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Enhancing Drug Management, Cost Savings, and Staff Satisfaction in Anesthesiology: A Quality Improvement Project in a Chinese Tertiary Hospital

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Abstract

Introduction

In alignment with China’s national directive for improved drug management in anesthesiology, the Affiliated Hospital of Qingdao University initiated a quality improvement project, aiming to tackle the prevailing challenges of inefficiencies in drug administration, escalating drug costs, and the notable communication gap between pharmacists and anesthesiologists.

Methods

We employed a Plan-Do-Study-Act methodology to establish a pharmacy team and execute a multidimensional pharmaceutical intervention. The interventions included the formulation of standard procedures, guidelines and regulations, assistance from an information system (including automatic dispensing cabinets and prospective prescription review system), communication feedback (via WeChat groups), and education for anesthesiology staff. The intervention spanned from April to September 2023, focusing on optimizing medication management, achieving cost savings, and enhancing the satisfaction of anesthesia team members, with an additional observation from October to December 2023.

Results

Following the interventions, improvements were observed in drug management practices. These enhancements included increased compliance with accounting procedures, more rigorous registration of controlled substances, and more effective disposal of liquid residues. There was no adverse events related to high-alert medications or look-alike drug usage errors. The introduction of automatic dispensing cabinets and a prospective prescription review system markedly improved work efficiency. The utilization of a WeChat group facilitated effective communication about unreasonable prescriptions and drug-related issues. Among the 29,061 patients who underwent surgery both before and after the interventions, significant reductions were observed both in the drug proportion and the per capita drug costs (P = 0.03, P = 0.014, respectively). The per capita drug cost decreased by 20.82%, from ¥723.43 to ¥572.78, consistently remaining below ¥600 throughout the 9-month observation period. The per capita cost of monitoring drugs including dezocine, butorphanol, haemocoagulase agkistrodon, penehyclidine, and ulinastatin experienced a significant reduction (P < 0.05). Additionally, in the satisfaction questionnaires returned, a remarkable 94.44% of anesthesiology staff expressed high satisfaction with the comprehensive pharmaceutical interventions.

Conclusion

The quality improvement project has yielded remarkable positive outcomes, serving as a model worthy of reference and replication in similar healthcare settings.

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Acknowledgements

We acknowledge all of the members of QI cooperative group in the Affiliated Hospital of Qingdao University.

Author Contributions

Designed the study: Fanbo Jing, Xiaomin Xing, Hanjun Qu. Collected the data: Xiaomin Xing, Longyuan Wang, Xiaojia Hao. Sorted out and analyzed data: Longyuan Wang, Xiaojia Hao, Yalan Zhong. Drafted the paper: Xiaomin Xing. Critical revision for the paper: Fanbo Jing, Hanjun Qu. All authors approved the final version of the manuscript.

Funding

The study was supported by the Shandong Province Medical Association-Qilu special (grant number YXH2022ZX02064) and Shandong Province Medical Association clinical pharmaceutical research special (grant number: YXH2021ZX010). The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The journal’s Rapid Service Fee was funded by the authors.

Data Availability

The data underlying this article are available in the article. Additional data will be provided by the author upon reasonable request.

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Authors and Affiliations

  1. Department of Pharmacy, The Affiliated Hospital of Qingdao University, Shandong, Qingdao, China

    Xiaomin Xing, Haijun Qu, Longyuan Wang, Xiaojia Hao, Yalan Zhong & Fanbo Jing

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  1. Xiaomin Xing
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  2. Haijun Qu
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Correspondence to Fanbo Jing.

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Disclosures

All authors have nothing to disclose.

Ethics Approval

This project was considered a local QI project by the Affiliated Hospital of Qingdao University Institutional Review Board, and did not require informed consent from individual patients/families.

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Xing, X., Qu, H., Wang, L. et al. Enhancing Drug Management, Cost Savings, and Staff Satisfaction in Anesthesiology: A Quality Improvement Project in a Chinese Tertiary Hospital. Adv Ther 41, 1953–1966 (2024). https://doi.org/10.1007/s12325-024-02814-z

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