Cost justification of decentralized pharmaceutical services for the emergency room.

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.