常惠礼,林杰茹,刘文亮,何源君
CHANG Huili,LIN Jieru,LIU Wenliang,HE Yuanjun

• 1:广州医科大学附属第六医院/清远市人民医院药学部

摘要(Abstract)：

目的 探讨住院药房绩效核算的效果。方法 基于RBRVS理论，以住院药房6个班次绩效为研究对象，对比2021年10月至2022年1月、3～4月分别以医嘱单数、条目数、药品数为单位工作量数据，确认变异系数最小的为工作量统计值。以该工作量统计值转换工作量数据，并设定工作质量分项核算绩效，观察2022年5～10月各班次工作量差异、医嘱处理效率、差错发生情况以及患者满意度。结果 以医嘱药品数计算工作变异系数最小。除副班改善前后工作量差异没有统计学意义外，其余班次改善前后P<0.05，差异均有统计学意义。各班次改善前后工作量变异系数分别为17.91%、11.46%,P=0.010 6。改善前后医嘱处理效率分别为4.52分/张、3.94分/张（P=0.019 3）。其中长期医嘱处理效率分别为2.58分/张、2.31分/张（P=0.021 5）；临时医嘱分别为0.39分/张、0.33分/张（P=0.000 7）；统领单医嘱分别为1.55分/张、1.37分/张（P=0.040 8）。差错发生DPMO（百万机会缺陷数）=4.3，大于5个西格玛水平；患者满意度从93.9%上升至97.4%。药师较前节约5人，劳务费用节省54万元/年。结论基于RBRVS理论，应用工作量变异系数最小的医嘱药品数为单位核算住院药房绩效工作量，同时与工作质量分项共同绩效考核，整体的工作效率和质量均有提高，患者满意度上升，节省人力成本。
OBJECTIVE To investigate the effect of the performance accounting of inpatient pharmacy. METHODS Based on the RBRVS theory,the performance of 6 shifts in the inpatient pharmacy was the research object. Compared with October 2021 to January 2022 and March-April,the number of medical orders,the number of entries,and the number of medicines was the least confirmed to confirm that the mutation coefficient was the smallest.. The workload data with the statistics was converted to the workload,andthe performance of work quality was set to observe the differences in the workload of each class.The processing efficiency of the doctor's order,the incident of error,and the patient satisfaction of patients from May to October 2022 were observed. RESULTS The coefficient of variation of the number of medical orderswas the smallest. Except for the difference in workload before and after the improvement of the sub-shift,the difference in workload before and after the improvement of the other shifts was P<0.05,and the difference was statistically significant. The coefficients of variation of workload before and after the improvement of each shift were 17.91% and 11.46% respectively,and P=0.010 6. The efficiency of medical order processing before and after improvement was 4.52 minutes/piece and 3.94 minutes/piece,respectively(P=0.019 3). Among them,the efficiency of long-term medical order processing was 2.58 and 2.31 minutes/piece,respectively(P=0.021 5). The provisional medical orders were 0.39 and 0.33 minutes/piece(P=0.000 7),respectively. The medical orders were 1.55 and 1.37 minutes/piece,respectively(P=0.040 8). DPMO(millions of chance defects) was 4.3,greater than 5 sigma levels. Patient satisfaction rose from 93.9% to 97.4%. Pharmacists saved 5 people compared with the previous one,and labor costs saved 540 000 yuan per year. CONCLUSION Based on RBRVS theory,the number of drugs with the least variation coefficient of application workload is to calculate the performance workload of the hospital for hospitalization. At the same time,it will be assessed with the work quality split item. The overall work efficiency and quality are improved. Patient satisfaction has increased,labor costs are saved.

关键词(KeyWords)： RBRVS;住院药房;绩效
RBRVS;inpatient pharmacy;performance

Abstract:

Keywords:

基金项目(Foundation): 广东省医院协会药学科研专项基金（2022YSGL03）

作者(Author): 常惠礼,林杰茹,刘文亮,何源君
CHANG Huili,LIN Jieru,LIU Wenliang,HE Yuanjun

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