门诊配药服务质量指标体系的可行性和可靠性
Feasibility and reliability of a quality indicator system for an ambulatory dispensing service.
作者信息
Bautista Gómez Andrea Jetzú, López Orozco Maricela, Barajas Esparza Liliana, de La Cruz Durán Hermelinda, Chehue Romero Alejandro, Bermúdez Camps Isis Beatriz, Téllez López Ana María, López Vargas Laura Cristina, Valverde Merino María Isabel, Martínez Martínez Fernando, Reyes Hernández Ivette
机构信息
Department of Pharmaceutical Services, Hospital H+ Querétaro, Queretaro, Mexico.
Pharmacy Academic Area, Institute of Health Sciences, Universidad Autónoma del Estado de Hidalgo, Pachuca, Hidalgo, Mexico.
出版信息
Drugs Context. 2024 May 24;13. doi: 10.7573/dic.2024-1-3. eCollection 2024.
BACKGROUND
For a medication dispensing service to function with quality, continuous evaluation is required, which is why it is necessary to have reliable measurement tools that make it possible. Quality indicators can serve as tools for managing quality, as they are variables that directly or indirectly measure changes in a situation and help evaluate the progress made in addressing it. This article aims to determine the feasibility and reliability of a quality indicator system for a drug dispensing service for paediatric outpatients in two Mexican hospitals.
METHODS
A study of the development type of health systems and services at a microlevel was conducted from October 2020 to October 2021 in the pharmaceutical service of two Mexican hospitals. To determine the feasibility of the quality indicators, a retrospective evaluation was performed, which considered the indicators that could be calculated with the available information to be feasible. To determine reliability, an inter-observer agreement study (Kappa (κ)) was performed.
RESULTS
The feasibility analysis revealed that all five reference indicators related to the structure were feasible in both hospitals. In the Infantil of the Californias hospital, all six process indicators evaluated were feasible, whilst only one was found feasible in H+ Querétaro. As for outcome indicators, only one was feasible in the Infantil of the Californias hospital. The causes of non-feasibility in both hospitals were the non-documentation of the primary data related to the stages of the process and the lack of instruments to measure patient satisfaction. The reliability of the indicators showed little variability.
CONCLUSION
Although not all indicators were feasible, solutions were proposed so that the 15 reference indicators could be used if an organization decided to do so. The reliability of the indicators was demonstrated, evidencing the importance of the data sheet as a tool to generate valid reliable measures.This article is part of the Special Issue: https://www.drugsincontext.com/special_issues/hospital-pharmacy-rational-use-of-medicines-and-patient-safety-in-latin-america/.
背景
为使药物调配服务高质量运行，需要持续评估，这就是为什么要有可靠的测量工具来实现这一点。质量指标可作为质量管理工具，因为它们是直接或间接衡量情况变化并有助于评估在解决该情况方面所取得进展的变量。本文旨在确定墨西哥两家医院儿科门诊药物调配服务质量指标体系的可行性和可靠性。
方法
2020年10月至2021年10月，在墨西哥两家医院的药学服务部门开展了一项微观层面卫生系统与服务发展类型的研究。为确定质量指标的可行性，进行了回顾性评估，将能根据现有信息计算的指标视为可行指标。为确定可靠性，开展了观察者间一致性研究（卡帕（κ））。
结果
可行性分析表明，两家医院中与结构相关的所有五个参考指标均可行。在加利福尼亚儿童医院，评估的六个过程指标均可行，而在克雷塔罗H+医院仅发现一个可行。至于结果指标，在加利福尼亚儿童医院仅一个可行。两家医院不可行的原因是与过程各阶段相关的原始数据未记录以及缺乏测量患者满意度的工具。指标的可靠性显示出很小的变异性。
结论
尽管并非所有指标都可行，但提出了解决方案，以便如果一个组织决定使用，这15个参考指标可以被采用。指标的可靠性得到了证明，证明了数据表作为生成有效可靠测量工具的重要性。本文是特刊的一部分：https://www.drugsincontext.com/special_issues/hospital-pharmacy-rational-use-of-medicines-and-patient-safety-in-latin-america/ 。
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