基层医院药事管理质量现状及提升路径探讨

Current Situation and Improvement Path of Pharmaceutical Management Quality in Grass-Roots Hospitals

目的分析基层医院药事管理质量现状并探讨其提升路径。方法根据《成都市医疗服务质量检查标准》,对四川省成都市金堂县部分医院(2019年21家,2020年18家)进行为期7~9 d的药事管理检查,2019年(干预前)检查后对各医院面授整改方案及意见,统计多条款药事管理质量得分,将2020年(干预后)检查结果用箱式图表示,采用Scheffe法筛选出有待提高的条款。选取2019年和2020年均接受检查的8家医院的药事管理项目,分析检查及整改对医疗机构药事管理质量的影响。结果抗菌药物、质量与安全、储存养护管理是该县医疗机构药事管理普遍存在的问题;督导检查能明显提升基层医院的药事管理能力(t=-4.044,P<0.05);2020年该县基层医院基本药物、质量与安全、药事管理委员会的相关管理质量均提升明显。结论现阶段,基层医院要迅速有效提升药事管理质量,需以质量与安全管理为基础,对科室人员进行质量管理工具使用的培训,使其能使用管理工具,提升自我专业知识水平和处理问题的能力。

Objective To analyze the current situation of the pharmaceutical management quality in grass-roots hospitals,and to investigate its improvement path.Methods According to the Chengdu Medical Service Quality Inspection Standards,the pharmaceutical management of some hospitals(21 hospitals in 2019 and 18 hospitals in 2020)in Jintang County,Chengdu City,Sichuan Province was inspected for 7 to 9 d.After the inspection in 2019(before intervention),each hospital was given face-to-face rectification plans and suggestions,and the scores of the pharmaceutical management quality of multiple provisions were calculated.The inspection results in 2020(after intervention)were shown in a box plot,and the provisions to be improved were screened out by the Scheffe method.The projects of pharmaceutical management quality of eight hospitals inspected in 2019 and 2020 were selected to analyze the impact of inspection and rectification on the pharmaceutical management quality in medical institutions.Results Antibiotics,quality and safety,storage and maintenance management were the common problems in the pharmaceutical management of medical institutions in the county.Supervision and inspection can significantly improve the pharmaceutical management level of grass-roots hospitals(t=-4.044,P<0.05).In 2020,the relevant management quality of essential drugs,quality and safety,and pharmaceutical management committees in the county's grass-roots hospitals improved significantly.Conclusion At the present stage,in order to rapidly and effectively improve the pharmaceutical management quality in grass-roots hospitals,it is necessary to train the department staff in the use of quality management tools based on quality and safety management,and enable them to use management tools to improve their professional knowledge levels and ability to deal with problems.