Effect of an integrated clinical pharmacy service with the general medical units on patient flow and medical staff satisfaction: a pre- and postintervention study

Background: Health services are under pressure to accommodate increasing numbers of emergency department presentations. This can contribute to prescribing errors. Integration of a pharmacist into the general medical team may reduce the incidence of prescribing errors on discharge and improve patient flow and medical staff satisfaction. Aim: This study evaluated the effect of an integrated pharmacy service provided to the general medical units (GMUs) on patient flow and medical staff satisfaction. Method: This study was a 4-week pre- and postintervention study involving GMUs at a major metropolitan hospital in Australia. During the intervention period, an integrated clinical pharmacy service, which included attending medical ward rounds and assisting with the preparation of discharge prescriptions, was provided to medical units. The primary endpoint was the median time (min) past 9am that patients were discharged from the ward. Secondary outcomes included the proportion of prescriptions requiring an amendment and medical staff satisfaction with the service. Results: There were 87 and 84 patients discharged from the medical units before and after the intervention. During the intervention period, pharmacists prepared 79% of prescriptions, which reduced the proportion requiring an amendment from 65% to 17% (p < 0.01). Patients were discharged 77 min earlier during the postintervention period (median 380 vs 303 min after 9am; p = 0.03). Medical staff felt the integrated clinical pharmacy service improved patient flow and should be incorporated into standard practice. Conclusions: An integrated clinical pharmacy service with proactive pharmacist intervention within the GMUs improved patient flow and medical staff satisfaction, and decreased prescriptions requiring an amendment.