title: Clinical benefits and economic impact of post-surgical care provided by pharmacists in a Canadian hospital.
abstract: OBJECTIVE
  Clinical pharmacists improve the quality of patient care by reducing adverse drug events (ADEs), length of stay and mortality. This impact is currently not well described in surgery. The objective was to evaluate clinical and economic outcomes after clinical pharmacist services were added to two general surgical wards in an adult hospital.
  
  
  METHODS
  This was a prospective, observational study. All clinical interventions to resolve drug therapy problems were documented and assessed for severity, value and the probability of preventing an ADE. Cost avoidance was calculated using two methods: by avoiding additional days in hospital (CA$3593/ADE) or additional hospital costs ($7215/ADE). Two clinical pharmacy specialists and the surgical care pharmacist independently categorized the interventions; disagreements were resolved by consensus.
  
  
  RESULTS
  The pharmacists made 1097 interventions in 6 months with a 98% acceptance rate by surgical staff. Half of the interventions were rated significant for severity (561, 51.1%) and value (559, 51.0%). One-quarter of the interventions had a 40% or greater probability of preventing an ADE (270, 24.6%). Cost avoidance was estimated to be $0.68-1.36 million or $617-1239 per intervention. Pharmacists avoided an additional 867 days in the hospital for surgical patients.
  
  
  CONCLUSIONS
  The pharmacist's role in the management of the drug therapy needs of the post-surgical patient has the potential to improve clinical and patient outcomes and avoid healthcare costs. The inclusion of clinical pharmacists in surgical wards may result in $7 in savings for every $1 invested.
authors: Pharmacy Services, Capital Health, Halifax, NS, Canada.
authors: Heather L
authors: HL
authors: Neville
authors: Bernadette
authors: B
authors: Chevalier
authors: Chris
authors: C
authors: Daley
authors: Lisa
authors: L
authors: Nodwell
authors: Claudia
authors: C
authors: Harding
authors: Anne
authors: A
authors: Hiltz
authors: Tammy
authors: T
authors: MacDonald
authors: Chris
authors: C
authors: Skedgel
authors: Neil J
authors: NJ
authors: MacKinnon
authors: Kathryn
authors: K
authors: Slayter
mesh_terms: D002170:Canada; D016527:Drug Costs; D006801:Humans; D007902:Length of Stay; D010595:Pharmacists; D010607:Pharmacy Service, Hospital; D011182:Postoperative Care / Q000191:economics*; D011446:Prospective Studies
keywords: adverse drug events; clinical interventions; cost avoidance; medicines management; patient safety