AHRQ’s Work Helps Convince Army Medical Center to Reinstate E.D. Clinical Pharmacist

Patient Safety

July 2015

Influenced by AHRQ-sponsored research showing how clinical pharmacy services can reduce medication-related errors, the Carl R. Darnall Army Medical Center in Ft. Hood, Texas, restarted a clinical pharmacy program in its emergency department (ED).

"AHRQ research laid the groundwork for hospital funding of the [clinical pharmacist] program," said Laquisha Cartwright, Pharm.D., B.C.P.S., an emergency medicine clinical pharmacist.

The AHRQ research that inspired the emergency pharmacist program at Darnall was conducted in 2005 by Rollin J. Fairbanks, M.D., M.S., and colleagues at the University of Rochester Medical Center in New York. The findings helped identify how emergency pharmacist programs might best be structured.

In September 2011, officials at Darnall, situated on the U.S. Army’s largest active-duty armored post, hired Dr. Cartwright to start a clinical pharmacy program in the ED in order to reduce medication-related errors. The effort was launched following the death of an emergency room patient who had been prescribed an opioid fentanyl patch. In 2012, the first full year the effort was in place, 1,639 clinical interventions were documented.

“I review the medication orders that physicians write,” noted Dr. Cartwright. “I’m involved with underdose and overdose prevention, but I also perform medication therapy consults on patients, adverse drug reaction consults, toxicology consults, therapy change recommendations, resident education, discharge counseling, and medication decision-making during traumas.”

“Though some were skeptical at first, the medical staff have expressed gratitude that a clinical pharmacist has been added to the department. They have seen the value of the position over and over again,” Dr. Cartwright said.

The AHRQ research was funded under the “Partnerships in Implementing Patient Safety” grant program.

Impact Case Study Identifier:

2015-19

AHRQ Product(s): Research

Topics(s): Patient Safety, Emergency Medical Services (EMS)

Geographic Location: Texas

Implementer: Carl R. Darnall Army Medical Center

Date: 07/16/2015

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Fairbanks RJ, Hildebrand JM, Kolstee KE, Schneider SM, Shah MN. Medical and nursing staff highly value clinical pharmacists in the emergency department. Emerg Med J 2007;24:716-8.

Page last reviewed July 2015

Internet Citation: AHRQ’s Work Helps Convince Army Medical Center to Reinstate E.D. Clinical Pharmacist. July 2015. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/policymakers/case-studies/201519.html