基于Delphi法的医疗机构药学服务质量控制指标体系研究

Study on the Quality Control Index System of Pharmaceutical Care in Medical Institutions Based on Delphi Method

目的:为提高医疗机构药学服务水平、实现药学服务精准化提供参考。方法:在依托广西医院药事管理质控中心对广西三级甲等医院进行抽样调查摸底的基础上,结合文献分析结果和国际相应标准,运用Delphi法采用现场调研和电子邮件调研两种方式发放专家咨询表,对4轮专家咨询的调查结果进行分析总结,建立医疗机构药学服务质量控制指标体系。结果与结论:所有专家(100%)均认为医疗机构药学服务工作非常重要并需要质控指标体系。根据专家咨询结果,最终拟定出5个一级指标(包括药学服务管理组织构架建设、合理用药管理、药学服务专业能力管理、药学服务监测管理和特色药学服务管理)及26个二级指标。一级指标中,“药学服务管理组织构架建设”“合理用药管理”“药学服务专业能力管理”等指标被专家普遍认为是重要的质控指标,“很重要”和“重要”占比分别为96.65%、100%和100%;二级指标中,“组织建设”“制度建设”“处方用药管理”“住院医嘱审核”“不良反应监测”“药学知识”“临床知识”等指标被专家普遍认为是重要的质控指标,“很重要”和“重要”占比分别为95.65%、95.65%、100%、95.66%、96.65%、100%、91.30%。本研究所拟定的医疗机构药学服务质量控制指标体系权威性较高,现已经广西医院药事管理质控中心审核、定稿,并在广西15家医疗机构进行试点。

OBJECTIVE:To provide reference for improving the level of pharmaceutical care in medical institution,and realizing the precision of pharmaceutical care. METHODS:A sampling survey of third grade class A hospitals in Guangxi was conducted on the basis of Guangxi Hospital Pharmaceutical Administration Quality Control Center. Based on the results of literature analysis and international standard,by using Delphi method,the expert consultation form was issued by E-mail and field investigation;the results of four rounds of expert consultation were analyzed and summarized. Pharmaceutical care quality control index system was established in medical institutions. RESULTS & CONCLUSIONS:All experts(100%)agreed that pharmaceutical care in medical institutions was very important and required a quality control index system. Finally,5 first-level indicators (including the construction of pharmaceutical care management organizational framework, rational drug use management, pharmaceutical care professional capacity management,pharmaceutical care monitoring management and characteristic pharmaceutical care management) and 26 second-level indicators were fitted according to results of expert consultation. Among first-level indicators,the indicators of“the construction of pharmaceutical care management organizational framework”,“rational drug use management”and“pharmaceutical care professional competence management”were generally considered as important quality control indicators by experts;the proportion of“very important”and“important”were 96.65%,100% and 100%. Among second- level indicators,the indicators of“organization construction”“system construction”“prescription drug use management”“hospitalization medical order review”“adverse drug reaction monitoring”“medicine knowledge”“clinical knowledge”were generally considered as important quality control indicators by experts;the proportion of“very important”and“important”were 95.65%,95.65%,100%,95.66%,96.65%,100% and 91.30%. The quality control index system of pharmaceutical care in medical institutions fitted by this research institute is authoritative. Now,15 medical institutions in Guangxi Zhuang Autonomous Region have been pilot implemented after audited and finalised by Guangxi Hospital Pharmaceutical Administration Quality Control Center.