精益管理前后对降低儿童医院门急诊静脉药物输液中心调配处方差错的影响

Influence on Reducing Admixing Prescription Errors in OUIVA of Children's Hospital by before and after Lean Management

目的:研究精益管理前后对儿童医院门急诊静脉药物输液中心(Out-patient pharmacy intravenous admixture center,OUIVA)调配处方差错的影响。方法:抽取2017年1—4月间OUIVA调配输液处方为精益管理前组;另抽取2017年5—8月间OUIVA调配输液处方为精益管理后组;应用鱼骨图和柏拉图分析法,找出各个环节导致调配差错的原因;并用6S理论调整流程、环境、人员和找出影响患者等待时间的原因。结果:精益管理后比精益管理前调配差错明显下降,患者缴费到输液登记的时间以及输液登记到输液时间分别为(12.3±1.1)min和(23.7±4.7)min短于精益管理前分别为(16.6±3.7)min和(30.8±1.8)min,经组间比较其差异均有统计学意义(t=6.232,10.862;P<0.01);精益管理后患者对服务的满意度明显高于精益管理前组(Z=-3.656,P<0.01)。结论:采用精益管理改善了儿童医院门急诊OUIVA的环境,降低了输液配制的差错率,缩短了患者等待时间,提高了患者对服务的满意度,确保了儿童用药的安全性。

Objective： To study the influence on redtlcing admixing prescription errors in out-patient pharmacy in- travenous admixture center（OUIVA） of Children＇s Hospital by before and after lean management. Methods： The mixing intiision prescriptions of OUIVA from January to April 2017 were selected as a lean management group, and the infusion of OUIVA during May and August of 2017 were selected as the post lean management group. The causes of the errors were identified by the fishbone diagram and Piaton analysis method, and tile process, environment, and personnel were adjusted and the reason for the waiting time was analyzed by the 6S theory. Results： After lean management, the errors were significantly lower than before pre-lean management .the time of the patient＇s payment to the infusion registration, and the time of the infusion registration to the infusion were （12.3±1.1） rain and （23.7±4.7） rain respectively below before the lean management （16.6±3.7） min and （30.8±1.8） rain respectively, and the diffrences were statistically significant （t=-6.232,10.g62;P〈0.01）, and the patients after lean management were compared. The satisfaction of ser- vice is significantly higher than that of before lean management group （Z=-- 3.656, P〈0.01）. Conclusion：The lean management improved the environment in OUIVA of Children＇s Hospital outpatient and emergency, redticed the errors of infusion, shortened the waiting time of patients, improved patient＇s satisfaction, and ensured the safety of children＇s medication.