Examples of Transformational Change
Clinical Pharmacy Education Program in VTE Prophylaxis
A hospital-wide clinical pharmacy education program increased utilization of venous thromboembolism prophylaxis in medical patients in a community teaching hospital from 43% to 58%. See Dobesh PP, Stacy ZA. Effect of a clinical pharmacy education program on improvement in the quantity and quality of venous thromboembolism prophylaxis for medically ill patients. J Manag Care Pharm. 2005;11(9):755-62. [PDF]
Pharmacist-Managed Antimicrobial Prophylaxis
One study demonstrated that 242,704 Medicare patients from 860 hospitals without pharmacist-managed antimicrobial prophylaxis were associated with higher death rates from surgical site infections (52.06% higher or 105 excess deaths), longer length of stay (10.21% higher or 167,941 excess patient days), and higher drug charges (7.24% higher or $54,262,360 excess drug charges) than hospitals where pharmacists managed this care.
See Bond CA, Raehl CL. Clinical and economic outcomes of pharmacist-managed antimicrobial prophylaxis in surgical patients. Am J Health Syst Pharm. 2007;64(18):1935-42. Erratum in: Am J Health Syst Pharm. 2007;64(21):2218.
Pharmacists on Rounding Teams
Pharmacist participation in daily medical rounds, provision of patient care services at the bedside, documentation of pharmacotherapy history and provision of discharge counseling significantly reduced preventable adverse drug events from 26.5/1000 patient days to 5.6/1000 patient days (78% decrease). See Kucukarslan SN, Peters M, Mlynarek M, Nafziger DA. Pharmacists on rounding teams reduce preventable adverse drug events in hospital general medicine units. Arch Intern Med. 2003 Sep 22;163(17):2014-8.
Pharmacists Care of Patients with Heart Failure
In a review of 12 randomized, controlled trials involving 2,060 heart failure patients, care by a pharmacist was associated with 30% fewer hospitalizations.
The study authors theorized that, based on more than 1 million heart failure hospitalizations a year, this reduction would have a substantial impact. They recommended that inclusion of pharmacists in teams caring for heart failure patients should be strongly considered by health policy makers. See Koshman SL, Charrois TL, Simpson SH, et al. Pharmacist care of patients with heart failure: a systematic review of randomized trials. Arch Intern Med. 2008;168(7):687-94.
ASHP Best Practices and Resources
- Guidelines on adverse drug reaction monitoring and reporting
- Guidelines on preventing medication errors in hospitals [PDF]
- Guidelines on Preventing medication errors with antineoplastic agents [PDF]
- Guidelines on the safe use of automated medication storage and distribution devices [PDF]
- Statement on the pharmacist’s role in informatics [PDF]
- ASHP Patient Safety Web resource center
