用失效模式和影响分析法规范药品供应链协同服务平台在门诊药房领药中的应用
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摘要
目的强化门诊药房运用药品供应链协同服务平台领药的规范化管理,确保医院药品供应,合理降低药品库存积压,提升门诊药房领药管理能力。方法利用失效模式和影响分析(FMEA)法及时发现药品供应链协同服务平台中领药系统潜在的风险,并制定相应改进措施。结果通过对供应链服务平台领药流程的改进,使领药差错从137次下降为32次,风险降低比率达到76.64%,显著地降低了领药错误的风险。结论通过FMEA法,前瞻性地发现领药系统的漏洞和隐患,通过不断研究改进措施,切实提高药品供应链协同服务平台的领药功能,使门诊药房领药更加合理与准确。
Objective To strengthen the system of drug supply chain collaborative service platform in drug supply,decrease drug inventory backlog,and improve the outpatient pharmacy management capacity in outpatient pharmacy.MethodsFailure mode and effects analysis(FMEA)method was used to discover the potential risks in the drug supply chain collaborative service platform and formulate the corresponding improvement measures.Results The number of drug-receiving errors dropped from 137 times to 32 times and the risk reduction rate was 76.64%after improving the procurement process of the supply chain service platform,which significantly reduced the risk of contracting errors.Conclusion FMEA method could help to figure out the loopholes and hidden dangers of the pharmacy system,which made the outpatient pharmacy more reasonable and accurate by constantly improving the measures of the drug supply chain collaborative service platform.
Objective To strengthen the system of drug supply chain collaborative service platform in drug supply,decrease drug inventory backlog,and improve the outpatient pharmacy management capacity in outpatient pharmacy.MethodsFailure mode and effects analysis(FMEA)method was used to discover the potential risks in the drug supply chain collaborative service platform and formulate the corresponding improvement measures.Results The number of drug-receiving errors dropped from 137 times to 32 times and the risk reduction rate was 76.64%after improving the procurement process of the supply chain service platform,which significantly reduced the risk of contracting errors.Conclusion FMEA method could help to figure out the loopholes and hidden dangers of the pharmacy system,which made the outpatient pharmacy more reasonable and accurate by constantly improving the measures of the drug supply chain collaborative service platform.
引文
[1]陈莉华,黄齐慧,成明建,等.基于精益思想的医院领药业务流程再造[J].中国民族民间医药,2012,15(2):159-160.
[2]李惠莹,云雄.供应链协同服务平台系统在医院药库中的应用[J].医药导报,2014,33(10):1398-1340.
[3]沈烽,张健,杨传敏,等.我院药库物流信息化管理实践及体会[J].中国药房,2009,20(31):2429-2431.
[4]周玲,缪丽燕.院内供应链药品采购模式对改善我院药品库存管理探讨[J].中国药房,2011,22(9):821.
[5]马瑛,庞成森,王新鹏.完善医院药品供应链与优化库存结构的实践与体会[J].医药导报,2013,24(21):1969.
[6]庞成森,董海燕,董亚琳.基于互联网的药品供应链协同平台在我院药库的应用[J].中国药师,2014,17(4):682-684.
[7]SAE J.Potential failure mode and effects analysis in design(Design FMEA)potential failure mode and effects analysis in manufacturing and assembly processes(Process FMEA),and potential failure mode and effects analysis for machinery(Machinery FMEA)[S].2002.
[8]SAE ARP5580.Recommended failure modes and effects analysis(FMEA)practices for non-automobile applications[S].2001.
[9]BS EN60812:2006Analysis techniques for system reliability,procedures for failure mode and effect analysis(FMEA)[S].2006.
[10]于雁玲,武建康,范慧霞.失效模式后果分析在高危药品管理中的应用[J].中国药物与临床,2013,11:1503-1504.
[11]ONODERA K.Effective techniques of FMEA at each life-cycle stage[A],Proceedings,Annual Reliability and Maintainability Symposium[C].IEEE,1997.
[12]武志昂.试论药品风险管理和质量价值链[j].中国药物评价,2012,29(2):180-182.
[13]ASHLEY L,ARMITAGE G.Failure mode and effects analysis:an empirical comparison of failure mode scoring procedures[J].J Patient Saf,2010,6(4):210-215.
[14]宋相梅,曲建华,王莉梅,等.运用FMEA法规范住院药房麻醉药品及一类精神药品质量管理[J].中国药物评价,2017,34(2):153-156.
[15]梁婉宁,赵育鹏,廖志斌.计算门诊药房二级库药品库存上下限的方法分析[J].中国医学创新,2017,14(10):140-143.
[16]WU M,SIN A,NISHIOKA F,et al.Non-drug costa associated with outpatient infliximab administration in pediatric inflammatory bowel disease[J].Inflammatory Bowel Diseases,2013,19(7):1514-1517.
[17]贾俊琴,宋沧桑,包金颖.PDCA循环在病区药品管理持续改进中的应用[J].中国药物评价,2016,33(4)::251-252.
[18]宋菲,董迪,甄健存.风险管理在胰岛素及其类似物用药错误防范中的应用[J].药学实践杂志,2017,37(7):650-653.
