Novek J
Department of Sociology, University of Winnipeg, Manitoba, Canada.
Int J Health Serv. 1998;28(3):445-65. doi: 10.2190/W2BT-FGXQ-QL0G-YNL9.
Automated medication dispensing systems for hospital pharmacies, heralded as an important means of reducing drug errors and improving labor productivity, have also been seen as a means of furthering the transformation of the pharmacy profession from its role in dispensing prescriptions to a clinical profession concerned with treatments and patient outcomes. Automation aids this transformation by transferring the responsibility for routine dispensing to technicians performing rationalized and computer-mediated tasks. Not all pharmacists agree with these trends. Some fear a loss of professional status and employment as their knowledge is expropriated and incorporated into machinery operated by those with lesser qualifications. They fear an industrial rather than a clinical future. Their concerns are compounded by health care cutbacks. These issues were studied at two hospitals in Canada and one in France, all mid-sized public hospitals with automated unit dose drug delivery systems installed in the late 1980s and early 1990s. Preliminary results indicated national differences in approaches to hospital pharmacy automation. In Canada, pharmacists have resisted major changes in their control of the dispensing process and in their traditional roles vis à vis doctors and pharmacy technicians. In France, where hospital pharmacy as a profession is less developed than in North America, automation has brought about a far more radical substitution for pharmacists' labor.
医院药房的自动配药系统被誉为减少用药错误和提高劳动生产率的重要手段，也被视为推动药学专业从传统的处方调配角色向关注治疗和患者治疗结果的临床专业转变的一种方式。自动化通过将常规调配工作的责任转移给技术人员来完成合理化的计算机介导任务，从而有助于这种转变。并非所有药剂师都认同这些趋势。一些人担心随着他们的知识被剥夺并融入由资质较低的人员操作的机器中，他们的职业地位和就业机会会丧失。他们担心未来是工业化而非临床化的。医疗保健开支的削减使他们的担忧更加复杂。在加拿大的两家医院和法国的一家医院对这些问题进行了研究，这三家医院都是中等规模的公立医院，在20世纪80年代末和90年代初安装了自动单剂量给药系统。初步结果表明，各国在医院药房自动化的方式上存在差异。在加拿大，药剂师抵制在调配过程控制以及他们相对于医生和药房技术人员的传统角色方面的重大变革。在法国，医院药学作为一个专业的发展程度不如北美，自动化对药剂师劳动力的替代要激进得多。
