Purpose: To develop a collaborative practice between hospitalists and pharmacists by following the recommendations from the consensus statement published by the Society of Hospital Medicine (SHM) and the American Society of Health-System Pharmacists (ASHP).
Methods: Between November 2011 and February 2012, the hospitalist-pharmacist collaboration developed six order sets, a collaborative practice, and a patient interaction program. Outcomes from these initiatives were collected to determine the impact a collaborative hospitalist-pharmacist practice had on patient safety and cost avoidance.
Results: The following order sets were developed during the study period: diabetic ketoacidosis, acute alcohol withdrawal, hypoglycemia, nicotine replacement, admission, and contrast-induced nephropathy prophylaxis. In addition to the creation of order sets, a collaborative practice was developed that resulted in a total of 77 interventions during the study period. These interventions included IV to PO conversions, initiation of therapy, discontinuation of therapy, duration of therapy, and medication regimen adjustments. These interventions resulted in $5,602 of cost avoidance. A patient interaction program was also developed to increase interactions between patients and pharmacists that were admitted to the hospitalist service. This project resulted in a total of 79 interventions that included allergy clarification, allergy identification, and pain management assessment. These interventions resulted in $4,223 of cost avoidance. The cumulative impact of the hospitalist-pharmacist collaboration included the development of six order sets, 156 total interventions, and a total cost avoidance of $9,825 during the study period.
Conclusions: An interdisciplinary approach to health care has the potential to improve the quality, safety, and cost of patient care. Our study used the recommendations from the consensus statement published by SHM and ASHP to develop a successful hospitalist-pharmacist collaborative relationship. We found that when these ideas were introduced into practice, patient care was improved.