Call for 1 to 10 pharmacist ratio to improve care in Australia’s emergency departments

A new blueprint for emergency medicine pharmacy services to improve patient care while reducing total service cost in Australia’s emergency departments and short stay units, including 1:10 pharmacist-patient ratios, has been released today by the Society of Hospital Pharmacists of Australia (SHPA).

Reflecting strong working partnerships between pharmacists and doctors in hospitals, the SHPA Standards of Practice in Emergency Medicine for Pharmacy Services was reviewed by the Australasian College for Emergency Medicine (ACEM), and published in the December 2019 issue of the Journal of Pharmacy Practice and Research (JPPR) alongside a supporting editorial by Simon Judkins, ACEM Board Member and immediate Past President.

Susan Welch, immediate past Chair of SHPA’s Emergency Medicine Leadership Committee, says the standard describes current best care for the provision of emergency medicine pharmacy services.

‘The provision of emergency medicine pharmacist services improves healthcare outcomes through timely and accurate best possible medication history (BPMH) documentation; liaison between emergency and other departments on medicine-related issues such as stock shortages or substitutions; early involvement of the pharmacist in decision making and administration of time-critical medications; and reductions in the total cost of care.

‘Where there is the delivery of emergency services, or where patients are admitted to short stay acute medical assessment units for less than 48 hours, we recommend 1.0 FTE pharmacist for clinical pharmacy services, per day, for every 10 patients at risk of medication related problems.’

SHPA Chief Executive Kristin Michaels says research into the benefits of expanding emergency medicine pharmacy is compelling, given services are established in less than two-thirds of Australian hospitals.

‘The addition of a clinical pharmacist within an emergency department has been proven to reduce the number of medicines omissions and dosing delays, and a systematic literature review from 2009-16 demonstrated the role of the emergency pharmacist led to a diverse range of positive patient outcomes.

‘2016 research showed 40% of Australian hospitals do not have a dedicated emergency medicine pharmacy service.

‘Through the leadership of SHPA members, who are medicines experts working in busy and challenging clinical environments, this Standard provides clear guidance that we hope will support the closing of this gap to the benefit of Australia’s most critically ill patients.’

Writing in SHPA’s flagship journal today, ACEM’s Simon Judkins says effective, efficient, timely and equitable patient-centred care is what all health professional strive to deliver in emergency departments.

‘Clinical pharmacists are an essential part of the ED multidisciplinary team and the adoption into practice of the roles and services outlined in SHPA’s Standards needs to be a priority to improve the care provided to our patients.

‘The ACEM has welcomed contributing to the development of these Standards and looks forward to working with our pharmacy colleagues to further strengthen and embed clinical pharmacists as part of the emergency care team.’

Download the media release.