北京大医院医药分开：药剂师由药品供应者变身用药“把关人” Beijing big hospital medicine apart:Pharmacists by drug supplier change medicine"gatekeeper"

　　“医药分开后，医院药房不仅不能给医院带来利润，反而已了‘负担’。”北京刚一提出进行医药分开试点时，大医院的药剂师们一度担心药房和自己都会被裁撤。目前，北京共有5家医院试点医药分开。记者5日到北京同仁医院和北京朝阳医院药剂科采访，发现这些昔日的药品供应者已经变身为用药“把关人”。

"Separated medicine,Hospital pharmacy not only bring profits to the hospital,But has the‘burden’."Beijing just a suggestion on medicine apart when the pilot,Big hospital pharmacists once worried about pharmacy and yourself will be fired.At present,Beijing five hospitals pilot medicine apart.Journalist 5 days to Beijing tongren hospital and Beijing chaoyang hospital pharmacy interview,Found that the former drug supplier has become as a drug"gatekeeper".

　　继北京友谊医院、北京朝阳医院两家大型公立医院启动“医药分开”试点后，北京天坛医院、同仁医院和积水潭医院12月1日也推行医药分开改革试点，取消15%药品加成、挂号费、诊疗费，设立医事服务费。“医药分开让药品销售和医院收入脱钩，但医药分开不是医药分家，不是要把药房和药剂师分离出去。”同仁医院院长伍冀湘说，“医药分开后，药剂师的作用更关键。”

The Beijing friendship hospital/Beijing chaoyang hospital two large public hospital start"Medicine separate"After pilot,The temple of heaven in Beijing hospital/Tongren hospital and ji shui tan hospital on December 1, implementation of the pilot reform of medical and separate,Cancel the 15% drug addition/Registration fee/fee,Set up medical service charge."Medical parted and let drug sales and hospital income decoupling,But medicine is not separate medical centre,Not to the pharmacy and pharmacists separation."Tongren hospital dean WuJiXiang said,"Separated medicine,The role of pharmacists more key."

　　与朝阳医院、友谊医院等医院的做法类似，同仁医院药剂师的职责也已发生转变。同仁医院药剂科主任王家伟说：“过去主要负责药品供应，现在除保证供应外，还要负责对医师的处方把关。”在同仁医院药房“收方窗口”，患者拿药交处方后，药剂师要对处方进行首次审核。如果药剂师认为医生的处方存在用药问题，有权把处方退到医生手里；如果感到有疑问，可将处方交给更高级别的药剂师甚至医院药事专家委员会，点评医师的处方。

And chaoyang hospital/Friendship hospital and hospital practice similar,Tongren hospital pharmacists responsibilities has also change.Tongren hospital pharmacy department director WangGuWei said:"The past is mainly responsible for drug supply,Now in addition to guarantee the supply,To be responsible for the doctors prescription checks."In tongren hospital pharmacy"Debit side window",May or may not prescribe medicine for patients in the prescription,The pharmacist to prescription for review.If the pharmacist think the doctor's prescription drug problem there,The prescription shall have the right to return to the doctor hand;If feel doubt,But will the prescription to higher level hospital pharmacists even drug expert committee,The doctor's prescription.

　　“坦率地说，医药分开取消药品加成，切断了医院收益和药品销售的关系，但是医生多卖药，医药公司给提成的利益关系还没有切断，要遏制‘大处方’就要发挥药剂师的把关作用。”伍冀湘说。北京积水潭医院、同仁医院每天由药剂师等人组成的委员会对金额大于400元的所有处方进行点评；每月对销售金额、销售数量排序前20位的药品进行动态监控，对超常使用药品的处方进行抽样点评。北京进行医药分开的5家医院均表示，对于点评确认的“大处方”，将对开“大处方”的医生进行诫勉谈话，直至暂停其处方资格。

"To be frank,Medical separate cancel drug addition,Cut off the hospital income and drug sales relationship,But the doctor sells more medicine,Pharmaceutical companies to commission relationship of interests have not cut off,To restrain‘DaChuFang’The pharmacist will play a role."WuJiXiang said.Beijing ji shui tan hospital/Tongren hospital every day, by the pharmacist committee of amount to more than 400 yuan of all prescription comments;Monthly sales amount/Sales volume ranking top twenty drug for dynamic monitoring,Use of the drug prescription of supernormal sampling comment on.Beijing medical separate five hospitals are said,To comment on confirmed"DaChuFang",Will split"DaChuFang"A JieMian conversation,Until suspended its prescription qualification.

　　“过去药剂师阵地在药房内，现在要走向临床，指导医生、患者安全用药。”王家伟说，药剂师审核处方用药的标准是：安全、有效、经济、适用。同仁医院要求药剂师每周去临床责任科室收集患者不良反应报告，给患者和医生宣传用药知识及接受用药咨询；同仁医院呼吸科、心血管科等部分临床科室，临床药剂师要参与查房、会诊、疑难病例讨论等；住院患者出院前，临床药剂师还要对患者进行床旁教育，指导患者出院后安全用药。(记者李亚红)

"In the past the pharmacist position within the pharmacy,Now want to clinical,Guiding the doctor/Patients drug safety."WangGuWei said,The pharmacist audit standard is a prescription medication:safety/effective/economic/apply.Tongren hospital pharmacists are required to collect a week clinical responsibility department patients report adverse reactions,To patients and doctors propaganda medicine knowledge and accept medication consultation;Tongren hospital respiratory medicine/Such as cardiovascular department of clinical departments,Clinical pharmacists to participate in ward/consultation/The discussion of difficult case, etc;Hospitalized patients before discharge,Clinical pharmacist but also in the patients bedside education,Guide patients after discharge medication safety.(Reporter LiYaGong)