PDCA循环管理法干预前后门诊处方合理率比较

Comparison of Rationality of Outpatient Prescriptions before and after Intervention of PDCA Cycle Management

目的:探讨PDCA循环管理法在提高门诊处方合理率中的作用。方法:每月随机抽取中山大学肿瘤防治中心(以下简称"我院")2014年7月—2015年12月门诊处方300张,共5 400张,按PDCA循环管理法实施的时间分为干预前(2014年7—12月)和第1轮循环阶段(2015年1—6月)、第2轮循环阶段(2015年7—12月),比较PDCA循环管理法应用前后的处方合理率和各类不合理处方数。结果:PDCA法实施两轮循环后,门诊处方合理率由干预前86.22%(1 552/1 800)升高至第2轮循环阶段后的95.33%(1 716/1 800);我院主要不合理处方类型包括不规范处方、用药不适宜处方、超常处方,干预后各类不合理处方数量较干预前明显减少。结论:PDCA循环管理法用于门诊处方合理率的持续改进效果显著。

OBJECTIVE ： To probe into effects of PDCA cycle management in improving the rationality of outpatient prescriptions. METHODS： 300 prescriptions each month were randomly extracted from Jul. 2014 to Dec. 2015 in Cancer Center of Sun Yat-Sen University（ hereinafter referred to as ＂our hospital＂）, 5 400 prescriptions in total were divided into before intervention （Jul. 2014-Dec. 2014）, the first cycle of PDCA （Jan. 2015-Jun. 2015 ） and the second cycle of PDCA （Jul. 2015-Dec. 2015 ） according to the implementary time of PDCA. Numbers of rational prescriptions and irrational prescriptions before and after intervention of PDCA were compared. RESULTS： After carrying out two cycles of PDCA, the rate of rational prescription increased from 86.22% （1 552/1 800 ） before intervention to 95.33% （1 716/1 800） after the second cycle stage; irrational prescriptions mainly included lack of standardization, inappropriate drug application, abnormal prescriptions and so on. The number of all kinds of irrational prescriptions was significantly decreased after the intervention of PDCA. CONCLUSIONS： The application of PDCA cycle management can significantly improve the rationality of outpatient prescriptions.