Yuanyuan Guo, Yishan Bu, Yi Zhang

Department of Pharmacy, Tianjin First Central Hospital, Tianjin, People’s Republic of China

Correspondence: Yi Zhang, Department of Pharmacy, Tianjin First Central Hospital, Tianjin, People’s Republic of China, Tel +86-15122785710, Email yyguoxj@163.com

Purpose: To explore the application of Lean Six Sigma (LSS) combined with pre-prescription review system in reducing the irrational rate of emergency prescriptions.
Methods: The emergency prescriptions of our hospital in May 2022 to May 2023 and June 2023 to December 2024 were selected as the research objects. Based on the pre-prescription review system and LSS, a comparative analysis was carried out regarding the irrational rate of emergency prescriptions, the changing trend of the irrational rate, the types of irrational prescriptions and their departmental distribution, patients’ satisfaction, and the proportion of doctors’ returning and modifying irrational prescriptions before and after the implementation of intervention measures.
Results: After the adoption of LSS and Review system, the irrational rate of emergency prescriptions was significantly reduced (P< 0.001); The irrational prescription rate decreased by 0.07% (P< 0.001, 95% CI=[− 0.06, 0.20]) month by month; The main types of irrational prescriptions remained unchanged, but except for combination medication, incompatibility and repeated medication, all types of irrational prescriptions were significantly lower than those before the intervention (P< 0.05); Before and after the intervention, the irrational prescriptions were mainly issued by emergency internal medicine and urology emergency department, and the pediatric emergency department increased after the intervention; Patients’ satisfaction was significantly improved after intervention (P< 0.05); The proportion of physicians returning to correct irrational prescriptions increased significantly after the intervention (P< 0.001).
Conclusion: LSS combined with pre-prescription review system can effectively reduce the irrational rate of emergency prescriptions, optimize emergency medication management, and ensure patient medication safety.

Keywords: Lean Six Sigma, pre-prescription review system, emergency, irrational prescriptions