most common nonclinical activities were walking (91 min; 4% of total time), looking for something (57 min; 3%), and teaching pharmacy students on practicum (60 min; 3%).

CONCLUSIONS

Although the pharmacists spent most of their time on clinical activities, face-to-face time with patients (direct clinical activities) seemed low, which highlights an area for potential improvement. The pharmacists spent much more time documenting information in pharmacy-specific monitoring forms (i.e., assessment and evaluation) than they spent writing notes or recommendations in the chart, for sharing with other health care professionals.

摘要

背景

药剂师业务范围的扩大使得综合护理得以增加,患者治疗效果得以改善,但代价是药剂师的工作量增加和时间需求增多。对于药剂师在工作日花费在各项活动上的时间,描述性指标有限。对不同活动所花费时间进行评估有助于对工作流程进行潜在优化,主要重点是将更多时间用于直接的患者护理活动。

目的

量化医院和诊所药剂师花费在临床活动(包括直接和间接患者护理)以及非临床活动上的时间量。

方法

在不列颠哥伦比亚省的两所医院——温哥华总医院和列治文医院开展了一项观察性固定间隔工作抽样研究。经过培训的观察员在一段固定时间内跟踪每位药剂师。药剂师的活动以1分钟为增量进行记录,并分类到不同类别。

结果

总共观察了涉及11位药剂师的2044分钟活动。临床活动占总时间的82%,其中直接患者护理活动占12%(251分钟),间接患者护理活动占70%(1434分钟)。最常见的直接临床活动是进行患者用药史访谈(73分钟;占总时间的4%),最常见的间接临床活动是评估(585分钟;占29%)。最常见的非临床活动是行走(91分钟;占总时间的4%)、寻找物品(57分钟;占3%)以及指导药学专业学生实习(60分钟;占3%)。

结论

虽然药剂师大部分时间都花在临床活动上,但与患者面对面的时间(直接临床活动)似乎较少,这凸显了一个有潜在改进空间的领域。药剂师在特定药房监测表格中记录信息(即评估)所花费的时间,比在病历中撰写记录或建议以供其他医疗保健专业人员共享所花费的时间多得多。

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