NIMS 도입이 의료기관 약제부서 마약류의약품 관리 업무에 미치는 영향 및 업무 수가 제안
Effects of the Introduction of NIMS on Pharmacy Workflow and Proposal of Reimbursement Adjustment
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Objectives : This study aimed to investigate the impact of the Narcotics Information Management System (NIMS) on pharmacy workflow and to propose appropriate manpower size and reimbursement fees for safer narcotics management. Methods : A survey was carried out to investigate the time spent on each of the four narcotic management duties (preparation, management, reporting and monitoring & education [M&E]) and the relative value of workload. Duty definition and survey questionnaire were developed through focus group interviews and previous studies. The manpower standards were calculated using the time required per day as full time equivalent units. Relative value was calculated following an examination of the relative importance and work intensity of each workload component. Results : Twenty tertiary hospitals and fourteen general hospitals responded (response rate 62% and 11%, respectively) in this analysis. There was a large variation in the length of time spent on each task across institutions. A large amount of time was used on basic tasks and the performance rates of M&E were quite low. The required manpower was calculated as 1 FTE per 170 prescription sheets based on the current conditions and 1 FTE per 132 sheets based on the secured time for work practice improvement. The relative value for narcotics management was calculated as approximately 3 when the standard conduct value was set to 1. To sum up, the dispensing-counseling fee needs to be increased by 50%~60% and the narcotics management fee needs to be doubled. Conclusion : To meet NIMS goal, it is necessary to standardize relevant work through national guidelines, introduce legal grounds for each scope of task and secure dedicated manpower. It is also necessary to reflect the relative value of narcotics management after NIMS and improve the related fee structure.
Abstract
Objectives : This study aimed to investigate the impact of the Narcotics Information Management System (NIMS) on pharmacy workflow and to propose appropriate manpower size and reimbursement fees for safer narcotics management. Methods : A survey was carried out to investigate the time spent on each of the four narcotic management duties (preparation, management, reporting and monitoring & education [M&E]) and the relative value of workload. Duty definition and survey questionnaire were developed through focus group interviews and previous studies. The manpower standards were calculated using the time required per day as full time equivalent units. Relative value was calculated following an examination of the relative importance and work intensity of each workload component. Results : Twenty tertiary hospitals and fourteen general hospitals responded (response rate 62% and 11%, respectively) in this analysis. There was a large variation in the length of time spent on each task across institutions. A large amount of time was used on basic tasks and the performance rates of M&E were quite low. The required manpower was calculated as 1 FTE per 170 prescription sheets based on the current conditions and 1 FTE per 132 sheets based on the secured time for work practice improvement. The relative value for narcotics management was calculated as approximately 3 when the standard conduct value was set to 1. To sum up, the dispensing-counseling fee needs to be increased by 50%~60% and the narcotics management fee needs to be doubled. Conclusion : To meet NIMS goal, it is necessary to standardize relevant work through national guidelines, introduce legal grounds for each scope of task and secure dedicated manpower. It is also necessary to reflect the relative value of narcotics management after NIMS and improve the related fee structure.
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