AHRQ Patient Safety Research Spurs Development of 100 Emergency Department Pharmacies

Since 2007, nearly 100 U.S. hospitals have developed and implemented an emergency pharmacist role in their institutions through an American Society of Health-System Pharmacists (ASHP) mentoring program called the "Patient Care Impact Program" (PCIP). The program was originally inspired by AHRQ-sponsored research that showed how clinical pharmacy services reduce medication-related errors in hospital emergency departments (EDs).

The goal of PCIP is to provide experiential training to practicing pharmacists seeking to establish ED pharmacy services. Under the guidance of national experts, pharmacists from a range of institutions—community-based hospitals to academic and tertiary care institutions—learn to start, grow, and improve fledgling ED pharmacy programs. The Institute of Medicine has identified medication errors as the most common type of error in health care.

"The AHRQ grant has really had a big impact on patient safety and patient care," says Daniel B. Hays, PharmD, an emergency pharmacist at the University of Arizona and one of PCIP's two mentors. The research that led to PCIP was funded under one of AHRQ's Partnerships in Implementing Patient Safety grants and was led by Hays' colleague, Rollin J. Fairbanks, MD, MS, of the University of Rochester. When Fairbanks received the AHRQ grant, Hays says, "there was little in the research literature on hospital-based pharmacy, despite that it's a critical needs area."

One of Fairbanks' findings was that EDs, where patients can present with complex medical challenges, rarely benefited from the medication review systems that were routine in the rest of the hospital. ASHP's mentoring program focuses on reducing medication errors in the fast-paced ED by helping hospitals create permanent programs that get clinical pharmacists involved with ED medication use.

"We're developing the community of emergency medicine practitioners who are directly impacting improvements in care and patient safety in the highly intense, error-prone emergency room," says Barbara Nussbaum, MEd, PhD, Director of Adult Learning and Education in ASHP's Educational Services Division.

"The interest in PCIP has continued to peak," says Hays, who directs PCIP with colleague Kevin Reilly, MD. Part of the reason, Hays notes, is the impact an emergency pharmacist can have, including reducing preventable adverse drug events, improving medication reconciliation, spurring interdisciplinary health care team collaboration, and potentially saving more than an estimated $3 million a year.

Each year, up to 15 pharmacists and other care team members enroll in the 6-month educational PCIP in order to start or expand emergency pharmacy efforts. Hays and Reilly lead PCIP participants in brainstorming sessions and monthly teleconferences for status updates, group mentoring, problem solving, and more.

With some 30,000 members, ASHP is a national professional association representing pharmacists who practice in hospitals, health maintenance organizations, long-term care facilities, home care, and other areas. ASHP aims to prevent medication errors, help people make the best use of medicines, and assist pharmacists in fulfilling these goals.

For more information on PCIP, visit: http://www.ashp.org/menu/Education/Traineeships/PatientCare.aspx.