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医院药学绩效考核模式探索与实践

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目的 促进医院药学工作提质增效。方法 探索医院药学绩效考核模式,经人才队伍建设、制度分层保障、药师配备网格化、以目标为导向的项目式管理,建立院内药事绩效考核体系及药剂科绩效考核体系,以信息化系统对药学工作进行监管,并于 2022 年 1 月对体系进行修订。比较医院 2021 年(修订前)及 2022 年(修订后)超常处方、合理用药指标、临床科室对临床药师药学服务满意度的相关数据,以评价院内药事绩效考核体系的应用效果;比较 2021 年 7 月至 12 月(381 315 例)及 2022 年 7 月至 12 月(387 105 例)门诊患者的取药等候时间,2021 年及 2022 年门诊药房与住院药房的处方调配差错情况,以评价药剂科绩效考核体系的应用效果。结果 院内药事绩效考核体系应用后,超常处方数、抗菌药物超常处方数、麻醉药品和精神药品超常处方数占不合理处方数的比例分别由5。83%,3。33%,0。83%降至0。55%,0。55%,0;点评处方占比、抗菌药物使用强度、住院患者基本药物使用率等合理用药指标均改善;30个临床科室(599 名医护人员)对临床药师各项药学服务的总满意度均提升。药剂科绩效考核体系应用后,门诊患者的取药等候时间由(10。27±0。49)min缩短为(9。29±0。60)min(P<0。05);门诊药房、住院药房的处方调配差错率分别由 0。32‱和 0。04‱降至 0。08‱和 0。02‱,存在药品质量问题、数量错误、一品多规、厂家错误的门诊药房处方及存在数量错误、一品多规、厂家错误、剂型错误的住院药房处方调配差错占比均降低。结论 该医院药学绩效考核模式科学可行,有助于提升药师的工作效率与工作质量,促进临床合理用药。
Exploration and Practice of Performance Assessment Mode for Hospital Pharmacy
Objective To improve the quality and efficiency of hospital pharmacy-related work.Methods The performance assessment mode for hospital pharmacy was explored.Through the talent team construction,hierarchical support of systems,grid-based pharmacist staffing and goal-oriented project-based management,a hospital pharmaceutical performance assessment system and a pharmacy department performance assessment system were constructed,the pharmacy-related work was regulated by the information system,and the above two systems were revised in January 2022.The data related to extraordinary prescriptions,rational drug use-related indicators and satisfaction rate of clinical departments with pharmaceutical care of clinical pharmacists in hospital in 2021(before revision)and 2022(after revision)were compared to evaluate the application effect of the hospital pharmaceutical performance assessment system.The waiting time for outpatient patients to get medicines from July to December 2021(381 315 cases)and from July to December 2022(387 105 cases),the prescription dispensing errors of outpatient and inpatient pharmacies in 2021 and 2022 were compared to evaluate the application effect of the pharmacy department performance assessment system.Results After the application of the hospital pharmaceutical performance assessment system,the proportions of extraordinary prescriptions,extraordinary prescriptions of antibiotics,extraordinary prescriptions of anaesthetic drugs and psychotropic drugs to irrational prescriptions decreased from 5.83%,3.33%,0.83%to 0.55%,0.55%,0 respectively;the rational drug use-related indicators(including the proportion of reviewed prescriptions,the antibiotics use density,the use rate of essential medicines of inpatients)all improved;the total satisfaction rates of 599 medical staff(30 clinical departments)with various aspects of pharmaceutical care of clinical pharmacists all increased.After the application of the pharmacy department performance assessment system,the waiting time for outpatient patients to get medicines decreased from(10.27±0.49)min to(9.29±0.60)min(P<0.05);the prescription dispensing error rates in outpatient and inpatient pharmacies decreased from 0.32‱,0.04‱ to 0.08‱,0.02‱respectively;the proportion of dispensing errors in outpatient pharmacy prescriptions(with drug quality-related problems,quantity errors,one product with multiple specifications,manufacturer errors)and inpatient pharmacy prescriptions(with quantity errors,one product with multiple specifications,manufacturer errors,dosage-form errors)decreased.Conclusion This performance assessment mode for hospital pharmacy is scientific and feasible,which can improve the work efficiency and quality of pharmacists,and promote the rational drug use in clinical practice.

performance assessmenthospital pharmacypharmaceutical carerational drug use

周后凤、范玉婷、王雪莹、冯滔

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四川省成都市第五人民医院,四川 成都 611130

绩效考核 医院药学 药学服务 合理用药

四川省医院协会医院管理科研专项四川省成都市医学科研项目

YG23122022540

2024

中国药业
重庆市食品药品监督管理局

中国药业

CSTPCD
影响因子:1.369
ISSN:1006-4931
年,卷(期):2024.33(12)