Kusarudzwa Kwemishonga Muzvipatara
Fomura yemuchipatara runyorwa rwemishonga yakasarudzwa inotenderwa kushandiswa munzvimbo yehutano, ine mirairo yekushandisa uye ruzivo rwunotsigira. Fomura inopfuura kungova runyorwa rwemazita emishonga; chishandiso chakakosha chekuona kuti kurapa kune musoro, kwakachengeteka, kunoshanda, uye kunodhura. Pakati pekuoma kuri kuramba kuchiwedzera kwezvirwere, mhando dzakasiyana dzemishonga, uye kumanikidzwa kuwana mari inoshanda, maitiro ekusarudza mishonga mukati mefomura ndiyo hwaro hwakakosha hwekutonga kwemishonga yekiriniki uye manejimendi yemishonga muzvipatara.
Tsanangudzo uye chinangwa chefomulary
Kuverenga mishonga yemhando yeformulary kunobva pachisarudzo cheboka revanhu vose, chinowanzo tungamirwa nePharmacy and Therapeutics Committee (PCH) kana timu yakafanana. Zvinangwa zvayo zvinosanganisira: (1) kuvandudza mhando yehutano nekukurudzira kushandiswa kwemishonga zvichibva pauchapupu hwesainzi, (2) kuchengetedza kuchengetedzeka kwemurwere kuburikidza nekuenzanisa kurapwa uye kuderedza kusiyana kusingakoshi, (3) kuve nechokwadi chekuwanikwa kwemishonga inokosha ine chekuita nezvirwere zvemuno, uye (4) kudzora mitengo pasina kukanganisa mhedzisiro yekiriniki. Nekushandisa mishonga yemhando yeformulary, zvipatara zvinogona kubatanidza maitiro ekiriniki pakati pevanachiremba, kufambisa kutenga nekuronga masheya, uye kusimbisa mapurogiramu ekudzivirira kusashanda kwemishonga inorwisa mabhakitiriya.
Nheyo huru dzekusarudza mishonga
Kusarudzwa kwemishonga mufomulary kunofanirwa kunge kwakavakirwa pamisimboti yekushandiswa kwemishonga zvine musoro. Izvi zvinoreva kuti mishonga inosarudzwa nekuda kwekubatsira kwayo kwakajeka uye njodzi dzinogadziriswa, kwete kungoenderana netsika, kukwidziridzwa, kana kufarira kwemunhu. Mitemo inowanzo shandiswa inosanganisira: kushanda zvakanaka kwekiriniki, kuchengetedzeka, mhando yezvigadzirwa, nyore kushandisa, kuwanikwa kwemafomu emuyero akakodzera, kutevedzera nhungamiro dzekiriniki, uye kushanda zvakanaka kwemutengo. Uyezve, kusarudzwa kunofanirwa kufunga nezvezvinodiwa nevarwere vechipatara—semuenzaniso, chipatara chekutumira varwere vane zvirwere zvakaoma chinoda mishonga yakasiyana-siyana kupfuura chipatara chinopa mabasa ekutanga.
Basa reKomiti yeMishonga neKurapa
Komiti yeMishonga yeFormulary (KFT) ndiyo inonyanya kukurudzira mukusarudza nekuongorora mishonga yeFormulary. Nhengo dzeKFT dzinowanzo kuve vanachiremba vanobva muminda yakasiyana-siyana, varapi vemishonga, vanamukoti, nevashandi vekutungamira. KFT ine basa rekugadzira mitemo, kuongorora zvirongwa zvitsva zvemishonga, kutarisa kushandiswa kwemishonga, uye kuongorora kuchengetedzeka kuburikidza nekushuma zviitiko zvakaipa zvemishonga. Sarudzo dzeKFT dzinofanira kuve dzakajeka uye dzichitungamirirwa nedata. Kusawirirana kwezvido kunofanirwa kugadziriswa, semuenzaniso nekuzivisa hukama neindasitiri yemishonga uye kuderedza kubatanidzwa mukusarudza mishonga chaiyo.
