Transformation of a pharmacy department: impact on pharmacist interventions, error prevention, and cost.
BACKGROUND
Current medical literature supports the unit-based (UB) pharmacy concept as a best practice. In an effort to determine its feasibility, Huntsville Hospital (Huntsville, Alabama) conducted a pilot study to compare the central-based (CB) model with the UB model and then implemented the new model.
Data were collected for two high-volume nursing units for 10 days for each model. Pharmacists practicing in the UB setting documented more interventions than the CB pharmacist by a factor of three to one, resulting in an 85% increase in cost avoidance.
Converting the pharmacy services to a UB model entailed creating 16 new pharmacist positions. Extrapolation of the savings for the UB model ($520 per day) and the CB model ($280) for 1 year suggested that adoption of the UB model would generate an additional $87,600 in cost avoidance for these two nursing units. Each new pharmacist was trained for at least 3 months before being scheduled to work independently as a UB pharmacist. Clinical interventions by pharmacists greatly increased after implementation of the UB model. The baseline monthly average of interventions for the 6 months before implementation was 239, and the monthly cost avoidance was $21,300. In October 2001, the first full month of implementation, there were 1,315 interventions and a monthly cost avoidance of $130,192.


CONCLUSIONS
Converting to the UB model has required a considerable increase in the number of pharmacist positions, yet there has been a dramatic increase in clinical pharmacy interventions, with a corresponding decrease in drug expenditures.
Crowson
Karren
K
Huntsville Hospital, 101 Sivley Road, Huntsville, AL 35801, USA. karrenw@knology.net
Collette
David
D
Dang
Mary
M
Rittase
Nellie
N
D000407:Alabama; D001331:Automation; D019985:Benchmarking; D002497:Centralized Hospital Services / Q000191:economics; D016303:Clinical Pharmacy Information Systems; D017046:Cost Savings; D017598:Efficiency, Organizational; D006757:Hospital Units / Q000191:economics; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control; D008510:Medication Systems, Hospital / Q000458:organization & administration*; D017146:Models, Organizational; D009013:Morale; D009936:Organizational Innovation; D010595:Pharmacists / Q000523:psychology / Q000600:supply & distribution; D010607:Pharmacy Service, Hospital / Q000458:organization & administration*; D010865:Pilot Projects; D024382:Professional Role