Pharmacy, Royal Brompton and Harefield Hospitals, London, UK
Pharmacy, Evelina London Children's Hospital, London, UK.
BMJ Open Qual. 2022 Dec;11(4). doi: 10.1136/bmjoq-2022-001916.
To evaluate (1) views and perceptions of patients/parents/carers and healthcare professionals on the medicines optimisation (MO) process following virtual outpatient clinic (VOC) during the COVID-19 pandemic and (2) the processes introduced at this time, identifying areas for improvements and suggest potential solutions.
A mixed-methods service evaluation using qualitative and quantitative methods of the MO pathway in children aged 0-18 years following VOC across three specialist children's units.Semi-structured interviews were conducted over the telephone with the participants exploring their experiences and categorised into themes.Process mapping sessions with the multidisciplinary team identified areas for improvement and an ease impact framework developed for potential solutions.Outcome measures included: (1) themes from interviews, (2) patients satisfaction rates, (3) process maps and (4) development of a simplified future process.
One hundred and twenty-five patients' families were contacted: 71 families consented to participate and their views were categorised into four main themes: (1) patient experience, (2) communication, (3) need for virtual video consultations for patient education by hospital pharmacists and (4) need for electronic processes to send prescriptions to local pharmacies.Median patient satisfaction rate was 96% (range 67%-100%). The convenience of receiving medications directly to patient's homes; access to medicines information helplines and education provided by pharmacists were regarded as valuable. Communication between care providers, development of virtual video consultations by hospital pharmacists and electronic transfer of some prescriptions directly to community pharmacies were identified as areas of improvement.
Participants appreciated the pharmacy processes adopted during the pandemic, however, challenges and recommendations for improvement in delivering MO VOC were identified. As digital innovations evolve within the NHS, future research should focus on integrated care and improved communication between care providers with selected medications prescribed directly to community pharmacies using electronic prescription service, with clinical screening and education provided by hospital pharmacists.
评估(1)在 COVID-19 大流行期间,虚拟门诊(VOC)后,患者/家长/照顾者和医疗保健专业人员对药物优化(MO)流程的看法和看法,以及(2)在此期间引入的流程,确定改进的领域,并提出潜在的解决方案。
使用定性和定量方法对三个儿科专科病房的 0-18 岁儿童进行虚拟门诊后,对 MO 通路进行混合方法服务评估。通过电话对参与者进行半结构化访谈,探讨他们的经验,并将其归类为主题。与多学科团队进行流程映射会议,确定改进领域,并为潜在解决方案开发易于实施的框架。结果测量包括:(1)访谈主题,(2)患者满意度,(3)流程映射和(4)简化未来流程的开发。
共联系了 125 名患者家属:71 名家属同意参与,他们的观点分为四个主要主题:(1)患者体验,(2)沟通,(3)需要医院药剂师通过虚拟视频咨询对患者进行教育,以及(4)需要电子流程将处方发送到当地药店。患者满意度中位数为 96%(范围为 67%-100%)。直接将药物送到患者家中的便利性;药剂师提供的药物信息帮助热线和教育被认为是有价值的。改善护理提供者之间的沟通、医院药剂师开展虚拟视频咨询以及某些处方直接通过社区药店电子传输等被确定为改进领域。
参与者赞赏大流行期间采用的药房流程,但也确定了在提供 MO VOC 方面的挑战和改进建议。随着 NHS 内部数字创新的发展,未来的研究应关注整合护理和改善护理提供者之间的沟通,选择通过电子处方服务将药物直接开给社区药店,并由医院药剂师提供临床筛查和教育。