Construction And Practice Of Hospital Pharmaceutical Care Evaluation System In County Medical Institutions

[Objective]This paper,starting from the main pharmaceutical service items(drug supply guarantee,drug dispensing,clinical pharmaceutical care and adverse drug reaction monitoring)of a county medical institution in the pilot medical reform,this paper explores the establishment of a relatively complete hospital pharmaceutical service evaluation system,and tests the feasibility of the evaluation system through the satisfaction of patients and departments to the hospital pharmaceutical service.The system aims to standardize the work ethics of pharmacists and improve the quality of pharmaceutical care,so as to promote the virtuous circle of pharmaceutical care work in County medical institutions,and provide ideas and reference for the development and evaluation of pharmaceutical care in other medical institutions.[Methods]1.Establishment of pharmaceutical care evaluation system:On the basis of literature analysis and preliminary investigation,the current situation of pharmaceutical care projects in County medical institutions was preliminarily mastered;next,relevant experts and staff were organized to set up an activity group with the help of quality control circle activities,and the factors influencing their work were found through brainstorming;then,the fishbone diagram analysis method was used to classify and summarize them;next,the real cause investigation was used to identify the causes Methods the real influencing factors were listed as the evaluation indexes;then,the reliability of the above-mentioned evaluation indexes was tested by using the ? coefficient;then,the weight of the evaluation indexes was calculated by the entropy weight method;finally,the evaluation system of pharmaceutical care projects was formed with the help of SPO model.2.Establishment of the satisfaction evaluation system:First,relevant personnel were organized to set up an activity group with the help of quality control circle activities.Brainstorm the factors affecting the satisfaction of patients and departments according to the five dimensions of SERVQUAL model,and classify and summarize them with fishbone diagram analysis method.Next,the real influencing factors are listed as evaluation indexes through the real cause inspection method.Then,a coefficient of the above are used to determine the reliability of the evaluation index;Then,entropy weight method is used to calculate the weight of evaluation index.Finally,the SERVQUAL model is used to form the evaluation system.3.Empirical study on satisfaction evaluation system:Questionnaires were designed according to the satisfaction evaluation system established by SERVQUAL model.Questionnaires were used to evaluate the basic situation of patients and hospital departments in some county medical institutions,their cognition of pharmaceutical care and satisfaction,and statistical analysis was conducted.[Results]1.Establishment of pharmaceutical care evaluation system:(1).Drug supply security:3 first-level indicators,6 second-level indicators and 13 third-level indicators,with the maximum weight being 0.149 and the minimum being 0.021;(2)Drug dispenser:3 first-level indicators,6 second-level indicators and 10 third-level indicators,among which the maximum weight is 0.168 and the minimum is 0.034;(3)Clinical pharmaceutical care:3 first-level indicators,5 second-level indicators and 13 third-level indicators,with the maximum weight of 0.223 and the minimum of 0.048;(4)ADR monitoring:three first-level indicators,five second-level indicators and 12 third-level indicators,with the maximum weight of 0.165 and the minimum of 0.026.2.Establishment of a satisfaction evaluation system:(1)Patient satisfaction:2 primary indicators,10 secondary indicators and 26 tertiary indicators,with the maximum weight being 0.049 and the minimum being 0.020;(2)Department satisfaction:2 first-level indicators,10 second-level indicators and 32 third-level indicators,among which the maximum weight is 0.042 and the minimum is 0.023.3.Empirical study on satisfaction evaluation system:Using the method of convenience sampling,the basic information,cognition and satisfaction of pharmaceutical care of 1060 outpatients,360 inpatients,160 clinical department workers and 110 functional department workers in some county medical institutions were investigated through questionnaire.T-test was used to analyze the difference between the respondents' expectation of pharmaceutical care and their satisfaction after receiving the service.Among them,P<0.001 was found among out-patients,inpatients and nurses.P>0.001 for clinicians and functional departments.[Conclusion]The pharmacology service evaluation system is relatively reliable,the index selection process is scientific,and the evaluation system basically covers a comprehensive range of items,but there are some limitations,such as:objects and methods do not play a full role.This evaluation system reflects the following three deficiencies in some county medical institutions:1.Patients have little understanding of hospital pharmaceutical care and low satisfaction with pharmaceutical care;2.2.Lack of linkage mechanism with clinical departments and full support from other departments;3.Functional departments have a low recognition degree of pharmaceutical care,thus affecting their attention.