School of Pharmacy and Medical Science, Griffith University, Gold Coast, QLD, 4222, Australia.
Pharmacy Department, Gold Coast Health, Southport, QLD, 4215, Australia.
Int J Clin Pharm. 2022 Aug;44(4):1028-1036. doi: 10.1007/s11096-022-01436-1. Epub 2022 Jun 27.
Discharge medicine lists provide patients, carers and primary care providers a summary of new, changed or ceased medicines when patients discharge from hospital. Hospital pharmacists play an important role in preparing these lists although this process is time consuming. AIM : To measure the time required by hospital pharmacists to complete the various tasks involved in discharge medicine handover. METHOD : Time-and-motion study design was used to (1) determine the time involved for pharmacists to produce discharge medicine lists, (2) explore how pharmacists utilise various software programs to prepare lists, and (3) compare the time involved in discharge medicine handover processes considering confounding factors. An independent observer shadowed 16 pharmacists between 22 February and 12 March 2021 and recorded tasks involved in 50 discharge medicine handovers. Relevant information about each discharge was also collected. RESULTS : Pharmacists observed represented a range of practice experiences and inpatient units. Mean time to complete discharges was 26.2 min (SD 13.6), with over half of this time used to check documentation and prepare discharge medicine lists. A mean of 4.0 min was spent on manually retyping and reconciling medicine lists in different software systems. Medical inpatient unit discharges took 4.6 min longer to prepare compared to surgical ones. None of the 50 discharges involved support from pharmacy assistants; all 50 discharges had changed or ceased medicines. CONCLUSION : There is a need to streamline current discharge processes through optimisation of electronic health software systems and better delegation of technical tasks to trained pharmacy assistants.
出院医嘱清单为患者、护理人员和初级保健提供者提供了患者出院时新的、更改或停止的药物的摘要。医院药剂师在准备这些清单方面发挥着重要作用,尽管这一过程很耗时。目的:测量医院药剂师完成出院医嘱交接各项任务所需的时间。方法:采用时间与动作研究设计,(1)确定药剂师制作出院医嘱清单所需的时间,(2)探讨药剂师如何利用各种软件程序来准备清单,以及(3)考虑混杂因素比较出院医嘱交接过程中涉及的时间。一名独立观察员在 2021 年 2 月 22 日至 3 月 12 日期间跟踪了 16 名药剂师,并记录了 50 次出院医嘱交接中涉及的任务。还收集了与每次出院相关的信息。结果:观察到的药剂师代表了不同的实践经验和住院病房。完成出院手续的平均时间为 26.2 分钟(SD 13.6),其中一半以上的时间用于检查文件和准备出院医嘱清单。平均花费 4.0 分钟在不同软件系统中手动重新输入和核对药物清单。与外科病房相比,内科病房的出院准备时间延长了 4.6 分钟。这 50 次出院中的任何一次都没有得到药剂师助理的支持;这 50 次出院都有更改或停止的药物。结论:需要通过优化电子健康软件系统和更好地将技术任务委托给经过培训的药剂师助理来简化当前的出院流程。