The implementation of decentralized pharmaceutical services in an emergency room (ER) is described, with emphasis on cost justification. As part of an overall hospital goal of improving patient-care services in the ER the pharmacy department identified its role in the plan. The objectives of the pharmacy included providing faster prescription-filling services with more patient education, to increase the number of ER prescription filled in-house, to improve drug control and accountability of floor stock medications in the ER, and to expand clinical services inthe ER. To do this, a satellite pharmacy was established in the ER. Implementation costs for the first year of operation were estimated at +122,875; of this represented a transfer of inventory from other pharmacy areas, and +62,900 represented personnel cost that were also transferred from other areas. Actual costs of operation were less; the actual expense was +103,557. The drug and supply cost were +48,186; inventory turnover rate was 8.8. The ER pharmacy had a +48,901 margin of revenue over expenses. The ratio of ER prescriptions filled to discharges increased, indicating an increase in prescription filling volume. Despite a decrease in the number of ER visits, the number of prescriptions filled increased 14%. Decentralized ER pharmaceutical services in this institution met the outlined objectives on a cost-effective basis.

 

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