The Role of the Pharmacist
Pharmacists' education and training prepares these health professionals to lead efforts that ensure safe and evidence-based medication use. Scientific literature demonstrates improved clinical outcomes, fewer adverse events, and more cost-effective medication use when pharmacists are involved in patient care. The benefits of pharmacist leadership in antimicrobial stewardship programs, management of chronic disease, and involvement in care of sepsis, pneumonia, and heart failure patients are significant and have demonstrated effectiveness in decreasing mortality and hospitalizations. Pharmacists have also applied their knowledge to information systems and automation to reduce risk in the medication-use process.
Examples of Transformational Change in Pharmacy Practice
Below are highlights of the important role pharmacists play in improving safety:
Falls Prevention Program: In 2003, Mercy Health Center's patient fall rate exceeded the national average. Clinical pharmacists who were assigned to the Falls Risk Committee designed and implemented a falls prevention program that included developing a tool to identify and follow patients at high risk based on medications prescribed. 
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As a result, fall-related injuries decreased by 32% and cost savings from preventing both injury falls and total falls has been approximately $216,000 per year. Since inception, dollars saved in prevented falls is estimated to be $400,000.
For additional details, please contact ASHP.
Interdisciplinary Antimicrobial Subcommittee: Increasing antimicrobial resistance and rising antibiotic expenditures led the pharmacy department of a Kentucky hospital to form an interdisciplinary antimicrobial subcommittee charged with ensuring appropriate use, reducing costs, and controlling the emergence of resistance. Read more
The group developed a program that reduced inappropriate antimicrobial use and reversed resistance patterns for many isolates, including MRSA (which declined at an average of 3% per year). Pharmacy expenditures decreased 25%, saving $1,400,000.
For additional details, please contact ASHP.
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.
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. Read more
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 Hearth 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.
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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.
Relevant ASHP Best Practices
Other ASHP Resources