4M1E精细化管理法在优化我院门诊药房工作中的应用及效果评价
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篇名: 4M1E精细化管理法在优化我院门诊药房工作中的应用及效果评价
TITLE: Application and Effect Evaluation of 4M1E Refined Management Method in Optimizing Outpatient Pharmacy Service in Our Hospital
摘要: 目的:探索门诊药房精细化管理模式,提高门诊药房工作效率和服务质量。方法:从我院医院信息与大数据中心调取门诊患者取药相关数据,对传统管理模式下的门诊药房处方数据进行统计,通过鱼骨分析法发现可能影响患者候药时间和药房工作效率及质量的因素,采用质量管理工具4M1E法对相关问题进行改进并实施精细化管理。选择改进前、精细化管理第1阶段及第2阶段各10个工作日的处方数据,对改进前后的药师工作效率、患者平均候药时间、调配差错和盘点错误等进行对比分析,以评价精细化管理的实施效果。结果:通过鱼骨图分析发现,影响患者候药时间和我院门诊药房工作效率及质量的因素包括人员因素、机器因素、物料因素、方法因素、环境因素等,如人员上岗人数和时间分配不合理、机器老化等。实施精细化管理后,我院门诊药房采取了调整人员上岗时间并细化绩效奖励方案、维护自动发药机并更新处方扫描设备、设立临时药柜并优化货位号、加强药品管理和相关人员培训、开设特色单品种发药窗口等多种措施。统计结果表明,在实施精细化管理的第1阶段,我院门诊药房10个工作日的调剂处方数和处方条目数均有小幅上涨,门诊药房因上岗人数减少且开放窗口数量和时间有所变化,上岗人员累计工作时长由1680h减少至1440h;人均每小时调剂处方数和处方条目数分别由52.0张、58.7个增加至65.1张、69.6个(P<0.05);收集到的调配差错数量由30条减少为5条,患者候药时间和盘点错误数未见有明显变化。在第2阶段,在我院门诊药房调剂处方量相近的情况下,药师人均每小时调剂处方数和处方条目数分别由改进前的52.0张、58.7个增加至59.9张、67.3个(P<0.05),患者的平均候药时间由9.30min缩短到7.32min(P<0.05);经进一步细化差错数据收集方式和调整绩效激励方案后,门诊药房调配差错上报数增加至75条,盘点错误由5条降为0条。结论:我院门诊药房通过4M1E法进行精细化管理,实现了工作效率和质量的提升,缩短了患者的候药时间。
ABSTRACT: OBJECTIVE:To explore refined management mode of outpatient pharmacy ,and to improve the efficiency and quality of outpatient pharmacy service. METHODS :From the hospital information and big data center of our hospital ,the outpatient pharmacy prescription data under the traditional management mode were collected ;fish bone analysis was used to find out the factors that may affect the waiting time of patients ,the work efficiency and quality of pharmacy ;4M1E method was adopted to improve the related problems and implement refined management. The prescription data of 10 working days before improvement,stage 1 and stage 2 of refined management were selected. The work efficiency of pharmacists ,average waiting time of patients ,dispensing errors and inventory errors before and after the improvement were compared and analyzed to evaluate the effects of refined management. RESULTS :By fishbone diagram ,the factors influencing the waiting time of patients ,the work efficiency and quality of outpatient pharmacy service in our hospital included personnel factors ,machine factors ,material factors , method factors ,environmental factors ,such as the number of personel and time alloction was unreasonable ,the machine was aging,etc. After the implementation of refined management ,the outpatient pharmacy of our hospital had taken a variety of measures,such as adjusting the staff working time and refining the performance rew ard scheme ,maintaining the automatic dispensing machine and updating the prescription scanning equipment,setting up temporary drug containers and opti- mizing the location number ,strengthening drug management and relevant personnel training , openning the window ofcharacteristic single variety dispensing. The statistical results com showed that in the first stage of fine management ,the number of dispensing prescriptions and the number of p rescription items in the outpatient pharmacy of our hospital increased slightly in 10 working days. Due to the decrease of the number of on-the-job staff and the change of the number and time of open windows ,the cumulative working hours of on-the-job staff decreased from 1 680 hours to 1 440 hours;the number of dispensing prescriptions and prescription items per hour per capita increased from 52.0 pieces,58.7 to 65.1 pieces,69.6(P<0.05);the number of dispensing errors decreased from 30 to 5;there was no significant change in waiting time of patients and inventory errors. In the second stage of fine management ,when the amount of dispensing prescriptions in outpatient pharmacy of our hospital was similar ,the number of dispensing prescriptions and the number of prescription items per hour per capita increased from 52.0 pieces,58.7 to 59.9 pieces,67.3,respectively(P<0.05);the average waiting time of patients decreased from 9.30 min to 7.32 min(P<0.05). After further refining the error data collection method and adjusting the performance incentive scheme ,the number of dispensing errors in outpatient pharmacy increased to 75,and the number of inventory errors decreased from 5 to 0. CONCLUSIONS :By 4M1E method,outpatient pharmacy of our hospital carry out refined management ,to achieve the improvement of work efficiency and quality,shorten the waiting time of patients
期刊: 2021年第32卷第04期
作者: 徐晓涵,颉博闻,蔡峥,赵荣生
AUTHORS: XU Xiaohan ,JIE Bowen ,CAI Zheng,ZHAO Rongsheng
关键字: 门诊药房;精细化管理;4M1E法;效果评价;工作效率
KEYWORDS: Outpatient pharm acy;Refined management ;4M1E method ;Effect evaluation ;Work efficiency
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