Matanho ekusarudza mishonga: kubva pakudiwa kusvika pakusarudza
Maitiro ekusarudza mishonga anowanzo tanga nekuziva zvinodiwa. Zvipatara zvinoongorora maitiro ezvirwere, nhoroondo dzevarwere (vana, vakwegura, vane zvirwere zvinokonzeresa chirwere), uye mazinga ebasa (ER, ICU, kunze kwechipatara). Danho rinotevera chirongwa chemishonga kubva kuchiremba kana kuyuniti yebasa, pamwe chete nezvikonzero zvekurapa. Izvi zvinoteverwa nekuongorora zvinyorwa: miedzo yekiriniki, meta-analyses, nhungamiro dzekiriniki dzenyika nedzepasi rose, uye data rechokwadi, kana riripo.
Mushure meizvozvo, zvinhu zvekuchengetedza zvinoongororwa: migumisiro yakaipa, yambiro dzakakosha, kusangana kwemishonga, njodzi dzepamuviri kana matambudziko enhengo, uye zvikanganiso zvinogona kuitika pamishonga nekuda kwekufanana kwezita/kurongedza. Tevere, zvinhu zvemishonga zvinoongororwa—kugadzikana, kuenderana kwekusanganiswa, zvinodiwa pakuchengetedza cheni yechando, uye kuwanikwa kwemafomu emuyero (mapiritsi, majekiseni, mishonga yevana). Ndipo chete panoitwa ongororo yezvehupfumi hwemishonga, semuenzaniso, kuenzanisa mutengo wekurapa pazuva, mutengo wemhedzisiro yekiriniki, kana ongororo yemhedzisiro yebhajeti kuona kuti chipatara chinogona kupa mushonga uyu nenzira inogara iripo.
Kushanda zvakanaka uye zvinodiwa zvichibva pauchapupu
Kushanda zvakanaka ndicho chinhu chikuru chinodiwa. Mishonga inowedzerwa mufomulary ine humbowo hwakasimba hwekubatsira muchiratidzo chakakodzera. KFT inowanzoongorora kana mushonga mutsva uchipa mukana wakanaka pane wekurapa kwakajairika: kuwedzera huwandu hwekurapa, kuderedza kufa, kuderedza nguva yekugara, kana kuvandudza hupenyu. Mishonga ye "I-too" isingapi mabhenefiti akakosha ekurapa kazhinji haikosheswi kunze kwekunge paine zvinhu zvakakosha zvakaita sekuchengetedza kuri nani kana kudiwa kwehuwandu hwakati wandei.
Kuchengetedzwa kwevarwere uye kudzivirira kukanganisa kwemishonga
Kuchengetedzeka kwemurwere hakufaniri kutaurwa nezvazvo. Mishonga inongwarira zvakanyanya (semuenzaniso, mishonga inorwisa ropa, insulin, opioids, chemotherapy) inoda mitemo yakasimba yekushandisa, yakadai sekurambidza zviratidzo, nzira dzekuyera huwandu hwemushonga, uye kutarisa. Kusarudzwa kwemishonga kunofanirawo kufunga nezvemhedzisiro yezvikanganiso zvemushonga nekuda kwemishonga yakafanana nezwi (LASA). Zvipatara zvinogona kusarudza rudzi rumwe chete kana fomu remushonga kuderedza kuvhiringidzika, pamwe nekupa mavara ekunyevera uye masisitimu ekutsigira sarudzo dzekiriniki.
Kufunga nezvezvehupfumi hwezvemishonga uye kuenderera mberi kwebhajeti
Mutengo hausi mutengo wemushonga chete, asi mutengo wese wekurapa. Mishonga inodhura inogona kusarudzwa kana ikadzikisa matambudziko, ikadzikisa kudiwa kwekutevera, kana kupfupisa nguva yekugara. Nokudaro, kuongorora kushanda kwemari uye bhajeti kuri kuramba kuchikosha. F&B nevatungamiriri vanowanzo sanganisa data rekare rekushandiswa, mitengo yezvibvumirano zvekutenga, uye fungidziro yehuwandu hwevarwere. Munguva yekubhadhara mari inobva papakeji kana kuti inobva painishuwarenzi, kusarudza mushonga wakakodzera kunogona kubatsira zvipatara kuchengetedza mhando yebasa uye kugadzikana kwemari.
