蒋先仲

    中图分类号 R95 文献标志码 A 文章编号 1001-0408(2018)18-2552-05

    DOI 10.6039/j.issn.1001-0408.2018.18.23

    摘 要 目的：为我国临床药学的发展提供参考。 方法：分析现有临床药物治疗团队的学科结构需求，并应用品管圈管理和质量管理体系等理论分析目前我国临床药学发展困局，设计临床药学“CDOR”模式[即药物治疗方案审查(Check，C)、执行(Do，D)、优化(Optimise，O)、评价与研究(Research，R)]。结果与结论：当前药物治疗团队相关环节工作的主要承担者尚存在一定的专业知识/技能短板，药物治疗过程不能形成有效的“品管圈”，且现有药物治疗过程管理模式也不符合质量管理体系的管理思路。应用品管圈原理与质量管理体系原则设计的临床药学“CDOR”模型其4个临床药师站全程管理药物治疗过程，可以确保药物治疗安全、有效、合理；根据“CDOR”模式要求设计的与药物治疗过程各环节主要承担者定位相适宜的临床药师站的配置与准入、临床药师的职称与培养体系等，可有助于提升临床药师队伍的能力和水平。但该模式的推行涉及到卫生、教育等多方面的改革，宜先行试点再逐步推开。

    关键词 临床药学；学科结构；品管圈；质量管理体系；“CDOR”模式；临床药师

    ABSTRACT OBJECTIVE：Toprovide reference for the development of clinical pharmacy in China. METHODS：The development dilemma of clinical pharmacy in China was analyzed fromthe angle of needs for structure of discipline in present clinical pharmacy treatment team，quality control circle(QCC)and quality management system(QMS). The“CDOR”mode [i.e. check， do， optimize and research of drug treatment plan] of clinical pharmacy was designed. RESULTS & CONCLUSIONS： Main undertaker of present drug treatment team still have certain espertise/skills shortcomings. Effective “QCC” could not form during drug treatment. The existing management mode of drug treatment process does not conform to the management idea of QMS. Four “CDOR” clinical pharmacist workstations which designed by QCC management principle and QMS principle manage drug treatment course to guarantee safe ......