Application Of Six Sigma Management In Pharmacists Intervention On Clinical Irrational Drug Use

Purpose:This study researched irrational drug use of outpatient prescriptions with Six sigma (6σ) management before and after pharmacist intervention,found out the key reasons resulting in the phenomenon of irrational drug use,then improved this phenomenon with some intervention measures.This study aimed to reduce and eliminate the phenomenon of irrational drug use,ensure the safety,rationality,efficiency of medication use,so as to improve quality of health care,save medical resources,reduce medication incidents and drug-induced diseases, protect the patient safety of medical care.Methods:With DMAIC (Define, Measure, Analyze, Improve, Control) five-step method of Six sigma (6σ) management, we randomly selected 13,015 outpatient prescriptions in Second Hospital of Shandong University between July 2009 and December 2009, investigated the status of irrational drug use in prescriptions,using drug Instructions, "Clinical medicine Guide", "Prescription Management", "clinical guideline for antimicrobial agents", "New Drug Studies "(16th edition)," Hospital pharmacy management practices of Prescription Reviews(Trial) ",clinical guidelines of disease diagnosis and treatment as standards for rational drug use. Using Minitab15 statistical software,we analyzed the data and calculated the Z value of process capability, then with brainstroming method,we found the main factors that could lead to irrational drug use,drew a fishbone diagram, intervented the factors for the irrational drug use.After the intervention,15,338 prescriptions were randomly selected between May 2010 and October 2010.Comparing the data before and after intervention,we analysed the roles and action of six sigma management in pharmacists intervention on clinical irrational drug use.Results:With six sigma management in clinical intervention on irrational drug use, the rate of irrational drug use (defect rate) were respectively 8.93% and 4.06% (P<0.001) before and after intervention,Z value of process capability increased from 2.85 to 3.20, which was a significant difference.Conclusions:Through investigation and analysis of irrational drug use in outpatient prescriptions, it's found that there were a lot of clinical phenomenon of irrational drug use.There were various factors that could lead to clinical irrational drug use,including social factors,hospitals, doctors,nurses,pharmacists,patients,etc.Taking measures and targeted intervention of the phenomenon of irrational drug use could make the management of outpatient pharmacy more scientific and finer,improve the ability and level of pharmacists reviewing prescriptions,and promote hospital pharmacists to improve service levels.By training hospital administrators, doctors, nurses,pharmacists,hospital process was optimised,hospital operating costs were reduced and service quality were improved.The management,which is worth promoting,broke traditional work habits,created a new way of doing things and thinking,and produced the workflow, and laid a solid foundation for creating a pragmatic hospital culture in the process of continuous improvement.