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.
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.
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.
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.
Keywords: clinical pharmacists, emergency care, pharmacy services, residency, medication errors, survey