Reeder C E, Kozma C M, O'Malley C
College of Pharmacy, University of South Carolina, Columbia 29208, USA.
Am J Health Syst Pharm. 1998 Jan 1;55(1):35-43. doi: 10.1093/ajhp/55.1.35.
The results of a national survey of the ambulatory care functions of pharmacists in integrated health systems, including managed care organizations, are reported. Persons responsible for ambulatory care pharmaceutical services in 392 integrated health systems nationwide were interviewed by telephone and asked about their systems' organizational characteristics, information systems, pharmacist functions, and performance measures. Respondents reported a range of health-system components, including acute care hospitals, home health services, managed care products, and ambulatory care centers. Approximately 27% of respondents reported that their health system had an electronic medical records system, and 23% reported having one for ambulatory patients. Approximately 49% of respondents indicated that their system had an interdisciplinary care team for ambulatory patients that included a pharmacist. Overall, distributive functions consumed the largest portion (45%) of pharmacists' time, followed by clinical (30%) and administrative (21%) activities. The percentages of time spent on the different functions varied by geographic region and type of health system. Tracking adverse drug reactions, monitoring medication compliance, using pharmacoeconomic data for formulary decision-making, conducting medication management programs, and patient counseling were routinely provided as part of ambulatory care pharmaceutical services by 75% or more of health systems. Financial performance and patient satisfaction were the most frequently used performance-evaluation measures. Overall, pharmacists providing ambulatory care services in integrated health systems spent about 45% of their time on distributive, 30% on clinical, and 21% on administrative functions.
本文报告了一项针对综合医疗系统（包括管理式医疗组织）中药剂师门诊护理职能的全国性调查结果。通过电话采访了全国392个综合医疗系统中负责门诊护理药学服务的人员，询问了他们所在系统的组织特征、信息系统、药剂师职能和绩效评估指标。受访者报告了一系列医疗系统组成部分，包括急症医院、家庭健康服务、管理式医疗产品和门诊护理中心。约27%的受访者表示他们所在的医疗系统有电子病历系统，23%的受访者表示有针对门诊患者的电子病历系统。约有49%的受访者表示他们所在的系统有一个针对门诊患者的跨学科护理团队，其中包括一名药剂师。总体而言，配送职能占药剂师时间的最大比例（45%），其次是临床（30%）和行政（21%）活动。在不同职能上花费的时间百分比因地理区域和医疗系统类型而异。75%或更多的医疗系统将跟踪药物不良反应、监测用药依从性、使用药物经济学数据进行处方决策、开展药物管理项目以及患者咨询作为门诊护理药学服务的常规内容。财务绩效和患者满意度是最常用的绩效评估指标。总体而言，在综合医疗系统中提供门诊护理服务的药剂师将约45%的时间用于配送职能，30%用于临床职能，并将21%用于行政职能。
