Advanced practice model improves pharmacy practice in ED

Implementation of an advanced pharmacy practice model has “maximized opportunities” for pharmacists to provide direct patient care, practice “at the top of their license,” and promote safe and effective use of medications, according to a retrospective descriptive study.

The authors quantified clinical activities performed by pharmacists in an advanced pharmacy practice model in the emergency department (ED). They collected and reviewed data extracted from January 2015 to August 2017 from the department of pharmacy’s electronic documentation system and the hospital’s electronic medical record.

Cost savings were obtained from the system with adaptation from the previous literature and had been validated by the institution’s administration as an acceptable reflection of the impact for activity.

A total of 4,106 clinical activities had been participated in by the ED pharmacy team, resulting in a cumulative cost avoidance of $5,387,679. Pharmacotherapy consult (63.6 percent) and response to medical emergencies (20.7 percent) were the most common clinical activities that the pharmacy team provided overall.

ED clinicians placed a total of 16,219 medication orders, which were prospectively reviewed, and accepted 379 interventions. Median turnaround times for medication verification were 2 minutes (interquartile range [IQR], 1–6 minutes) for 2015, 2 minutes (IQR, 1–6 minutes) for 2016, and 2 minutes (IQR, 1–5 minutes) for 2017.

A research programme led by the ED pharmacotherapist published 14 peer-reviewed publications, based mainly on pharmacy practice or use of pharmacotherapy for acute pain.