COVID-19疫情期間醫學中心慢箋領藥分流防疫與網路預約之成效探討

Study on the Effect of Triage Mechanism and Internet Reservation for Patients with Refilling Prescriptions during COVID-19 Epidemic in Taiwan

本研究希望在COVID-19疫情期間，讓單純返院領慢箋之病人得以分流於戶外適當地點並可快速領取藥品。減少入院感染與降低醫院群聚感染的風險為本研究之主要目的。規劃於本醫院新大樓門診大廳門口處做為慢箋戶外領藥作業區，提供各種領藥族群返院領藥與提供藥來速（Drive-Through Pharmacy Service）服務，並建置「慢箋預約領藥網路作業系統」讓病人可事先預約何時返院領藥，藥師可於病人返院領藥前先行調劑。以本院醫院資訊系統（Hospital Information System, HIS）為主要資料來源，收集資料包含慢箋調劑筆數、實際領藥筆數、預約領藥筆數、戶外領藥筆數與室內領藥筆數。另外，也收集戶外慢箋領藥者每筆讀取健保卡時間與藥師發放藥品之離櫃時間，用以計算病人候藥時間。本研究共收集12週慢箋資料，戶外領藥占總慢箋領藥46.81％（由第1週31.85％提高至第12週的60.12％），預約領藥占總慢箋領藥26.84％（由第1週14.93％提升至第12週的36.79％）。預約慢箋領藥者之候藥時間平均為4.21分鐘、非預約慢箋領藥者（即戶外現場取號者）之候藥時間平均為25.97分鐘。本研究於COVID-19疫情期間藉由開設慢箋戶外領藥區成功地將慢箋領藥作業由原本完全於室內領藥分流約一半的病人至戶外領藥，甚至到後期約6成的戶外領藥比例，達到將病人分流於院外，減少病人入院感染與降低醫院內群聚感染風險的目的。研究中也發現預約領藥可有效節省病人候藥時間快速領到藥品，也對防疫分流於戶外領藥有正向的影響。

This study aims to propose a method for the patients with refilling prescriptions to be able to pick up their drugs in an outdoor dispensary during COVID-19 epidemic, so as to reduce the risk of nosocomial infection and cluster infection. This study planned to take the location near the entrance of the outpatient new building in the Hospital as the outdoor dispensary for patients with refilling prescriptions to receive drugs, and to provide services for various groups and drive-through pharmacy service. Moreover, the ''Network Reservation System for Refilling Prescriptions'' was built so that patients can make an appointment for the time of getting drugs in advance and pharmacists can dispense drugs before patients returning to the Hospital. In this study, a total of 12 weeks of data about refilling prescriptions were collected, and the patients receiving drugs outdoors accounted for 46.81% of patients with refilling prescriptions (increased from 31.85% in the first week to 60.12% in the 12th week), and the patients receiving drugs by reservation accounted for 26.84% of patients with refilling prescriptions (increased from 14.93% in the first week to 36.79% in the 12th week). The average waiting time was 4.21 minutes for the patients who made an appointment and 25.97 minutes for the patients who did not make an appointment to wait on the spot. In this study, during COVID-19 epidemic, about 50% of patients with refilling prescriptions were successfully diverted to the outdoor dispensary, and even about 60% of the patients in the later period, so as to separate the patients of the Hospital, and reduce the risk of nosocomial infection and cluster infection. It was also found that the reservation of receiving drugs could effectively save waiting time of patients and have a positive impact on COVID-19 epidemic prevention.