品管圈用于BR23疾病组临床用药干预模式建立的效果评价  

Application Effect of Quality Control Circle in Constructing the Clinical Medication Intervention Model for BR23 Disease Group

作　　者：周伟贤 陈荣[1] 姚池异 刘猛[1] 恽琴素 ZHOU Weixian;CHEN Rong;YAO Chiyi;LIU Meng;YUN Qinsu(The First People′s Hospital of Changzhou,Changzhou,Jiangsu,China 213000)

机构地区：[1]江苏省常州市第一人民医院,江苏常州213000

出　　处：《中国药业》2025年第5期30-34,共5页China Pharmaceuticals

基　　金：江苏省药品临床综合评价项目[KY20231613];江苏省常州市第四批科技计划项目[CJ20239009];江苏省常州市第十四批科技计划项目[CJ20219024];江苏省常州市第十三批科技计划项目[CM20223005]。

摘　　要：目的 探讨品管圈(QCC)活动在建立BR23疾病组(非5 d内死亡或转院,伴并发症或合并症的脑缺血性疾病)临床用药干预模式中的应用效果。方法 成立QCC小组,通过选定主题与拟订活动计划、明确攻坚点、确定活动目标、对策拟订与实施、实施效果确认、标准化处置与改进等QCC基本步骤改善经济性指标[BR23疾病组次均药费、疾病诊断相关分组(DRG)支付率、药占比]、合理性指标(BR23疾病组住院医嘱合理率、医嘱干预成功率)、保障性指标(审方药师团队人员储备数、药师审方水平考核合格率)。比较QCC活动实施前(2022年1月至7月)及实施后(2023年1月至7月)的有形成果(经济性、合理性、保障性指标)和无形成果(组员的自信心、凝聚力、发现并解决问题的能力、沟通能力、合作能力、拓展思维、学习新鲜事物、展示自己等活动能力评分)。结果 QCC活动实施后,有形成果中,审方药师团队人员储备数从实施前的8人增至16人;BR23疾病组药占比从实施前的30.24%降至28.03%,BR23疾病组DRG结付率从实施前的86.64%升至90.43%;BR23疾病组的次均药费显著低于实施前(P≤0.001);BR23疾病组的、住院医嘱合理率、医嘱干预成功率,以及药师审方水平考核合格率均显著高于实施前(P≤0.001)。无形成果中,组员的自信心、凝聚力、发现并解决问题的能力、沟通能力、合作能力、拓展思维、学习新鲜事物、展示自己等活动能力均较实施前提升。结论 QCC在建立BR23疾病组临床用药干预模式中可有效改善经济性、合理性、保障性指标,激发QCC组员学习的主动性,实现药学服务的转型。Objective To investigate the application effect of the quality control circle(QCC)activity in Constructing the clinical medication intervention model for the BR23 disease group(cerebral ischemic disease with complications or comorbidities that did not result in death or transfer within 5 d).Methods The QCC team was established to improve economic indicators[average per-visit medication cost,diagnosis-related groups(DRG)payment rate,and drug proportion of the BR23 disease group],rationality indicators(rational rate of inpatient medical orders,and order intervention success rate of the BR23 disease group),and guarantee indicators(reserve number of pharmacist review team members,assessment pass rate of the pharmacists′review levels)through selecting themes and developing activity plans,clarifying key points,determining activity goals,formulating and implementing countermeasures,confirming implement effectiveness,standardizing disposal and improvement,and other QCC basic steps.The tangible results(economic,rationality,and safety indicators)and intangible results(team members′confidence,cohesion,problem-solving ability,communication ability,cooperation ability,expanded thinking,learning new things,showcasing themselves)before(from January to July 2022)and after(from January to July 2023)the implementation of the QCC activity were compared.Results In terms of tangible results,after the implementation of the QCC activity,the reserve number of pharmacist review team members increased from eight pharmacists to sixteen pharmacists,the drug proportion in the BR23 disease group decreased from 30.24%to 28.03%,and the DRG payment rate in the BR23 disease group increased from 86.64%to 90.43%;the average per-visit medication cost in the BR23 disease group was significantly lower than those before the implementation of the QCC activity(P≤0.001);rational rate of inpatient medical orders,success rate of medical order intervention,and qualified rate of pharmacist prescription level assessment in the BR23 disease group were sig

关 键 词：品管圈 疾病诊断相关分组 BR23疾病组 临床用药 

分 类 号：R95[医药卫生—药学]