基于PDCA循环法构建标准化药学会诊模式  

Construction of standardized pharmacy consultation model based on PDCA cycle method

作　　者：周鹏翔[1,2] 董淑杰 李潇潇[1,2] 闫盈盈 程吟楚[1,2] 李慧博 石伟龙[1,2] 徐晓涵 应颖秋 杨毅恒[1,2] 王志桐 刘芳 ZHOU Peng-xiang;DONG Shu-jie;LI Xiao-xiao;YAN Ying-ying;CHENG Yin-chu;LI Huibo;SHI Wei-long;XU Xiao-han;YING Ying-qiu;YANG Yi-heng;WANG Zhi-tong;LIU Fang(Department of Pharmacy,Peking University Third Hospital,Beijing 100191,China;Institute for Drug Evaluation,Peking University Health Science Center,Beijing 100191,China)

机构地区：[1]北京大学第三医院药剂科,北京100191 [2]北京大学医学部药物评价中心,北京100191

出　　处：《中国医院药学杂志》2022年第20期2177-2181,共5页Chinese Journal of Hospital Pharmacy

基　　金：首都卫生发展科研专项(编号:首发2020-1-2031)。

摘　　要：目的:采用计划(P)、执行(D)、检查(C)和处理(A)(PDCA)循环法构建标准化药学会诊模式。方法:制订计划,通过回顾性分析、问卷调研、根因分析、医-药联合研讨、制度修订和标准化模板建立等初步构建会诊模板,通过效果评估,定期召开药学会诊交流研讨会,明确重点难点和持续改进方向。计数资料的组间比较采用χ^(2)检验。结果:北京大学第三医院2020年药学会诊总量为327例,全部采纳292例(89.30%)。根因分析提示,标准化药学会诊流程、思路与模板的建立是关键因素。项目组开展了“药学会诊持续改进研讨会”,并制订了3项改进措施,修订了药学会诊制度与流程,建立了10个标准化药学会诊模板。改进干预后,临床药师对药学会诊的书写规范进一步明确(P=0.029),且对会诊流程“非常明确”的构成比有增加趋势,药师对会诊的信心有所增加。结论:基于PDCA循环法构建的标准化药学会诊模式,为同级别医疗机构药学会诊制度的优化和建立提供了模式探索和实践经验,也为付费药学服务的质量控制和持续改进提供了参考。OBJECTIVE Applying Plan(P),Do(D),Check(C)and Action(A)(PDCA)cycle method to construct a standardized pharmacy consultation model.METHODS The pharmacy consultation mode was constructed by using cycle management method of PDCA.After analyzing the problems in the pharmacy consultation,a standardized model of the pharmacy consultation was planned to be constructed,through retrospective analysis,questionnaire survey,root cause analysis,joint medical-pharmaceutical seminars,system revision and standardized template development.After the initial establishment of the pharmacy consultation model,the effect was evaluated again,with chi-square test used to compare the count data between groups.Regularly seminars were considered to clarify key difficulties and continuous improvement directions.RESULTS The total number of pharmacy consultations was 327 cases in our hospital in2020,and292 cases of which were fully accepted(89.30%).Root cause analysis suggested that the establishment of standardized pharmacy consultation procedures,ideas and templates were key factors.Through“continuous improvement seminar on pharmacy consultation”,3improvement measures were developed.The system and process of pharmaceutical consultation were improved,and 10 standardized pharmaceutical consultation templates were established consequently.After the improvement of the intervention,clinical pharmacists further clarified on the writing standard of pharmacy consultation(P=0.029),and the composition ratio of“very clear”consultation process showed an increasing trend,with their confidence in consultation increase.CONCLUSION The standardized pharmacy consultation model based on the PDCA cycle provides model exploration and practical experience for pharmacy consultation system in medical institutions,providing a reference for the quality control and continuous improvement of paid pharmacy services.

关 键 词：PDCA循环法 临床药师 药学会诊 模式 

分 类 号：R951[医药卫生—药学]