Cost effectiveness of a clinical pharmacist on a neurosurgical team.
OBJECTIVE
In 1999, the Society of Critical Care Medicine formally recognized that pharmacists were essential for the provision of high quality care to the critically ill population. This study is a brief quantitative analysis of the benefit provided by a clinical pharmacist in a multidisciplinary neurosurgical setting.


METHODS
Patients admitted to the neurosurgical service in the 2 years before and 2 years after the implementation of dedicated neurosurgical pharmacy services were retrospectively reviewed. The clinical pharmacist was responsible for monitoring and evaluating all adult patients on the service and rounding with the team 6 days a week.


RESULTS
A total of 2156 patients were admitted during the study period. No significant differences were noted among severity of illness scores between the 2 groups. During this time, 11 250 interventions were recorded by the pharmacist. The average pharmacy and intravenous therapy cost per patient between the pre- and postimplementation groups decreased from $4833 to $3239, resulting in a total savings of $1,718,260 over the duration of the study period. The average hospital stay decreased from 8.56 to 7.24 days (P = 0.003). Early hospital mortality also decreased from 3.34% to 1.95% (P = 0.06). For those patients who were discharged from the hospital, there was a significant decrease in readmission rates between the 2 groups (P < 0.05)


CONCLUSIONS
Having a dedicated clinical pharmacist with critical care training rounding routinely with a neurosurgical team significantly reduced hospital stay, readmission rates, and pharmacy costs. Clinical pharmacists can have a significant effect on clinical and economic measures in the intensive care unit, and their participation on a multidisciplinary critical care team should be a standard of care.
Weant
Kyle A
KA
University of Kentucky HealthCare, Pharmacy Services, and Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, Kentucky 40536-0293, USA. kawean2@email.uky.edu
Armitstead
John A
JA
Ladha
Alim M
AM
Sasaki-Adams
Deanna
D
Hadar
Eldad J
EJ
Ewend
Matthew G
MG
D000328:Adult; D003362:Cost-Benefit Analysis; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D009493:Neurosurgery / Q000191:economics*; D010348:Patient Care Team / Q000191:economics; D010595:Pharmacists / Q000191:economics*