A study of time saved by emergency medicine physicians through working with clinical pharmacists in the emergency department

Grill, Justin; Bryant, Caleb; Markel, Kyle; Wisniewski, Samuel J.

doi:10.1016/j.ajem.2018.12.028

Cited by 5 publications

(3 citation statements)

References 9 publications

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“…Including hospital pharmacists in multidisciplinary teams can save time for other healthcare professionals and make workflows more efficient 38 40. A study by Grill et al 52 showed that clinical pharmacists in the emergency department saved 69.8 hours of total physician time over the study period, equating to 75 min/10-hour shift 52. Patients receive better treatment and achieved better outcomes due to effective interdisciplinary collaboration of healthcare professionals 53 54.…”

Section: Discussionmentioning

confidence: 99%

Development of hospital pharmacy services at transition of care points: a scoping review

Stoll,

Weidmann

2024

Eur J Hosp Pharm

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BackgroundSeveral hospital pharmacy services exist, which take place at different interfaces of patient care. Although they are an important tool for improving medication safety, they are not yet sufficiently implemented in hospitals around the world.ObjectiveThis scoping review aims to summarise different hospital pharmacy services at transition of care (TOC) points in order to identify development trends and practice patterns in high-income countries over the past decade.MethodsA literature search of four databases (PubMed, PubPharm, Cochrane Library (Ovid) and ScienceDirect) since 2011 was conducted. A detailed search strategy was developed and refined with the help of a research librarian. Title, abstract and full-text selection was carried out by two researchers independently. The study was reported in accordance with the PRISMA-ScR items to ensure quality standard reporting. Only studies originating from developed countries and published in the English language were included. The data obtained were extracted and summarised using a data extraction form developed to meet the research aims of the study.ResultsOf the 5456 search results, 65 studies met the inclusion criteria. These originated from Europe (n=29), North America/Canada (n=28), Australia (n=7) and Asia (n=1). Individual TOC services such as medication reconciliation and medication review on admission and at discharge were the main focus of published literature practice patterns between 2011 and 2016, after which a more holistic TOC service started to emerge that follows patients across all TOC points during their hospital stay. Facilitators and barriers were consistently dependent on resources and infrastructure. Clinical and economic outcomes show a mixed picture.ConclusionDuring the past decade pharmaceutical services have developed more holistic TOC services. Large-scale high-quality studies are needed to reliably determine clinical and economic benefit.

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Section: Discussionmentioning

confidence: 99%

Development of hospital pharmacy services at transition of care points: a scoping review

Stoll,

Weidmann

2024

Eur J Hosp Pharm

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“…Introducing pharmacists into the ED setting emerges as a strategic move to improve medication-related patient care [ 31 ]. By dedicating the majority of their work time to these tasks, as also evidenced by this study, pharmacists have the potential to significantly improve the quality and safety of patient care, strengthen interdisciplinary collaborations, and positively impact patient satisfaction and the well-being of ED healthcare personnel [ 18 , 19 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies from different countries have shown that ED pharmacists improve medication safety, reduce hospitalization, enhance patient satisfaction and save costs [ 14 , 15 , 16 , 17 ]. The pharmacists’ contribution to the interdisciplinary team can also relieve the other team members of their medication-related tasks and other duties, and reduce their work and cognitive overload [ 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

How Do Pharmacists Distribute Their Work Time during a Clinical Intervention Trial?—A Time and Motion Study

Holis,

Elenjord,

Lehnbom

et al. 2024

Pharmacy

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Emergency departments (EDs) handle urgent medical needs for a diverse population. Medication errors and adverse drug events pose safety risks in the ED. Clinical pharmacists, experts in medication use, play a crucial role in identifying and optimizing medication therapy. The aim of this study was to investigate how clinical pharmacists introduced into the ED interdisciplinary teams distribute their work time. In a time and motion study, we used the Work Observation Method By Activity Timing (WOMBAT) to observe pharmacists in two Norwegian EDs. The pragmatic approach allowed pharmacists to adapt to ED personnel and patient needs. The pharmacists spent 41.8% of their work time on medication-related tasks, especially those linked to medication reconciliation, including documenting medication-related issues (16.2%), reading and retrieving written information (9.6%), and obtaining oral information about medication use from patients (9.5%). The remaining time was spent on non-medication-related tasks (41.8%), and on standby and movement (17.4%). In conclusion, ED pharmacists spent 42% of their work time on medication-related tasks, predominantly medication reconciliation. Their relatively new role in the interdisciplinary team may have limited their broader clinical impact. Relative to other ED healthcare professionals, ED pharmacists’ goal remains to ensure accurate patient medication lists and appropriate medication use.

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A pharmacist-driven deprescribing protocol for negative urine and sexually transmitted infection cultures in the emergency department increases antibiotic-free days

Wang,

Knobloch,

Lovett

et al. 2023

American Journal of Health-System Pharmacy

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Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose Emergency department (ED) pharmacists commonly perform positive culture follow-ups that result in optimized antibiotic prescribing. The purpose of this study was to evaluate the potential positive impact on the outcome of antibiotic-free days through an ED pharmacist–driven protocol to contact patients with negative urine cultures and sexually transmitted infection (STI) test results who were discharged with antibiotics. Methods This was a single-center, prospective, observational, pre-post intervention study to determine antibiotic use in patients with negative urine cultures who were discharged from the Loyola Medical University Center ED with antibiotics prescribed. Patients were identified through daily positive culture reports. The primary outcome was days free of antibiotics, defined as the number of calendar days within 28 days after urine culture or STI test collection on which the patient did not receive any antibiotic treatments. Results One hundred ninety-two patients were screened. Sixty-three and twenty-six patients met the inclusion criteria in the pre- and postintervention groups, respectively. The study identified 163/465 (35.1%) antibiotic free days for the preintervention group, compared to 150.5/187 (80.5%) antibiotic-free days for the postintervention group. A majority of the patients did not have urinary tract infection as the chief complaint. The most common urinary and STI symptoms upon ED admission in the pre- and postintervention groups were dysuria (19.2% vs 28.1%) and unusual discharge (30.8% vs 28.6%), respectively. Conclusion This study showed that a pharmacist-driven protocol increased the number of antibiotic-free days for patients prescribed empiric antibiotic therapy and discharged from the ED with subsequent negative urine cultures and STI results. We propose taking a novel approach in discontinuation of antibiotics by implementing an expansion of ED culture programs to include negative cultures that promote antimicrobial stewardship.

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A study of time saved by emergency medicine physicians through working with clinical pharmacists in the emergency department

Cited by 5 publications

References 9 publications

Development of hospital pharmacy services at transition of care points: a scoping review

Development of hospital pharmacy services at transition of care points: a scoping review

How Do Pharmacists Distribute Their Work Time during a Clinical Intervention Trial?—A Time and Motion Study

A pharmacist-driven deprescribing protocol for negative urine and sexually transmitted infection cultures in the emergency department increases antibiotic-free days

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