Jusufi Herolind, Boivin Nicholas
Department of Pharmacy, University of Wisconsin School of Pharmacy, Madison, WI 53706, USA.
Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA.
Pharmacy (Basel). 2023 Jun 30;11(4):111. doi: 10.3390/pharmacy11040111.
(1) Background: The rising prices of medical infusions have resulted in the increased utilization of policies for payors to manage costs. These policies can be disruptive to the continuity of care, and health systems should develop a systematic strategy to address market changes and prevent patient leakage. (2) Methods: A quality improvement study was conducted by an interdisciplinary workstream to assess the current state of infusion services in an academic medical center in the Midwest and to provide recommendations for immediate access improvement and long-term system planning. An organizational assessment of the value stream was completed, which analyzed the available infusion capacity, billing strategy, patient mix/volumes, payor mix, staffing levels, and current policies. The interventions implemented after developing the infusion system strategy were triaging patients to the appropriate site of care to increase infusion capacity and eliminating paper orders in one of the health system's Infusion Centers. (3) Results: Patients receiving medical infusions for oncologic conditions warrant unique considerations in evaluating the Infusion Center's efficiency due to the infusion regimen's length, complexity, and tolerability. The management of the payor site of care also poses a challenge for health systems to triage patients effectively without fragmenting care. (4) Conclusions: An organizational strategy around infusion services must include broad stakeholder representation to address the clinical, operational, and financial challenges to provide timely care to patients.
(1) 背景:医用输液价格不断上涨,促使支付方更多地利用成本管理政策。这些政策可能会干扰医疗服务的连续性,卫生系统应制定系统战略来应对市场变化并防止患者流失。(2) 方法:一个跨学科工作小组开展了一项质量改进研究,以评估中西部一家学术医疗中心输液服务的现状,并就立即改善可及性和长期系统规划提供建议。完成了对价值流的组织评估,分析了可用输液能力、计费策略、患者组合/数量、支付方组合、人员配备水平和现行政策。在制定输液系统战略后实施的干预措施包括将患者分流到适当的护理地点以提高输液能力,以及在卫生系统的一个输液中心消除纸质医嘱。(3) 结果:由于输液方案的时长、复杂性和耐受性,接受肿瘤疾病医用输液的患者在评估输液中心效率时需要特别考虑。支付方护理地点的管理也给卫生系统带来了挑战,要在不使护理碎片化的情况下有效分流患者。(4) 结论:围绕输液服务的组织战略必须有广泛的利益相关者参与,以应对临床、运营和财务方面的挑战,为患者提供及时护理。