Survey of physicians regarding clinical pharmacy services in academic emergency departments

Abstract

Objectives Previous reports have shown that clinical pharmacists improve quality of care, but the extent of pharmacist involvement in emergency departments (EDs) is unknown. The objective of this study was to determine the prevalence and nature of clinical pharmacy services in academic EDs. Methods All programs listed in a national Emergency Medicine physician residency catalog in June 2006 were surveyed using a web-based survey instrument, which was developed based on literature and expert consensus. Only the primary residency hospital sites were considered. Data were compiled and analyzed using descriptive statistics and 95% confidence intervals. Results Of the 135 emergency medicine (EM) residency programs surveyed, there were 99 responses (73%). Eight percent of institutions reported that clinical pharmacy services were available 24-hours a day, 22% reported partial coverage, and 70% reported no coverage. Six percent reported the presence of a satellite pharmacy located in the ED and staffed by a pharmacist. The most common clinical pharmacy services reported in EDs with pharmacy coverage were modification of inventory according to formulary status, the provision of drug or toxicology information, and adverse drug event reporting. Even among institutions which had availability of clinical pharmacists, most did not provide services which have been shown to be valued, such as drug therapy recommendations, cost-effectiveness advice, patient counseling, or medical student and resident education. Conclusions A minority of academic EDs provide clinical pharmacy services with a dedicated clinical pharmacist. EM residency programs should lead the way in the integration of clinical pharmacists in emergency care.

Implementation of a 24-Hour Pharmacy Service with Prospective Medication Review in the Emergency Department

“…In a survey disseminated to 99 academic EDs, 30% reported coverage by a dedicated ED pharmacist, 22% reported partial coverage, and 6% reported the presence of a pharmacy satellite. 24 According to the American Society of Health-System Pharmacists (ASHP) guidelines on emergency medicine pharmacist services, a pharmacist's intervention is most valuable when it is performed prior to medication administration. 20 This concept was further supported when Patanwala et al 21 conducted a study to determine whether pharmacist activities led to the interception of medication errors.…”

Enhancing Safe Medication Use for Pediatric Patients in the Emergency Department

“…New US survey results of facilities offering emergency medicine residency programs found that 8% of institutions had a dedicated pharmacist in the emergency department 24 h/day, 22% had partial coverage, and 77% had no pharmacist coverage. 12 Two previous US studies found dedicated pharmacists in 3.5% 13 and 14% 14 of hospital emergency departments. In those hospitals where pharmacists are available in the emergency department, orders for pediatric patients, particularly orders for identified high-alert medications, can be given priority for review by the pharmacist before administration.…”

Emergency Medicine Pharmacy Practice

“…According to a recent survey of academic health care facilities with EM residencies, only 30% had some type of EM pharmacist coverage with 8% having 24/7 coverage. 11 Furthermore, many institutions did not utilize their ED pharmacist resources to their full potential (the definition of which included: provision of drug therapy recommendations or patient counseling and advice regarding cost effectiveness of drug therapy). This survey demonstrates growth of ED pharmacy services over published reports earlier in the decade.…”