院内処方における問い合わせ簡素化プロトコル導入の効果

抄録

Kyoto University Hospital introduced a protocol to simplify inquiries to physicians within the hospital and analyzed its impact on operational efficiency. The study period comprised three phases: a preprotocol period (April 1 to June 16, 2024), an early implementation period in nine wards (June 17 to August 31, 2024), and a full implementation period in all 26 wards (October 1 to December 16, 2024). The number of protocol-based prescription changes, details of the changes, and time required for the changes were examined. During the study period, prescription changes, including inquiries, totaled 543 cases in the initial nine wards and 707 cases in all 26 wards. Protocol-based changes were implemented in the initial nine wards (186 cases, 34.3％) and in all the wards (329 cases, 46.5％). During daytime shifts, the protocol reduced the proportion of pharmaceutical queries. However, 12.3％ of inquiries were cases in which the protocol could have been applied but were still handled as conventional inquiries. The most common protocol-based change was switching to an in-house drug containing the same active ingredient. The median time per prescription change decreased significantly from 23 min before implementation to 5 min after implementation (P < 0.001). Overall, the protocol reduced routine dispensing inquiries and shortened prescription modification time, thereby decreasing pharmacists’ workload. These findings suggest that implementing an inquiry simplification protocol in hospital settings is effective.