Kugadzirisa, zvirambidzo, uye nhungamiro dzekushandisa
Mushonga weforoma wakanaka unosanganisira nhungamiro dzekushandisa. Haasi mishonga yese inofanira kunyorerwa mahara pasina muganho. Mimwe mishonga inogona kurambidzwa, senge mishonga yekupedzisira inorwisa mabhakitiriya, iyo inoda mvumo kubva kuna chiremba chaiye kana timu yechirongwa chekurwisa mabhakitiriya (stewardship). Mitemo yekurapa kwematanho inodawo kushandiswa kwemishonga yekutanga usati waenda kune mishonga inodhura kana ine chepfu, kunze kwekunge ichirambidzwa. Kugadziriswa uku kunobatsira kuchengetedza kurongeka kwekurapa uye kuderedza kushandiswa kusina kukodzera.
Kuongororwa nguva nenguva uye manejimendi yemishonga inobuda (kubvisa kunyorwa kwemishonga)
Kusarudzwa kwemishonga hakusi kwekamwe chete. Nzira yekurapa inofanira kuongororwa nguva nenguva. Mishonga inogona kubviswa kana isingashande zvakanaka, iine matambudziko ekuchengetedza, isisipo, kana dzimwe nzira dziri nani dzikavapo. Data rinoshandiswa rinosanganisira maitiro ekunyora mishonga, kuongororwa kwekushandiswa kwemishonga, mishumo yemigumisiro, kutevedzera mitemo, uye kuongororwa kwemitengo. Kuongorora uku kunoita kuti nzira yekurapa irambe yakakodzera uye ichienderana nekufambira mberi kwesainzi yekurapa nemamiriro ekushanda muchipatara.
Kuitwa: rutsigiro rwehurongwa nedzidzo
Kunyora mishonga yemhando yeforoma yakanaka hakushande kana ikasashandiswa nemazvo. Zvipatara zvinofanirwa kuve nechokwadi chekuti mishonga yakanyorwa iripo, hurongwa hwekutenga hwakagadzikana, uye rutsigiro rwetekinoroji senge Computerized Physician Order Entry (CPOE) kana e-prescribing yakabatanidzwa nefomura. Dzidzo yevanachiremba, ma pharmacist, uye manesi yakakoshawo kuona kuti kurapwa kunotevedzera mitemo. Uyezve, kutaurirana kwemitemo yekutsiva mishonga yemhando ye generic, kushanda pamwe chete, uye maitiro ekukumbira mishonga isiri yemhando yeforoma kunofanirwa kuve kwakajeka kudzivirira kukanganisa kupa kwebasa.
Matambudziko mukusarudza mishonga
Mamwe matambudziko anowanzo buda anosanganisira kusiyana kwezvinodiwa nevarapi, kumanikidzwa kushandisa mishonga mitsva, iri kufarirwa, kukwidziridzwa kwemakambani, bhajeti shoma, uye nyaya dzekutengesa. Rimwe dambudziko inyaya dzinodiwa nevanhu vane dambudziko remishonga isingagoni kugadziriswa nemaitiro akajairwa. Saka, zvipatara zvinoda nzira inokurumidza asi inodzorwa yemishonga isiri yemhando yepamusoro, senge kuburikidza nekubvumidzwa kweKFT kana vapi vemazano vane chekuita nezvikonzero uye kuongororwa mushure mekushandisa.
Mhedziso
Kusarudzwa kwemishonga muchipatara inzira ine humbowo hwesainzi, kufunga nezvekuchengetedzwa, zvinodiwa pakurapa, uye kushandiswa zvakanaka kwemari. Nekutonga kwakasimba kuburikidza neHunhu hweMishonga (KFT), nzira dzakajekeswa dzekusarudza, kuongororwa nguva dzose, uye kushandiswa kwakarongeka, fomura inogona kuvandudza mhando yekurapa, kuderedza kusiyana kwemishonga isina kukodzera, uye kudzivirira varwere kubva panjodzi dzemishonga. Pakupedzisira, fomura inotungamirwa zvakanaka ndiyo mbiru huru yehutano hwakanaka, hwakachengeteka, uye hunoenderera mberi muzvipatara.
