采用六西格玛方法缩短PIVAS临时医嘱配置时间

To Shorten the Time of Admixture of Temporary Medical Order in PIVAS Using Six Sigma Method

目的:缩短静脉药物集中调配中心(PIVAS)临时医嘱配置时间,保障患者及时用药。方法:应用六西格玛方法的定义、测量、分析、改善、控制五步法,对我院2015年3月9-22日(改进前)PIVAS临时医嘱工作流程中的各环节耗时进行分析,找出关键控制点,制订相关措施并改进;再次收集分析2015年7月27日-8月9日(改进后)的临时医嘱工作流程中的各环节耗时,评价改进效果。结果:将工作流程中的分配输液批次、核对贴签、配制、复核包装、药品配送等环节耗时总长控制在120 min内确定为质量关键点;通过制订及实施改进信息系统、调整配制顺序及灵活调动人员岗位等各项措施,使改进后前3批临时医嘱的配置总时长分别约为120、98、77 min,与改进前比较分别缩短了约30、50、55 min(P<0.05)。结论:我院应用六西格玛方法缩短了临时医嘱配置时长,制订的措施有效、方法可行。

OBJECTIVE：To shorten the time of admixture of temporary medical order in PIVAS,and to guarantee the timely treatment of patients. METHODS：Through the definition,measurement,analysis,improvement and control ie. five steps of six sigma method,the consumed time of each link of temporary medical order admixture in PIVAS was analyzed in our hospital during Mar. 9th-22 nd in 2015（before improvement）;key points were found out,and relevant measures were formulated and improved;the consumed time of each link of temporary medical order admixture in PIVAS was collected again during Jul. 27th-Aug. 9th in2015 in order to evaluate improvement effects. RESULTS：It was quality key point that total length of temporary medical order admixture which included injection sequence,label checking,preparation,package rechecking,drug distribution and so on,was controlled within 120 min;through formulating and implementing various measures as improving information system,adjusting preparation sequence and shunting staff posts flexibly,the total time of first 3 batches of temporary order admixture were 120,98 and77 min after improvement,shortening by about 30,50 and 55 min respectively,compared with before improvement（P0.05）.CONCLUSIONS：The six sigma method has shortened the time of temporary order medical admixture in our hospital. The formulated measures are effective and feasible.