Study On Management Of Outpatient Prescription Based On Six Sigma

ObjectivePrescription, which the doctor prescribes for the patient, is the basis of dispensing pharmaceuticals for pharmaceutical personnel. Prescription quality management is an important part of hospital management. As evidence of dispensing pharmaceuticals in medical institutions, outpatient prescription directly affects the quality of outpatient drug rationality, safety, efficacy and medical costs. Outpatient prescription errors and irrational drug-use lead to the waste of tangible and intangible resources, as well as medical dissension, even medical malpractice, which not only damages the health of patients, but also results in economic losses affecting the hospital's reputation and the overall development of the hospital. Resorting to Six Sigma management philosophy and methods, the study applied the Six Sigma in the prescription quality management to "diagnose" and analyze of prescription errors and out-patient prescription drug-use, propose measures for improvement. In addition, the study made a summary of Six Sigma implementation experience in practice, which would provide evidence and reference for the application of Six Sigma management in other hospital quality management.Research methodsThrough literature research, relevant information of Six Sigma management theory and its application experience have been collected, analyzed and processed for research theoretical basis. The study adopted Six Sigma management of Define, Measure, Analyze, Improve, Control (DMAIC) 5 steps to analyze the of outpatient prescription quality ,and define qualified prescription rate, the rations of outpatient drug cost accounted for the total cost, the proportion of the antimicrobial drugs accounted for the total drug cost as the key points of quality control. Based on the measured data, the defects and the affecting factors of outpatient prescription have been defined by quantitative methods. Then the study group concerted efforts to develop appropriate interventions to improve the quality of outpatient prescriptions. Capacity Z value of the prescription process was computed by Minitab software.ResultsAdopting the same data collection methods to collect relevant data of August and September to assess the results of Six Sigma management, the results showed that: the implementation effect was not obvious in first month (September) with a small decrease of the total error rate, and there was no significant difference when using chi-square test to test the number of prescription errors in July and September; the effect was significant in the second month, and the total number of errors in October decline by 76.0% compared to that in July. There was significant difference when using chi-square test to test the number of prescriptions errors in July and October (P <0.05).Data of the drug use of outpatient departments were counted through the hospital HIS system. Compared with the standard and the situation of last month, the number of departments which were up to standard has increased significantly in October, and the rations of drug cost and antimicrobial drugs decreased significantly.ConclusionsSix-Sigma management is a novel effective target management method, which could be used to analyze the affecting factors of outpatient electronic prescription quality, develop appropriate interventions to fully promote the quality of outpatient e-prescribing. The application of Six Sigma in hospital management has the following characteristics: (1) take all work as a process. (2) More emphasis on team work. (3) Data-and fact-based, emphasis on continuity of quality improvement and upgrading. Applications of Six Sigma in hospital management should pay attention to the questions: (1) strengthen the training of project personnel (2) strengthen team work. (3) Strengthen the publicity of Six Sigma management. (4) focus on the sustainability of the project.