Emergency Medicine

Only a few academic emergency departments have dedicated pharmacists

The presence of clinical pharmacists can do much to increase patient safety, improve health outcomes, and reduce health care costs. Recently, the Institute of Medicine (IOM) has drawn attention to the value of clinical pharmacists in emergency departments (EDs). Yet, in 2003, only 3 percent of EDs had dedicated pharmacists present. This situation is improving somewhat, but not by much, suggests a new study by University of Rochester researchers led by Rollin J. Fairbanks, M.D., M.S.

The researchers developed a survey questionnaire that asked about the availability of pharmacy services in EDs. The Web-based survey was then sent to 135 emergency medicine residency programs in 2006; 99 responded. Only 8 percent of responding residency programs said they had a dedicated pharmacist on duty 24 hours a day in the ED. Less than a quarter (22 percent) of programs reported having partial pharmacy coverage. The vast majority (70 percent), however, said they had no clinical pharmacy coverage in their EDs. When coverage was available, the most common service provided by the pharmacist was modification of inventory according to drug formulary status. Other common services included providing drug or toxicology information and adverse drug event reporting.

While nearly one-third of residency programs had some type of clinical pharmacy service available to the ED, such expertise was not being utilized to its fullest advantage. Only a few EDs asked the pharmacist to provide drug therapy recommendations, advice on cost-effectiveness, or patient counseling. They also did not use these clinical pharmacists very much in the education of medical students and residents in the ED. The study was supported in part by the Agency for Healthcare Research and Quality (HS15818).

See "Survey of physicians regarding clinical pharmacy services in academic emergency departments," by Jillian M. Szczesiul, Pharm.D., Rollin J. Fairbanks, M.D., M.S., James M. Hildebrand, B.A., and others, in the March 15, 2009, American Journal of Health-System Pharmacy 65, pp. 576-579.

Return to Contents
Proceed to Next Article