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通过患者参与和精益方法改善门诊药房。

Improvement of outpatient pharmacy through patient participation and Lean methodology.

机构信息

Pharmacy Department, Hospital Clínic, Barcelona. Spain.

出版信息

Farm Hosp. 2021 Sep 28;45(6):317-322.

Abstract

OBJECTIVE

To improve the quality of the dispensing process and  pharmaceutical care in the Outpatient Pharmacy through patient participation and Lean methodology, and to analyse the results obtained in  terms of efficiency and patient satisfaction.

METHOD

Prospective observational single-centre study. A working group was  organized with the health care staff involved in outpatient care to apply Lean  methodology and detect improvement opportunities. We used a focus group  technique to understand the patients' experience. The impact on patient  satisfaction was measured through a mass survey mailed out in December  2019 (before introducing the main measures) and in December 2020.

RESULTS

More than 30 improvement actions were identified after surveying the opinions of the patients and health care staff involved. Nine actions were prioritized, which were mainly related to structural and circuit changes. Waiting times significantly improved (35% of patients waited for more than 30 minutes before the improvement actions vs 4.5% afterward). The results showed that waiting times and overall  satisfaction significantly improved in the period between the two surveys. In both cases, the degree of satisfaction was higher after introducing the improvement actions.

CONCLUSIONS

We analysed the situation of our Outpatient Service and designed the most appropriate improvement actions according to the resources available. This initiative was achieved through patient  participation (via a focus group and mass surveys), the participation of health  care staff, and the application of Lean methodology.

摘要

目的

通过患者参与和精益方法提高门诊药房发药流程和药学服务质量,并分析效率和患者满意度方面的结果。

方法

前瞻性观察性单中心研究。组织了一个由参与门诊护理的医疗保健人员组成的工作组,以应用精益方法并发现改进机会。我们使用焦点小组技术了解患者的体验。通过 2019 年 12 月(在引入主要措施之前)和 2020 年 12 月的大规模邮寄调查来衡量对患者满意度的影响。

结果

在调查了患者和相关医疗保健人员的意见后,确定了 30 多项改进措施。优先考虑了 9 项行动,这些行动主要与结构和流程变化有关。等待时间显著改善(在改进措施之前,有 35%的患者等待超过 30 分钟,而之后则为 4.5%)。结果表明,在两次调查之间,等待时间和整体满意度都有显著提高。在这两种情况下,引入改进措施后满意度都更高。

结论

我们分析了我们的门诊服务情况,并根据可用资源设计了最合适的改进措施。这一举措是通过患者参与(通过焦点小组和大规模调查)、医疗保健人员的参与以及精益方法的应用实现的。

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