Department of Pharmacy Services, Houston Methodist Hospital, Houston, TX, USA.
System Pharmacy Services, Houston Methodist Hospital System, Houston, TX, USA.
Am J Health Syst Pharm. 2022 Sep 7;79(18):1562-1569. doi: 10.1093/ajhp/zxac154.
The purpose of this study was to evaluate the impact of implementing an electronic health record (EHR)-integrated mobile dispense tracking solution.
This quasi-experimental study was conducted at Houston Methodist Hospital. The study timeframe consisted of 1-year pre- and postimplementation phases, with a 1-month washout period. The medication tracking function was implemented in a multiphase approach. The primary endpoint was the weekly redispense rate due to missing medication or delay in delivery. The secondary endpoints were total redispenses due to missing medication or delay in delivery per 1,000 medication messages and per 1,000 inpatient discharges and dispense tracking scanning compliance post implementation.
Analyses demonstrated a sustained decrease in redispenses from 3.24% to 2.70% (95% CI, 0.10-0.60; P = 0.006). The study also demonstrated a statistically significant decrease in redispenses per 1,000 medication messages from 190 to 127 (95% CI, -27.21 to -4.23, P = 0.008). Analysis of redispenses per 1,000 patient discharges showed a nonsignificant reduction after implementation from 216 to 194 (95% CI, 54.63 to -77.71; P = 0.730). The department achieved 90.7% dispense tracking compliance.
EHR-integrated mobile dispense tracking technology effectively reduced the redispense rate and total redispenses normalized to medication messages for missing medication and delay in delivery. Interprofessional collaboration and effective change management strategies are essential to the successful implementation of medication dispense tracking technology.
本研究旨在评估实施电子病历（EHR）集成移动配药跟踪解决方案的影响。
这是一项在休斯顿卫理公会医院进行的准实验研究。研究时间框架包括实施前和实施后 1 年的阶段，以及 1 个月的洗脱期。药物跟踪功能分多个阶段实施。主要终点是由于缺药或配送延迟导致的每周重新配药率。次要终点是每 1000 个药物信息和每 1000 个住院患者出院和配药跟踪扫描后实施的药物重新配药总数，以及由于缺药或配送延迟导致的每 1000 个药物信息的重新配药率。
分析表明，重新配药率从 3.24%持续下降到 2.70%（95%置信区间，0.10-0.60；P=0.006）。研究还表明，每 1000 个药物信息的重新配药数量从 190 下降到 127（95%置信区间，-27.21 至-4.23，P=0.008），具有统计学意义。分析实施后每 1000 个患者出院的重新配药数量显示，从 216 减少到 194（95%置信区间，54.63 至-77.71；P=0.730），但无统计学意义。该部门实现了 90.7%的配药跟踪合规率。
EHR 集成移动配药跟踪技术有效地降低了由于缺药和配送延迟导致的重新配药率和每 1000 个药物信息的重新配药总数。多专业合作和有效的变更管理策略对于成功实施药物配药跟踪技术至关重要。
