Clinical Pharmacy Services in Canadian Emergency Departments: A 2022 National Survey
Bibliographic record
Abstract
Background: Support for the role of an emergency department (ED) clinical pharmacy team is evidence-based and recognized in numerous professional guidelines, yet previous literature suggests a low prevalence of ED clinical pharmacy services in Canadian hospitals. Objectives: To update (from a survey conducted in 2013) the description and quantification of clinical pharmacy services in Canadian EDs. 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 separate electronic surveys were distributed by email 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 November 2021 and January 2022. Results: Of the 254 hospitals identified, 117 (46%) had at least 0.5 FTE clinical pharmacy services in the ED (based on initial telephone screening). Of the 51 (44%) of 115 ED pharmacy team survey responses included in the analysis, 94% (48/51) had pharmacists and 55% (28/51) had pharmacy technicians. The majority of pharmacy managers and ED managers identified the need for ED pharmacy services where such services did not exist. Inadequate funding, competing priorities, and lack of training remain the most commonly reported barriers to providing this service. Personal safety concerns were reported by 20% (10/51) of respondents. Conclusions: Although the establishment of clinical pharmacy services in Canadian EDs has grown over the past 8 years, lack of funding and ED-specific training continue to limit this evidence-supported role in Canadian hospitals. Keywords: emergency department, pharmacist, technician, survey, clinical pharmacy, best possible medication history RÉSUMÉ Contexte : La pratique de pharmacie clinique au service des urgences (SU) est fondée sur les données probantes et reconnue dans de nombreuses lignes directrices professionnelles. Cependant, des données portent à croire à une faible prévalence de ces services dans les SU des hôpitaux canadiens. Objectif : Mettre à jour la description et la quantification des services de pharmacie clinique dans les SU canadiens (à partir d’une enquête menée en 2013). Méthodes : Tous les hôpitaux canadiens dotés d’un SU et d’au moins 50 lits de soins de courte durée ont été contactés pour recenser la présence de services de pharmacie dédiés au SU (définis comme au moins 0,5 poste équivalent temps complet [ETC]). Trois sondages électroniques différents ont été distribués par courriel aux membres de l’équipe de la pharmacie du SU (le cas échéant), aux gestionnaires de pharmacie (dans les hôpitaux sans équipe de pharmacie au SU) et aux gestionnaires du SU (tous les hôpitaux). Les enquêtes ont été réalisées entre novembre 2021 et janvier 2022. Résultats : Sur les 254 hôpitaux recensés, 117 (46 %) disposaient d’au moins 0,5 ETC de services de pharmacie clinique au SU (d’après la sélection téléphonique initiale). Des 51 (44 %) sur 115 équipes de pharmacie du SU qui ont été inclus dans l'analyse, 94 % (48/51) avaient des pharmaciens et 55 % (28/51) avaient également du personnel technique en pharmacie. La majorité des directeurs de pharmacie et des directeurs des SU ont identifié le besoin de services de pharmacie au SU là où de tels services n’existent pas. Un financement inadéquat, des priorités concurrentes et le manque de formation demeurent les obstacles les plus souvent signalés à la prestation de ce service. Des problèmes de sécurité personnelle ont été mentionnés par 20 % (10/51) des répondants. Conclusion : Bien que l’établissement de services de pharmacie clinique dans les SU canadiens ait augmenté au cours des 8 dernières années,le manque de financement et de formation spécifique en pharmacie de médecine d’urgence continue de limiter ce rôle fondé sur des données probantes dans les hôpitaux canadiens. Mots-clés : service des urgences, pharmacien, support technique, sondage, pharmacie clinique, meilleur schéma thérapeutique possible
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.005 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".