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香港医院管理局通过44家公立医院,向全港市民提供医疗保健服务,其中6家医院有肿瘤学中心。目前已有4家肿瘤学中心由药剂部提供100％的化疗药物配置服务,仅一家中心雇用护士提供该服务。6家肿瘤学中心的工作人员数量不等,而且有些员工人数与工作量不相称。香港的肿瘤学药剂师仍处于机械式工作状态,他们只有足够时间从事日常的药品调剂工作,没有时间深入临床药剂的研究,更加没有机会参与日常病房的巡查工作。通常他们根据轮转式值勤表上班,该模式妨碍了药剂师提高专业水平和技能。伊利沙伯医院(QEH)创新地将药剂师从该模式中解脱出来,以改善工作体系,保证工作质量,加强与医生的联系以及培训专门调配化疗药物的药剂师。又将全静脉营养输液(total parenteral nutrition)生产系统全面自动化,允许药剂师重新投入化疗药物配置服务等工作。标准化的工作制度使得生产更加合理化,“剂量分组”方案提高了工作效率。药剂师还参与了医院的化疗药物安全监管委员会,从而使药剂师意识到化疗药物配置服务存在的职业风险。尽管伊利沙伯医院药剂部在该领域有所突破,但是通往临床肿瘤药学的道路仍然是漫长而曲折的。
The Hong Kong Hospital Authority provides health care services to all Hong Kong citizens through 44 public hospitals, of which 6 have oncology centers. Currently there are 4 oncology centers provided by the Department of Pharmacy 100% of the chemotherapy drug delivery services, only one center hired nurses to provide the service. The number of staff at the six oncology centers varies, and some of them are disproportionate to the workload. Oncologists in Hong Kong are still in a mechanical working condition. They have only enough time to carry out routine drug adjustment work. They do not have time to go deep into clinical drug research and have no chance of participating in daily ward inspections. Often they operate on a rotational duty watch, a model that prevents pharmacists from improving their professionalism and skills. QEH Innovatively relieves pharmacists from this paradigm by improving the work system, ensuring quality of work, strengthening contact with doctors and training pharmacists who specialize in the delivery of chemotherapeutic drugs. In turn, it has fully automated the production system of total parenteral nutrition, allowing pharmacists to reintroduce chemotherapeutic drug delivery services. Standardized work systems make production more rationalized and the “dose grouping” program increases work efficiency. Pharmacists also participate in the hospital’s chemotherapeutic drug safety regulatory committee, thereby enabling pharmacists to be aware of the occupational risks of chemotherapeutic drug delivery services. Despite a breakthrough in this area at the Queen Elizabeth Hospital Department of Pharmacy, the road to clinical oncology is still long and tortuous.