基于AHP-DEMATEL和QFD的发热门诊智慧药事服务模式再造研究

目的 基于质量功能展开(quality function deployment,QFD)原理,结合层次分析法(analytic hierarchy process,AHP)与决策试验和评价试验法(decision-making trial and evaluation laboratory,DEMATEL)的混合模型,指导发热门诊智慧药事服务模式再造。方法 采用问卷调查收集患者原始需求数据,运用AHP-DEMATEL方法计算,然后进行同行竞争性评估和质量规划,确定患者需求的最终权重,之后将患者需求转化为相应的服务质量特性,并构建质量屋,根据分析结果,制定再造方案并实施。结果 以全自助取药和患者分流为特点的新模式实施后,患者平均取药时间由257 s缩短至102 s,患者平均等候注射时间由945 s缩短至323 s,同时避免药师与患者的直接接触,极大程度降低了交叉感染风险,患者满意度从88.50%提升至95.73%,另一方面药师满意度达到99.26%,医护人员满意度达到98.12%。药师人力成本投入下降95.8%,管理时间成本投入下降81.8%,调剂正确率提升至100%。结论 运用AHP-DEMATEL和QFD方法能确定影响高品质智慧药事服务的关键质量特性,为新模式再造提供决策依据和改进方向,从而显著提升药学服务质量,加强感染防控工作的药学保障。

Study on Reconstruction of Fever Outpatient Intelligent Medicine Service Pattern Based on AHPDEMATEL and QFD

OBJECTIVE To guide the reengineering of intelligent medicine service model in fever clinic, based on the principle of quality function deployment(QFD), combined with the mixed model of analytic hierarchy process(AHP) and decision-making trial and evaluation laboratory(DEMATEL). METHODS The original demand data of patients were collected by questionnaire and calculated by AHP-DEMATEL method. Then peer competitive evaluation and quality planning were carried out to determine the final weight of patient demand. After that, patient demand was transformed into corresponding service quality characteristics, and the house of quality was constructed. Based on the results of the analysis, the reengineering plan was formulated and implemented. RESULTS After the implementation of the new model featuring self-help getting medicine and patients with shunt, the average time of taking medicine was shortened from 257 s to 102 s, and the average waiting time for injection was shortened from 945 s to 323 s. At the same time, the direct contact between pharmacists and patients was avoided, which greatly reduced the risk of cross-infection. On the other hand, the satisfaction of patients increased from 88.50% to 95.73%, and the satisfaction of pharmacists reached 99.26%. The satisfaction of medical staff reached 98.12%. The manpower cost of pharmacists decreased by 95.8%, the management time cost decreased by 81.8%, and the dispense accuracy increased to 100%. CONCLUSION AHP-DEMATEL and QFD methods can be used to determine the key quality characteristics that affect the high-quality intelligent pharmaceutical service, and provide the decision-making basis and improvement direction for the new model reengineering, so as to significantly improve the quality of pharmaceutical care and strengthen the pharmaceutical security for infection prevention and control.