"Most EDs across the nation don't have pharmacists. They have a central pharmacy that processes orders, and have limited hours," says Larison. "By having the ED pharmacy, we head off potential problems before they occur. We can clarify patient allergies for physicians and determine cross-sensitivity to avoid adverse reactions."
Pharmacists are assigned around-the-clock to the Sarasota Memorial Hospital emergency department. "From a business perspective, it enhances the patient care and there are overall decreased costs," Larison says. Pharmacists have reviewed drug supplies in the hospital and there have been reduced costs in budgets when it was determined some pharmaceuticals were not needed as much as others, she says.
"We actually saved money by significantly decreasing the amount of drugs we don't use," Larison says. "If we can intervene at the outset, that is the best choice for better outcomes."
Although Sarasota officials are still compiling revenue figures on pharmacists assigned for the ED, studies conducted for the American Society of Health-System Pharmacists, show significant savings for hospitals, Larison says. In one of the largest studies, in 2003, pharmacists participated over a four-month period in the care of 1,042 patients triaged in the ED, and 2,150 pharmacist interventions were documented—which included recommendations for drug adjustment, alternative drug therapy, drug compatibility, and other issues. The overall savings amounted to about $1 million, according to the study.
The ASHSP has recommended that every pharmacy department provide the ED with pharmacy services to ensure safe and effective patient care. Only a small percentage of hospitals now have pharmacists in the ED, but the numbers are growing, according to Larison.
The idea is "to assist the physicians and nurses and enhance the care of the patients," she says.