Practice Research Of Construction And Management Of Pharmacy Intravenous Admixture Service Of Hospital

Research Background and SignificanceThe overall goal of the healthcare reform is, establishing and improving the urban and rural residents covered by basic medical and health system, in order to provide people with safe, effective, convenient, affordable medical and health services. Among them, the pharmacy service is an important part of medical and health services. The new medical reform aims not only to improve the poor on the accessibility of basic drugs, but also to the pharmaceutical services in the future direction, which is standard clinical drug use, rational drug use, quality management. The new medical reform requirements will accelerate the work of transformation from traditional hospital pharmacy drug supply type to knowledge and technical service.PIVAS is an essential part of pharmacy in hospital in developed countries. Because of its intensive advantages in many aspects, it can provide the high-quality service for the clinical pharmacy services, so they soon got the attention. It has been developing rapidly in western countries, and has become one of the important content of the work of clinical pharmacists in hospital. At the beginning of the twenty-first Century, in the United States93%of the for-profit hospitals and100%nonprofit hospitals built PIVAS in different size. The developed countries in Europe and America’s teaching hospitals also have built of PIVAS, and will gradually expand to the clinics, community health service system as well as the small hospital.Intravenous drug use centralized deployment mode in domestic developed later. Central Hospital of Shanghai Jing’an District became the first to carry out the service of the hospital in1999. Since then, Guangdong, Shanghai, Jiangsu, Shandong and other provinces and cities have also established PIVAS. The Ministry of Health has pointed out to establish total parenteral nutrition and chemotherapy and intravenous fluid compound for the centralized supply in2002and2011. Until2006, more than200hospitals has built PIVAS. But compared with287797medical institutions in China, its penetration is far lower than the United States and Australia. By the end of2009, China has built350hospital pharmacy intravenous admixture services, but the few can play its due role and advantages real fully.Since the new century, people on medical service level enhance unceasingly, the development of new drugs emerges in an endless stream, and drug compatibility becomes more complex, and safe transfusion has become an important topic in hospital management. In2010, the Ministry of Health promulgated the quality management standard of pharmacy intravenous admixture service. The basic requirements for constructing PIVAS and operation process were discussed, and the name of the specification, identified as PIVAS (Pharmacy Intravenous Admixture Services). Subsequently, more and more hospitals are beginning to build PIVAS. Each hospital should establish and improve the pharmacy intravenous admixture mode, combined with the current situation of the development of service of the hospital and the requirement of hospital, and gradually change the drug distribution model, in order to ensure medication safety and reasonable.But the construction and operation mode of PIVAS in hospitals are great different due to various factors, so it is necessary to review and summarize the theory and practice system for the establishment and management of PIVAS, put forward effective intravenous medication of centralized deployment mode and implementation example of construction management system. This task is to carry out in order to facilitate future new PIVAS in hospital as a reference, and provide reference method for optimizing the original hospital pharmacy intravenous admixture services.Research Theory and MethodThe whole process of this paper attempts to introduce the idea of Lean management to realize high efficiency and safety of PIVAS in construction and management. Lean management comes from Toyota Auto production system. In1996, James Womack and Daniel Jones put forward concept of lean management in the first time in their brilliant book Lean Thinking.Lean manufacturing industry from production was developed into a set of management theory system, widely used in aerospace, machinery manufacturing, construction, food sales, postal services, banks, car, hotel and other industries. Lean is not a simple management strategy which is applicable only to manufacturing or cost reduction methods; on the contrary, it has been used in most commercial and non-profit organization. In the medical industry, many of the world leading hospitals as the second hospital MAYO CLINIC medical group of United States, Alexander Changi General Hospital of Singapore, employed Lean management into the daily work, established a set of system and mechanism, and put it in the organizational structure of a certain height position.According to the Lean theory, an ideal process should be able to create their required value when the customer need. Similarly, in the medical industry each step can be created for patients that they required value. Previously, medical staff in hospital often design mechanical process by convenient or medical professional need, but rarely take into account the needs of patients. For the hospital management department, the biggest challenge is how to start providing efficient service flow from the patient’s needs. Therefore, as an idea and method in the modern business management, Lean management has been gradually applied to the hospital medical work flow and pharmacy.Research Ideas and ContentThis dissertation focuses on the construction modes and design standards of the pharmacy intravenous admixture service, according to the actual situation of research and design of the hospital pharmacy intravenous admixture service platform in Nanfang Hospital. Combining with the advanced management idea and method, the research deploy optimization the work flow and the information flow to realize the vein drug concentration maximum. The other problems of PIVAS in sustainable development need to pay attention to the discussion also. This paper aims to clarity the nature, ultimate goal and the core value of intravenous admixture model which realize the transformation of pharmaceutical service mode, provide theoretical basis for the management system and practice experience of the pharmacy intravenous admixture service platform.This paper is divided into the following parts:The preface focuses on the analysis of the environment requires and development background of intravenous medication and pharmacy service, advantages and disadvantages of traditional significance and intravenous drug dispensing mode in centralized deployment mode comparison, comparative analysis of the construction situation and development trends of international and domestic intravenous drug control mode, summarizes the purpose and significance of the establishment and implementation of centralized deployment mode of intravenous medication. On this basis, the research ideas and the main content of this paper have been put forward.The first part states the mode of the construction and design standards of PIVAS and introduces the construction mode selection and configuration, operation of PIVAS in Nanfang Hospital as an example. The second part analyses the problem of PIVAS on the existing personnel management, work process, information system and other aspects, and focus on how to use the advanced concept of lean management theory and scientific method improve and optimize PIVAS system and achieved effect. The third part discusses the other problems of sustainable development of PIVAS as drug management, quality control and infection control, cost effectiveness and the corresponding management measures. The fourth part states the fundamental and core value of PIVAS to realize the transformation of pharmaceutical service mode.ConclusionThis paper apply Lean management, the advanced management idea and method, to the optimization of medical work flow and pharmaceutical service of hospital pharmacy intravenous admixture mode to achieve real change pharmaceutical service mode, and provides a reference example of construction and implementation of pharmacy intravenous admixture service model for other hospitals.To sum up, the PIVAS platform can realize the fundamental transformation of pharmaceutical service mode and give full play to the professional role of pharmacists.