Teamwork Makes the Dream Work: Partnered Pharmacist Medication Charting in the Emergency Department

Nearly 47.8% of medication errors that occur in emergency departments (ED) may be potentially serious. Yet, ED medical workers dedicate only an estimated 18% of their time to medication-related tasks.

Credit: Jacob Lund - stock.adobe.com

Due to the high volume, time-sensitive, and complex nature of patient care within EDs, pharmacists should advocate for implementation of Partnered Pharmacist Medication Charting (PPMC). A new 2023 study published by the International Journal of Environmental Research and Public Health compared PPMC to pharmacist collection of a best-possible medication history (BPMH) and traditional medical charting. The results indicated PPMC significantly reduced the prevalence of clinically serious medication errors when compared to the other arms.

The PPMC model enables pharmacists to participate in charting and decision-making in collaboration with medical officers. To evaluate PPMC’s efficacy, patients/providers were randomized into 3 arms:

• The PPMC arm of the study examined pharmacist-driven solicitation of a BPMH followed by collaborative development of a patient-specific treatment plan.
• The BPMH arm of the study looked at pharmacist-driven solicitation of a BPMH in isolation without collaborative discussion.
• The traditional medical charting arm examined charting without pharmacist involvement.

Independent researchers collected and evaluated data from patient digital medical records to find medication errors, which the study defined as preventable occurrences resulting in inappropriate medication use or patient harm. Results indicated 3.5% of patients in the PPMC group experienced at least 1 error compared to 49.4% in the BPMH group and 61.4% in the traditional medical charting group.

Overall, the significant reduction in medication errors among the PPMC group highlights the importance of interprofessional decision-making between pharmacists and ED medical officers. Evidence from the study shows, “the majority of medication error corrections result from interprofessional discussion rather than retrospective approaches.”

Although BPMH reduced medication discrepancies, pharmacist collection of BPMH alone did not. In the ED setting, collaborative teamwork helps reduce medical officers’ heavy workloads.

The time-consuming nature of medication-related tasks, coupled with the lack of accurate and complete medication information on unfamiliar patients, contributes to the higher prevalence of medication errors in the ED. Fortunately, pharmacist involvement through PPMC can remedy this. The researchers concluded that involving pharmacists in medication co-prescribing/co-charting was the best method to prevent errors.

Ultimately, preventing medication errors reduces length of stay, hospital-acquired complications, and medication adverse effects. The bottom line: pharmacist input on clinical decisions improves patient outcomes.

About the Author

Kimberly Ma is a 2024 PharmD candidate at the University of Connecticut.

Reference

Atey TM, Peterson GM, Salahudeen MS, et al. Impact of Partnered Pharmacist Medication Charting (PPMC) on Medication Discrepancies and Errors: A Pragmatic Evaluation of an Emergency Department-Based Process Redesign. Int J Environ Res Public Health. 2023;20(2):1452. Published 2023 Jan 13. doi:10.3390/ijerph20021452