[19]PONTO T,ISMAIL N I,ABDUL MAJEED A B,et al.A prospective study on the pattern of medication use for schizophrenia in the outpatient pharmacy department,Hospital Tengku Ampuan Rahimah,Selangor,Malaysia[J].Methods Find Exp Clin Pharmacol,2010,32(6):427-432.
[20]JAGER N G,ROSING H,SCHELLENS J H,et al.Tamoxifen dose and serum concentrations of tamoxifen and six of its metabolites in routine clinical outpatient care[J].Breast Cancer Res Treat,2014,143(3):477-483.
[21]KUO G M,TOUCHETTE D R,MARINAC J S.Drug errors and related interventions reported by United States clinical pharmacists:the American College of Clinical Pharmacy practice-based research network medication error detection,amelioration and prevention study[J].Pharmacotherapy,2013,33(3):253-265.
[22]BAO L,WANG Y,SHANG T,et al.A novel clinical pharmacy management system in improving the rational drug use in department of general surgery[J].Indian J Pharm Sci,2013,75(1):11-15.
[23]YEH M L,CHANG Y J,YEH S J,et al.Potential drug-drug interactions in pediatric outpatient prescriptions for newborns and infants[J].Computer Methods and Programs in Biomedicine,2014,113(1):15-22.
[2]李惠莹,云雄.供应链协同服务平台系统在医院药库中的应用[J].医药导报,2014,33(10):1398-1340.
[3]沈烽,张健,杨传敏,等.我院药库物流信息化管理实践及体会[J].中国药房,2009,20(31):2429-2431.
[4]周玲,缪丽燕.院内供应链药品采购模式对改善我院药品库存管理探讨[J].中国药房,2011,22(9):821.
[5]马瑛,庞成森,王新鹏.完善医院药品供应链与优化库存结构的实践与体会[J].医药导报,2013,24(21):1969.
[6]庞成森,董海燕,董亚琳.基于互联网的药品供应链协同平台在我院药库的应用[J].中国药师,2014,17(4):682-684.
[7]SAE J.Potential failure mode and effects analysis in design(Design FMEA)potential failure mode and effects analysis in manufacturing and assembly processes(Process FMEA),and potential failure mode and effects analysis for machinery(Machinery FMEA)[S].2002.
[8]SAE ARP5580.Recommended failure modes and effects analysis(FMEA)practices for non-automobile applications[S].2001.
[9]BS EN60812:2006Analysis techniques for system reliability,procedures for failure mode and effect analysis(FMEA)[S].2006.
[10]于雁玲,武建康,范慧霞.失效模式后果分析在高危药品管理中的应用[J].中国药物与临床,2013,11:1503-1504.
[11]ONODERA K.Effective techniques of FMEA at each life-cycle stage[A],Proceedings,Annual Reliability and Maintainability Symposium[C].IEEE,1997.
[12]武志昂.试论药品风险管理和质量价值链[j].中国药物评价,2012,29(2):180-182.
[13]ASHLEY L,ARMITAGE G.Failure mode and effects analysis:an empirical comparison of failure mode scoring procedures[J].J Patient Saf,2010,6(4):210-215.
[14]宋相梅,曲建华,王莉梅,等.运用FMEA法规范住院药房麻醉药品及一类精神药品质量管理[J].中国药物评价,2017,34(2):153-156.
[15]梁婉宁,赵育鹏,廖志斌.计算门诊药房二级库药品库存上下限的方法分析[J].中国医学创新,2017,14(10):140-143.
[16]WU M,SIN A,NISHIOKA F,et al.Non-drug costa associated with outpatient infliximab administration in pediatric inflammatory bowel disease[J].Inflammatory Bowel Diseases,2013,19(7):1514-1517.
[17]贾俊琴,宋沧桑,包金颖.PDCA循环在病区药品管理持续改进中的应用[J].中国药物评价,2016,33(4)::251-252.
[18]宋菲,董迪,甄健存.风险管理在胰岛素及其类似物用药错误防范中的应用[J].药学实践杂志,2017,37(7):650-653.
[19]PONTO T,ISMAIL N I,ABDUL MAJEED A B,et al.A prospective study on the pattern of medication use for schizophrenia in the outpatient pharmacy department,Hospital Tengku Ampuan Rahimah,Selangor,Malaysia[J].Methods Find Exp Clin Pharmacol,2010,32(6):427-432.
[20]JAGER N G,ROSING H,SCHELLENS J H,et al.Tamoxifen dose and serum concentrations of tamoxifen and six of its metabolites in routine clinical outpatient care[J].Breast Cancer Res Treat,2014,143(3):477-483.
[21]KUO G M,TOUCHETTE D R,MARINAC J S.Drug errors and related interventions reported by United States clinical pharmacists:the American College of Clinical Pharmacy practice-based research network medication error detection,amelioration and prevention study[J].Pharmacotherapy,2013,33(3):253-265.
[22]BAO L,WANG Y,SHANG T,et al.A novel clinical pharmacy management system in improving the rational drug use in department of general surgery[J].Indian J Pharm Sci,2013,75(1):11-15.
[23]YEH M L,CHANG Y J,YEH S J,et al.Potential drug-drug interactions in pediatric outpatient prescriptions for newborns and infants[J].Computer Methods and Programs in Biomedicine,2014,113(1):15-22.