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Pharmacists Learn Ins & Outs of Creating New ED Position

Mar 01, 2008

            Tanya Claiborne, Pharm.D., had just been hired as the first emergency department (ED) pharmacist at Sentara Healthcare System in Tidewater, Va., when she discovered a new ASHP program to help her navigate the challenges of her new position.
            The six-month certificate patient-care impact program—“Introducing an Emergency Pharmacist into Your Institution”—brought together 20 pharmacists under the mentorship of three pharmacists and one physician in emergency medicine.
            “It was a wonderful coincidence,” Claiborne said, of the inau­gural program that launched at ASHP’s 2007 Summer Meeting in San Francisco and concluded at the Midyear Clinical Meeting in Las Vegas. “This is a new position, so it was great to have a program where you can learn what does work and what doesn’t.”

Monitoring Performance and Quality
            Participants focused on safe medication use in the intense, pressure-filled environment of the ED, including how to moni­tor pharmacists’ performance and conduct quality assurance. They learned how to develop a pharmacist position in emergency medicine, from devising a job description to obtaining support from hospital leaders. While some of the participants hadn’t worked in EDs prior to starting the program, all of them were working in EDs upon completing it.
            Participants, who hailed from as far away as Dublin, Ireland, completed projects detailing how they would successfully implement pharmacy services in the EDs within their own organizations. They also described the duties of the pharmacist in emergency medicine, which included verifying medication orders, assisting with trauma victims, providing drug information to other health profes­sionals, and performing medica­tion reconciliation. After months of emailing their mentors and meeting in groups via teleconference, the participants displayed their projects on posters viewed by thousands of Midyear attendees.
            Participants said their projects have measurable, positive impacts on patient care, including timely administration of pain medication. They also said they have provided valuable medication education to the nursing staff and decreased the opportunities for adverse drug events.
            One of the program mentors, Daniel P. Hays, Pharm.D., BCPS, clinical pharmacy specialist at the University of Rochester Medical Center Department of Pharmacy and Emergency Medi­cine, Rochester, N.Y., said the program is important because there aren’t many emergency medicine pharmacists, let alone training programs for them.
            “We need to increase our numbers in these roles,” he said. “There are so few post-graduate training opportunities in emer­gency departments. We get these people excited about becoming emergency pharmacists and then jumpstart their abilities.”

Interventions and the ED Pharmacist
            Rebecca Drake, Pharm.D., BCPS, emergency medicine clinical pharmacist at Union Memorial Hospital in Baltimore, joined the program with one goal: to convince the pharmacy’s administration that her presence as a full-time ED pharmacist would increase medical interventions that potentially save lives—and money. At the time, Drake was working in the ED for only one-fifth of her workweek.
            “I really wanted to put myself in the ED full time so that people there would know who I am and could ask me questions,” Drake said.
            For her project, Drake calculated the cost savings associated with the interventions she performed in the ED for a three-month period. She recorded a savings of $8,836 for 136 interventions, which included educating patients and obtaining their medication histories.
            Drake presented her findings to the pharmacy’s administra­tion, which subsequently approved her full-time position in the ED.
            Meanwhile, Claiborne successfully integrated herself in the ED at Sentara and is working to improve the quality and safety of medication use in the institution.
            “Slowly I’m getting things accomplished,” Claiborne said. “But there’s a lot of work to do.”
            ASHP believes every hospital pharmacy department should provide pharmacy services to EDs for safe and effective patient care. But only 3.5 percent of hospitals surveyed had a pharmacist assigned to the ED for any period of time, according to the 2005 ASHP National Survey. In June, ASHP’s House of Delegates will consider approving the new Statement on Pharmacy Ser­vices to the Emergency Department, which calls on pharmacists to collaborate with other healthcare professionals to develop medication-use systems in EDs to promote safe and effective medication use.
             The ASHP Research and Education Foundation; University of Rochester; Johns Hopkins University, Baltimore; Cedars-Sinai Medical Center, Los Angeles; and the Agency for Healthcare Research and Quality collaborated with ASHP on the program.

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