Expansion of pharmacists' responsibilities in an emergency department

The role of pharmacists in the emergency department (ED) of an acute care hospital is described.

The ED staff at Carolinas Medical Center-NorthEast care for approximately 80,000 patients per year, with approximately 215 patient visits per day. In July 2007, clinical pharmacy services were implemented in the ED, and four dedicated ED pharmacists were hired with the primary responsibilities of medication reconciliation for admitted patients and prospective review of physician orders. As these pharmacists became more involved with clinical interventions and physician consultations, two pharmacy technicians were placed in the ED to manage medication reconciliation under the supervision of a pharmacist. This allowed the ED pharmacists to assume additional clinical responsibilities, including management of patients' antimicrobial regimens, answering of medication-related telephone calls from discharged patients and the outpatient pharmacy, multidisciplinary team involvement, formal rounding, and participation in cardiopulmonary resuscitation.

ED pharmacists at one institution expanded their clinical role by taking on more direct patient care responsibilities. Pharmacists' interventions were well received by ED physicians, with an acceptance rate of 98%.