“360风险防范”药学服务创新模式的构建与实施

Construction and implementation of “360 risk prevention” pharmacy innovation services

目的:基于大数据平台探索药物风险预警、风险干预、风险教育的新型药学服务模式的构建,以提升安全用药水平,提高药学服务质量,体现药师对医疗质量的核心价值。方法:从技术、能力、动力3个维度,实现3个创新,即基于大数据平台的用药风险防范交互系统,以临床用药风险为导向的药师培训体系,以用药风险防范为指标的绩效考评机制。结果:通过近4年实践,解决了早期预警技术缺失、风险干预手段落后、风险管控职责不清、风险防范能力不足、个体考核标准缺乏、奖罚激励机制缺失6个问题,监测患者86 000例次,成功干预风险医嘱3 300例次,不合理医嘱率由实施前24.9%降至实施后3.90%,每年节省药费约7 000万元,显著降低了药源性损害发生率,改善了患者用药依从性,提高了药师风险防范积极性,实现了全流程、精细化管理。结论:“360风险防范”药学服务能力培养创新模式可解决医疗机构用药风险防范的6个问题,实现安全用药“0风险”的目标。

OBJECTIVE A new pharmacy service model of drug risk early warning, risk intervention, and risk education is constructed based on the big data platform, aiming to improve the level of safe medication use, improve the quality of pharmacy services, and reflect the core value of pharmacists to medical quality.METHODS Three innovations were achieved from three dimensions of technology, competence, and motivation.Namely, an interactive system for medication risk prevention based on the big data platform;a pharmacist training system oriented to clinical medication risk;and a performance appraisal mechanism with medication risk prevention as an indicator.RESULTS Through nearly four years of practice, six problems have been solved, including the lack of early warning technology, backward risk intervention means, unclear division of responsibilities, insufficient risk prevention capabilities, unsound assessment standards, and lack of reward and punishment incentive mechanisms.A total of 86 000 patients were monitored.3300 risky medical prescriptions were successfully intervened.The rate of unreasonable medical order decreased from 24.9% before the implementation to 3.90% after the implementation.The annual drug cost saving is about 70 million RMB,and significantly reduces the incidence of drug-induced damage, improves patient medication compliance and the enthusiasm of pharmacists for risk prevention, Ultimately, the whole process and refinement management is made possible.CONCLUSION The innovative model of “360 risk prevention” pharmacy service can solve the six problems of drug risk prevention and achieve the goal of “zero risk” for safe drug use.