title: Clinical Pharmacy Services in Canadian Emergency Departments: A National Survey.
abstract: BACKGROUND
  Providing clinical pharmacy services in emergency departments (EDs) is important because adverse drug events commonly occur before, during, and after ED encounters. Survey studies in the United States have indicated a relatively low presence of clinical pharmacy services in the ED setting, but a descriptive survey specific to Canada has not yet been performed.
  
  
  OBJECTIVE
  To describe the current status of pharmacy services in Canadian EDs and potential barriers to implementing pharmacy services in this setting.
  
  
  METHODS
  All Canadian hospitals with an ED and at least 50 acute care beds were contacted to identify the presence of dedicated ED pharmacy services (defined as at least 0.5 full-time equivalent [FTE] position). Three different electronic surveys were then distributed by e-mail to ED pharmacy team members (if available), pharmacy managers (at hospitals without an ED pharmacy team), and ED managers (all hospitals). The surveys were completed between July and September 2013.
  
  
  RESULTS
  Of the 243 hospitals identified, 95 (39%) had at least 0.5 FTE clinical pharmacy services in the ED (based on initial telephone screening). Of the 60 ED pharmacy teams that responded to the survey, 56 had pharmacists (27 of which also had ED pharmacy technicians) and 4 had pharmacy technicians (without pharmacists). Forty-four (79%) of the 56 ED pharmacist services had been established within the preceding 10 years. Order clarification, troubleshooting, medication reconciliation, and assessment of renal dosing were the services most commonly provided. The large majority of pharmacy managers and ED managers identified the need for ED pharmacy services where such services do not yet exist. Inadequate funding, competing priorities, and lack of training were the most commonly reported barriers to providing this service.
  
  
  CONCLUSIONS
  Although the establishment of ward-based pharmacy services in Canadian EDs has increased over the past 10 years, lack of funding and a lack of ED training for pharmacists were reported as significant barriers to the expansion of this role in most hospitals.
authors.affiliation: BSc, BSc(Pharm), ACPR, PharmD, is a Clinical Pharmacy Specialist (Emergency Medicine), Pharmacy Department, Royal Jubilee Hospital, Island Health Authority, Victoria, British Columbia.
authors.forename: Richard
authors.initials: R
authors.lastname: Wanbon
authors.affiliation: BSc(Pharm), MHSA, is Coordinator of Professional and Membership Affairs, Canadian Society of Hospital Pharmacists, Ottawa, Ontario.
authors.forename: Catherine
authors.initials: C
authors.lastname: Lyder
authors.affiliation: BPharm, MSc, PharmD, is a Clinical Pharmacist (Emergency Medicine), Pharmacy Department, McGill University Health Centre, Montreal, Quebec.
authors.forename: Eric
authors.initials: E
authors.lastname: Villeneuve
authors.affiliation: BSc(Pharm), ACPR, PharmD, FCSHP, is Clinical Coordinator, Pharmacy Department, Providence Healthcare, Lower Mainland Pharmacy Services, Vancouver, British Columbia. He is also a Clinical Professor with the Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Shalansky
authors.affiliation: BSc, BSc(Pharm), ACPR, PharmD, is Pharmacy Clinical Manager and Clinical Pharmacist (Emergency Medicine), Pharmacy Department, The Moncton Hospital, Horizon Health Network, Moncton, New Brunswick.
authors.forename: Leslie
authors.initials: L
authors.lastname: Manuel
authors.affiliation: BSP, ACPR, is a Clinical Pharmacist with the Emergency and Home Parenteral Therapy Program, Pharmacy Department, South Health Campus, Alberta Health Services, Calgary, Alberta.
authors.forename: Melanie
authors.initials: M
authors.lastname: Harding
keywords: Canada; emergency department; pharmacist; pharmacy; survey; technician