Clinical and economic impact of partnered pharmacist medication charting in the emergency department
Introduction: Partnered pharmacist medication charting (PPMC), a process redesign hypothesised to improve medication safety and interdisciplinary collaboration, was trialed in a tertiary hospital’s emergency department (ED).Objective: To evaluate the health-related impact and economic benefit of PPM...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-12-01
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| Series: | Frontiers in Pharmacology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2023.1273657/full |
| _version_ | 1827592568005722112 |
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| author | Tesfay Mehari Atey Gregory M. Peterson Mohammed S. Salahudeen Tom Simpson Camille M. Boland Ed Anderson Barbara C. Wimmer |
| author_facet | Tesfay Mehari Atey Gregory M. Peterson Mohammed S. Salahudeen Tom Simpson Camille M. Boland Ed Anderson Barbara C. Wimmer |
| author_sort | Tesfay Mehari Atey |
| collection | DOAJ |
| description | Introduction: Partnered pharmacist medication charting (PPMC), a process redesign hypothesised to improve medication safety and interdisciplinary collaboration, was trialed in a tertiary hospital’s emergency department (ED).Objective: To evaluate the health-related impact and economic benefit of PPMC.Methods: A pragmatic, controlled study compared PPMC to usual care in the ED. PPMC included a pharmacist-documented best-possible medication history (BPMH), followed by a clinical conversation between a pharmacist and a medical officer to jointly develop a treatment plan and chart medications. Usual care included medical officer-led traditional medication charting in the ED, without a pharmacist-obtained BPMH or clinical conversation. Outcome measures, assessed after propensity score matching, were length of hospital or ED stay, relative stay index (RSI), in-hospital mortality, 30-day hospital readmissions or ED revisits, and cost.Results: A total of 309 matched pairs were analysed. The median RSI was reduced by 15.4% with PPMC (p = 0.029). There were no significant differences between the groups in the median length of ED stay (8 vs. 10 h, p = 0.52), in-hospital mortality (1.3% vs. 1.3%, p > 0.99), 30-day readmission rates (21% vs. 17%; p = 0.35) and 30-day ED revisit rates (21% vs. 19%; p = 0.68). The hospital spent approximately $138.4 for the cost of PPMC care per patient to avert at least one medication error bearing high/extreme risk. PPMC saved approximately $1269 on the average cost of each admission.Conclusion: Implementing the ED-based PPMC model was associated with a significantly reduced RSI and admission costs, but did not affect clinical outcomes, noting that there was an additional focus on medication reconciliation in the usual care group relative to current practice at our study site. |
| first_indexed | 2024-03-09T01:57:20Z |
| format | Article |
| id | doaj.art-0130d20d9c9848f890aa78a19a2a5de1 |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-03-09T01:57:20Z |
| publishDate | 2023-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-0130d20d9c9848f890aa78a19a2a5de12023-12-08T12:41:12ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122023-12-011410.3389/fphar.2023.12736571273657Clinical and economic impact of partnered pharmacist medication charting in the emergency departmentTesfay Mehari Atey0Gregory M. Peterson1Mohammed S. Salahudeen2Tom Simpson3Camille M. Boland4Ed Anderson5Barbara C. Wimmer6School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS, AustraliaSchool of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS, AustraliaSchool of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS, AustraliaPharmacy Department, Royal Hobart Hospital, Tasmanian Health Service, Hobart, TAS, AustraliaPharmacy Department, Royal Hobart Hospital, Tasmanian Health Service, Hobart, TAS, AustraliaPharmacy Department, Royal Hobart Hospital, Tasmanian Health Service, Hobart, TAS, AustraliaSchool of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS, AustraliaIntroduction: Partnered pharmacist medication charting (PPMC), a process redesign hypothesised to improve medication safety and interdisciplinary collaboration, was trialed in a tertiary hospital’s emergency department (ED).Objective: To evaluate the health-related impact and economic benefit of PPMC.Methods: A pragmatic, controlled study compared PPMC to usual care in the ED. PPMC included a pharmacist-documented best-possible medication history (BPMH), followed by a clinical conversation between a pharmacist and a medical officer to jointly develop a treatment plan and chart medications. Usual care included medical officer-led traditional medication charting in the ED, without a pharmacist-obtained BPMH or clinical conversation. Outcome measures, assessed after propensity score matching, were length of hospital or ED stay, relative stay index (RSI), in-hospital mortality, 30-day hospital readmissions or ED revisits, and cost.Results: A total of 309 matched pairs were analysed. The median RSI was reduced by 15.4% with PPMC (p = 0.029). There were no significant differences between the groups in the median length of ED stay (8 vs. 10 h, p = 0.52), in-hospital mortality (1.3% vs. 1.3%, p > 0.99), 30-day readmission rates (21% vs. 17%; p = 0.35) and 30-day ED revisit rates (21% vs. 19%; p = 0.68). The hospital spent approximately $138.4 for the cost of PPMC care per patient to avert at least one medication error bearing high/extreme risk. PPMC saved approximately $1269 on the average cost of each admission.Conclusion: Implementing the ED-based PPMC model was associated with a significantly reduced RSI and admission costs, but did not affect clinical outcomes, noting that there was an additional focus on medication reconciliation in the usual care group relative to current practice at our study site.https://www.frontiersin.org/articles/10.3389/fphar.2023.1273657/fullpartnered pharmacistco-chartingmedication chartingemergency departmentlength of staycost-benefit |
| spellingShingle | Tesfay Mehari Atey Gregory M. Peterson Mohammed S. Salahudeen Tom Simpson Camille M. Boland Ed Anderson Barbara C. Wimmer Clinical and economic impact of partnered pharmacist medication charting in the emergency department Frontiers in Pharmacology partnered pharmacist co-charting medication charting emergency department length of stay cost-benefit |
| title | Clinical and economic impact of partnered pharmacist medication charting in the emergency department |
| title_full | Clinical and economic impact of partnered pharmacist medication charting in the emergency department |
| title_fullStr | Clinical and economic impact of partnered pharmacist medication charting in the emergency department |
| title_full_unstemmed | Clinical and economic impact of partnered pharmacist medication charting in the emergency department |
| title_short | Clinical and economic impact of partnered pharmacist medication charting in the emergency department |
| title_sort | clinical and economic impact of partnered pharmacist medication charting in the emergency department |
| topic | partnered pharmacist co-charting medication charting emergency department length of stay cost-benefit |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2023.1273657/full |
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