Lv Lisong, Yao Yi, Zhang Mingwan, Xin Chuanwei
Department of Pharmacy, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, People's Republic of China.
Patient Prefer Adherence. 2025 Jan 20;19:139-147. doi: 10.2147/PPA.S486478. eCollection 2025.
The purpose of this study was to explore the lean management strategies used by an outpatient hospital pharmacy in China to reduce internal errors in prescription dispense and to describe their impact on patient satisfaction.
The type and number of internal errors in prescription dispense from January 1, 2022, to December 31, 2022, were collected. The causes of these errors were analyzed based on a series of lean management concepts and methods, and Lean Management was implemented from January 1, 2023, to December 31, 2023, in this outpatient hospital pharmacy. The number of internal errors, the proportion of dispense errors and the change of patient satisfaction before and after Lean Management were compared.
Before the implementation of Lean Management, 2978 cases of internal errors were reported. It includes 1286cases (43.18%) of delivering wrong numbers, 612cases (20.55%) of medication in close proximity, 434cases (14.57%) of forget to dispense medication, 221cases (7.42%) of sound-alike medication, 203 cases (6.82%) of multiple sizes of a medication, 125 cases (4.20%) of look-alike medication, and 97 cases (3.26%) of others. The proportion of dispense errors was 3.46‰. After the implementation of Lean Management, the total number of internal errors in prescription dispense decreased to 219 cases, the proportion of internal errors in prescription dispense decreased to 0.27‰, which has a significant difference, and the satisfaction of patients increased from 52.94% to 72.97%.
The implementation of Lean Management can be an efficient approach to reduce the internal errors in prescription dispense.
本研究旨在探讨中国一家门诊医院药房所采用的精益管理策略，以减少处方调配中的内部差错，并描述其对患者满意度的影响。
收集2022年1月1日至2022年12月31日期间处方调配内部差错的类型和数量。基于一系列精益管理理念和方法对这些差错的原因进行分析，并于2023年1月1日至2023年12月31日在这家门诊医院药房实施精益管理。比较精益管理前后内部差错数量、调配差错比例以及患者满意度的变化。
在实施精益管理之前，共报告2978例内部差错。其中包括发错数量1286例（43.18%）、相近药品误发612例（20.55%）、漏发药品434例（14.57%）、听似药品221例（7.42%）、药品规格多发203例（6.82%）、看似药品125例（4.20%）以及其他97例（3.26%）。调配差错比例为3.46‰。实施精益管理后，处方调配内部差错总数降至219例，处方调配内部差错比例降至0.27‰，差异有统计学意义，患者满意度从52.94%提高至72.97%。
实施精益管理是减少处方调配内部差错的有效方法。
