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基于质量问题分析和精细化管理模型的门诊药品追溯码管理体系的构建与实践
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| 篇名： | 基于质量问题分析和精细化管理模型的门诊药品追溯码管理体系的构建与实践 |
| TITLE： | Construction and practice of outpatient drug traceability codes management system based on quality problem analysis and fine management model |
| 摘要： | 目的 为医疗机构门诊药房提高药品追溯码扫码率、扫码效率及准确率提供参考。方法选取我院门诊药房2025年6月前2周的4157条追溯码未扫描记录，采用帕累托图分析未扫码原因，并运用目标-规则-训练-考核-文化（ORTCC）模型对其实施精细化管理。比较扫码前（2024年6月）、管理前（2025年6月）、管理后第一阶段（2025年9月）与管理后第二阶段（2025年12月）的追溯码扫码率、药师工作效率（人均每小时发放处方数、人均每小时发放药盒数）、患者候药时间和调剂差错情况，评价管理效果。结果管理后第一阶段和管理后第二阶段的追溯码扫码率均较管理前显著升高（P＜0.05），且管理后第二阶段的追溯码扫码率显著高于管理后第一阶段（P＜0.05）。与扫码前相比，管理前人均每小时发放处方数、人均每小时发放药盒数显著减少（P＜0.05），患者候药时间显著延长（P＜0.05）；与管理前比较，管理后第二阶段人均每小时发放处方数、人均每小时发放药盒数均显著增加（P＜0.05），患者候药时间显著缩短（P＜0.05），且该时段人均每小时发放药盒数、患者候药时间与扫码前比较差异均无统计学意义（P＞0.05）。实行扫码管理后，各阶段的调剂差错呈逐渐减少的趋势。结论基于帕累托图与ORTCC模型构建的门诊药品追溯码精细化管理体系能够提高门诊药房追溯码扫码率及药师工作效率，并减少药品调剂差错。 |
| ABSTRACT： | OBJECTIVE To provide references for medical institutions’ outpatient pharmacies to increase the scanning rate， scanning efficiency and scanning accuracy of drug traceability codes.METHODS A total of 4 157 unscanned traceability code records from the first two‑week period of June 2025 were selected from the outpatient pharmacy of our hospital. Pareto chart was adopted to analyze the reasons for unscanned codes， and the Objective-Rules-Training-Check-Culture （ORTCC） model was utilized to carry out fine management. The traceability code scanning rate， pharmacists’ work efficiency （number of prescriptions dispensed per pharmacist per hour， number of drug boxes dispensed per pharmacist per hour）， patients’ medication-waiting time and dispensing errors were compared among four periods： before scanning implementation （June 2024）， before management intervention （June 2025）， the first phase after management （September 2025）， and the second phase after management （December 2025）， so as to evaluate the management effects.RESULTS The traceability code scanning rates in the first phase and second phase after management were remarkably higher than those before management （ P ＜0.05）， and the scanning rate in the second phase after management was obviously higher than that in the first phase after management （ P ＜0.05）. Compared with the period before scanning implementation， the number of prescriptions dispensed per pharmacist per hour， the number of drug boxes dispensed per pharmacist per hour， decreased significantly and patients’ medication-waiting time prolonged markedly before management （ P ＜0.05）. In the second phase after management， both the number of prescriptions dispensed per pharmacist per hour and the number of drug boxes dispensed per pharmacist per hour increased significantly， and patients’ medication-waiting time shortened greatly in contrast with the status before management （ P ＜0.05）. Besides， no statistically significant differences were found in the number of drug boxes dispensed per pharmacist per hour and patients’ medication-waiting time between the second phase after management and the period before scanning implementation （ P ＞0.05）.After the implementation of traceability-code scanning management， dispensing errors presented a gradually declining trend in each stage.CONCLUSIONS The fine management system for outpatient drug traceability codes constructed based on Pareto chart and ORTCC model can improve the traceability code scanning rate and pharmacists’ work efficiency of outpatient pharmacies， and reduce drug dispensing errors. |
| 期刊： | 2026年第37卷第19期 |
| 作者： | 卢杉杉；杨本军；邓明影；陈邵；程序；陈昭琳；马祥瑞；偶德峻；唐丽琴 |
| AUTHORS： | LU Shanshan，YANG Benjun， DENG Mingying，CHEN Shao，CHENG Xu，CHEN Zhaolin，MA Xiangrui，OU Dejun，TANG Liqin |
| 关键字： | 门诊药房;药品追溯码;精细化管理;帕累托图;ORTCC模型 |
| KEYWORDS： | Outpatient pharmacy;drugs traceability code;fine management;Pareto chart;ORTCC model |
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