Impact of a Pharmacy Resident on Hospital Length of Stay and Drug-Related Costs

Abstract

Background: The impact of pharmacy residents' interventions on medical rounds has not been well evaluated. Objective: To assess the impact of a resident's interventions on hospital length of stay, describe the types of interventions, and assess drug-related cost savings. Methods: Using a matched control design, we conducted an evaluative study of adults admitted to a general internal medicine unit over one month. The study group consisted of patients admitted to the service of a medical team that included a pharmacy resident and medical residents. The pharmacy resident prospectively collected data on patient demographics and interventions made during patient admission and follow-up rounds. The control group consisted of patients admitted to the service of a team consisting of medical residents only, over the same period. The medical records of the control group were retrospectively evaluated for potential interventions. Results: Forty patients were enrolled in each group (aged 63 ± 17 y, mean ± SD). In the study group, 250 of 271 interventions were accepted and fulfilled. In the control group, 321 potential interventions were identified. The mean length of stay of the study group was significantly lower than that of the control group (7.9 ± 7.2 days vs 10.9 ± 7.9 days, respectively; p = 0.008). In the study group and the control group, the total interventions were related to prescribing errors (51.3% vs 45.4%), preventable adverse drug events (32.9% vs 42.3%), patient monitoring (14% vs 7%), and drug interactions (1.8% vs 5.3%). In the study group, the net drug-related cost savings totaled $2087. Conclusions: Our study demonstrates the positive impact of a pharmacy resident on reducing the hospital length of stay and producing drug-related cost savings. Most interventions prevented adverse drug events and prescribing errors.