基于医疗失效模式与效应分析的医院药品管理界面风险识别与应对  

Identifying and responding to interface risk of hospital medicine management based upon healthcare fail⁃ure modes and effects analysis

作　　者：刘扬[1] 赵伟 刘越洋 姜凯文 冯彬 LIU Yang;ZHAO Wei;LIU Yueyang;JIANG Kaiwen;FENG Bin(Department of Pharmacy,Hei-longjiang Province Second Hospital,Heilongjiang Provincial Poison Rescue&Treatment Center,Heilongjiang Harbin 150010,China;School of Economic&Management,Tongji University,Shanghai 200092,China)

机构地区：[1]黑龙江省第二医院暨黑龙江省中毒抢救治疗中心药学部,黑龙江哈尔滨150010 [2]同济大学经济与管理学院,上海200092

出　　处：《中国医院药学杂志》2024年第11期1338-1344,共7页Chinese Journal of Hospital Pharmacy

基　　金：黑龙江省卫生健康委科研课题(编号:20211313040266)。

摘　　要：目的:识别、分析并降低医院药品管理界面风险。方法:建立项目团队,收集医院药品管理中存在的问题,应用医疗失效模式与效应分析方法对药品管理界面风险进行识别和分析。通过对失效模式的严重度(S)、发生频度(O)和探测度(D)进行评分及风险优先值(risk priority number,RPN)计算,量化并确定优先改进的界面风险失效模式,制订改进措施、实施干预。评价实施6个月后的干预效果。结果:确定了需优先改进的界面风险失效模式15项,制定了S、O、D评分标准,并据此逐项分析、评分与整改。干预后15项失效模式O、D值与RPN值均有所下降,且干预前、后差异有统计学意义(P<0.05),表明这些界面风险通过干预整改效果显著。干预前后S值无差异,表明各界面风险的严重程度不会随干预措施的实施而改变。结论:运用医疗失效模式与效应分析方法对医院药品管理界面风险进行识别和应对,各类界面风险的发生频度和探测度显著下降,有效降低了医院药品管理界面风险。OBJECTIVE To identify,evaluate and lower interface risk of hospital medicine management.METHODS A project team was dispatched to collect problems in medicine management in the hospital.And healthcare failure mode and effect analysis(HFMEA)was employed for examining the interface risks of medicine management.Through scoring the severity(S),occurrence(O)and detection(D)of failure modes and calculating the risk priority number(RPN),the interface risk failure modes prioritized for improvement were quantified.The improvement measures were formulated and interventions implemented.The effect of intervention was evaluated after 6 months.RESULTS A total of 15 interface risk failure modes for priority improve⁃ment were determined.Based upon S,O,D scoring standards,each interface risk failure mode was scored and rectified.After intervention,O,D and RPN values of 15 failure modes all declined.A significant difference existed between before and after inter⁃vention(P<0.05).That is,these interface risks had a significant effect through intervention.As for S-value,no difference existed before and after intervention.That is,severity of interface risk did not change with the implementation of intervention.CONCLUSION Adopting HFMEA method for identifying and coping with the interface risks of hospital interface management can significantly lower the frequency and detectability of various interface risks.Thus it may improves the quality of medicine man⁃agement and ensure patient safety.

关 键 词：界面风险 医院药品管理 医疗失效模式与效应分析 干预措施 

分 类 号：R954[医药卫生—药学]