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首页> 外文会议>Medical Informatics in Europe Conference. >A Constructivist approach? Using formative evaluation to inform the Electronic Prescription Service Implementation in Primary Care, England
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A Constructivist approach? Using formative evaluation to inform the Electronic Prescription Service Implementation in Primary Care, England

机译：建构主义方法？使用形成性评估向英格兰初级保健中的电子处方服务实施通知电子处方服务实施

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As part of the National Programme for IT (NPflT) in England, the Electronic Prescription Service (EPS) is being implemented in two releases. The first release placed barcodes on prescriptions and is widely implemented. Release two (EPS2), the electronic transmission of prescriptions between GP, pharmacy and the reimbursement body, has just started implementation. On the NPflT agenda, community pharmacies have been predicted to benefit from changes in work practice following the full EPS implementation. The study focused on how the advanced EPS (EPS2) might alter dispensing work practice in community pharmacies on issues such as workflow and workload; and the bearing of these issues on improvement in quality of service and safety. This paper demonstrates how findings of the pre-implementation study were used to provide formative feedback to the implementers. A mixed ethnographical method that combined non-participant observations, shadowing and interviews, before and after implementation, was used to qualitatively study eight community pharmacies across three early adopter Primary Care Trusts (PCTs) in England. Key implementation issues were fed-back to the PCTs as part of the EPS2 rolling-out process. Staff access to dispensing terminals needs to be improved if electronic dispensing is to be encouraged. Also, as a safety issue, pharmacists are planning to print off electronic prescriptions (tokens) and dispense from them. Although safer, this could increase workload. The EPS2 could positively alter work practice by improving certain demanding aspects of dispensing whilst reducing human errors. For example, the high demand of customers handing in prescriptions and waiting for them to be dispensed could be reduced through automation. Also, the extreme variation in workload during various times of the day could be evened out to improve workflow and provide a better service; however, in order for this to be fully realized, technical issues such as number of staff per dispensing station and dispensing from tokens would need to be addressed.
机译：作为英国国家计划（NPFLT）的一部分，电子处方服务（EPS）正在两次释放中实施。第一释放在处方的条形码下放，并且广泛实施。发布二（EPS2），GP，药房和报销机构之间的处方的电子传输刚刚开始实施。在NPFLT议程上，已预测社区药店从完整的EPS实施后受益于工作实践的变化。该研究侧重于先进的EPS（EPS2）如何在工作流程和工作量等问题上改变社区药房中的分配工作实践;和这些问题提高服务质量和安全问题。本文展示了如何使用预先实施研究的结果来为实施者提供形成性反馈。一种混合的民族图方法，即合并非参与者观察，遮蔽和访谈，在实施之前和之后，用于定性研究英格兰三次早期采用的初级保健信托（PCTS）的八个社区药典。作为EPS2推出过程的一部分，将关键实施问题送回PCT。如果要鼓励电子点化，则需要改善员工进入分配终端。此外，作为安全问题，药剂师正计划打印电子处方（令牌）并从中分配。虽然更安全，这可以增加工作量。 EPS2可以通过改善减少人类错误的某些要求苛刻的方面来积极改变工作实践。例如，可以通过自动化减少递交处方和等待待分配的客户的高需求。此外，可能会在一天中的各个时间内的工作量的极端变化来改善工作流程并提供更好的服务;但是，为了实现这一目标，需要解决每个分配站的工作人员数量和从令牌点分配的技术问题。

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