Vargas López Laura C, Viso Gurovich Fela, Dreser Mansilla Anahí, Wirtz Veronika J, Reich Michael R
Faculty of Pharmacy, Instituto de Ciencias de la Salud, Autonomy University of Hidalgo State, Carretera Pachuca-Actopan camino a Tilcuautla s/n Pueblo San Juan Tilcuautla, 42160, Hgo, Mexico.
, Pachuca, Mexico.
J Pharm Policy Pract. 2021 May 5;14(1):41. doi: 10.1186/s40545-021-00318-7.
The implementation of pharmaceutical services in hospitals contributes to the appropriate use of medicines and patient safety. However, the relationship of implementation with the legal framework and organizational practice has not been studied in depth. The objective of this research is to determine the role of these two factors (the legal framework and organizational practice) in the implementation of pharmaceutical services in public hospitals of the Ministry of Health of Mexico.
Semi-structured interviews were conducted with four groups of actors involved. The analysis focused on the legal framework, defined as the rules, laws and regulations, and on organizational practice, defined as the implementation of the legal framework by related individuals, that is, how they put it into practice.
The main problems identified were the lack of alignment between the rules and the incentives for compliance. Decision-makers identified the lack of managerial capacity in hospitals as the main implementation barrier, while hospital pharmacists pointed to poor regulation and the lack of clarity of the legal framework as the problems to consider.
Although the legal framework related to hospital pharmaceutical services in Mexico is inadequate, organizational factors (such as adequate skills of professional pharmacists and the support of the hospital director) have facilitated gradual implementation. To improve implementation, priority should be given to evaluation and modification of the current legislation along with the development of an official minimum standard for activities and services in hospital pharmacies.
医院药学服务的实施有助于合理用药和患者安全。然而，其实施与法律框架及组织实践之间的关系尚未得到深入研究。本研究的目的是确定这两个因素（法律框架和组织实践）在墨西哥卫生部公立医院药学服务实施中的作用。
对四组相关行为者进行了半结构式访谈。分析聚焦于法律框架（定义为规则、法律和法规）以及组织实践（定义为相关人员对法律框架的实施，即他们如何将其付诸实践）。
发现的主要问题是规则与合规激励措施之间缺乏一致性。决策者认为医院缺乏管理能力是主要的实施障碍，而医院药剂师则指出监管不力和法律框架缺乏清晰度是需要考虑的问题。
尽管墨西哥与医院药学服务相关的法律框架不完善，但组织因素（如专业药剂师具备足够技能以及医院院长的支持）促进了逐步实施。为了改进实施情况，应优先评估和修改现行立法，并制定医院药房活动和服务的官方最低标准。
