ED pharmacist can have positive impact on variety of ED outcomes

Like odd work hours, action-packed days?

An emergency department (ED) pharmacist can help improve patient safety and improve an ED's performance on quality measures.

Emergency department pharmacists are actively involved in managing the care of trauma patients, facilitating medication administration, evaluating medications, and preventing adverse drug events.

It's an interesting role for pharmacists, partly because it entails a different workflow.

"Emergency medicine is challenging because emergency rooms don't get busy until around noon, and they stay busy through midnight," says Curtis E. Haas, PharmD, FCCP, BCPS, director of pharmacy at the University of Rochester Medical Center in Rochester, NY.

"When we interview and recruit people for an emergency pharmacist position, we look for people who don't mind an eccentric schedule," he adds.

One of the areas in which an ED pharmacist can play an important role involves antimicrobial stewardship.

When the University of Rochester Medical Center had an ED pharmacist involved in antimicrobial stewardship, the percentage of patients who received the most appropriate therapy in-creased from about mid-80% to 100%, Haas says.

Another role for the ED pharmacist is to follow-up with patients when their lab results arrive after they've left the hospital.

Previously, the University of Rochester Medical Center had mid-level providers, including nurse practitioners and physician assistants, in charge of obtaining ED patients' cultures and contacting patients' physicians with follow-up information, says Nicole M. Acquisto, PharmD, BCPS, clinical pharmacist specialist in emergency medicine at the University of Rochester Medical Center.

"We contact patients, primary care providers, and the department of health if that's necessary," she says.

Physicians might need to make a new prescription based on the results, so it's important the information is reported in a timely manner.

The median time for this follow-up when mid-level providers were given this responsibility was four days with a range of one to 15 days, Acquisto says.

Now that the ED pharmacist is in charge of collecting the culture results and calling patients' primary care providers with the results, the median time for follow-up is three days with a range of one to four days, she says.

"There are better results with our involvement," Acquisto says.

The follow-up time would be even shorter if it weren't for weekend culture results. When lab results return on a Friday evening or Saturday morning, the ED pharmacist cannot call the provider until the following Monday morning.