The clinical pharmacist role in the emergency department (ED) is an exciting and rapidly growing area of interest for hospitals. Within the last ten years, we’ve witnessed an increase in the number of pharmacists providing services in emergency departments across the United States, from virtually none to almost 20% of hospitals.1,2 As patients increasingly seek care in EDs, care teams will continue to look to further involve pharmacists to provide essential services that improve ED efficiencies and the patient experience.
Recently, we explored how to optimize the pharmacists’ role in the emergency department and discovered the importance of leveraging technology to intervene early in the patient admission process to improve outcomes. Let’s further examine tangible steps to continue to increase and optimize pharmacists’ involvement in the ED.
1. Optimize inventory management
Pharmacists can support nursing teams through education regarding solutions for ongoing drug shortages and aiding with automated dispensing cabinets.
Pharmacists are the first to be informed of shortages and must work swiftly to find appropriate substitute medications. Establishing a consistent method of notification for nursing enables safer patient care. For example, a weekly email chart explaining current shortages, solutions, and the expectancy of change in therapy can drastically support nursing teams in navigating ongoing shortages.
For hospitals that use automated dispensing cabinets, quick changes can be made to how medications are loaded:
- Store fast movers in a more accessible drawer for quicker removal
- Create drawers that contain medications often administered together such as morphine with ondansetron
Identifying opportunities for efficiencies should be an ongoing discussion with ED nurses. Continually review their “wish list” items, track if new processes are helping, and explore other opportunities for improvement.
2. Support a culture of safety
EDs are high-risk environments more prone to errors that result in patient or staff harm. Pharmacists can help support a culture of safety in simple ways:
- Share examples of errors from the Institute of Safe Medication Practices (ISMP) and/or local data
- Subscribe to The ISMP Medication Safety Alert!® Acute Care, a bi-weekly newsletter publishing strategies for decreasing medication error risk
Initiate conversations regularly about preventing similar errors with colleagues across the ED.
3. Educate and share learnings across teams
Pharmacy practice is constantly shifting. With literature that is continually evolving, it’s essential to remain on the pulse of the latest data and share it across teams. How can pharmacists interact more with the Emergency Department? Participate in monthly staff education to network and share ideas. Establish brief presentations prior to the start of a shift from simple posters or handouts created by the pharmacist, interns or students.
When it can be more challenging to meet regularly with some of the Emergency Department Physicians, attend educational sessions with the Physicians or create brief written or verbal education tools to lead to constructive dialogue.
The role of the clinical pharmacist in the emergency department continues to expand and evolve. Establishing strong connections across care teams is essential to meeting the needs of more complex patients and improving patient care.
- Pederson CA, Schneider PJ,ScheckelhoffDJ. ASHP national survey of pharmacy practice in hospital settings: prescribing and transcribing—2004. Am J Health Syst Pharm. 2005 Feb 15;62(4):378-90.
- Pederson CA, Schneider PJ,ScheckelhoffDJ. ASHP national survey of pharmacy practice in hospital settings: prescribing and transcribing—2013. Am J Health Syst Pharm. 2014 June 1; 71 (11): 924-942.