Renata Vesela Holis, Beate Hennie Garcia, Elin C Lehnbom, Tine Johnsgård, Marie Fagerli, Ashrak Majeed, Birgitte Zahl-Holmstad, Kristian Svendsen, Eirik Hugaas Ofstad, Torsten Risør, Scott R Walter, Marit Waaseth, Frode Skjold, Renate Elenjord
{"title":"临床药师参与对急诊科医师工作时间分布影响的比较分析。","authors":"Renata Vesela Holis, Beate Hennie Garcia, Elin C Lehnbom, Tine Johnsgård, Marie Fagerli, Ashrak Majeed, Birgitte Zahl-Holmstad, Kristian Svendsen, Eirik Hugaas Ofstad, Torsten Risør, Scott R Walter, Marit Waaseth, Frode Skjold, Renate Elenjord","doi":"10.1177/20420986251361609","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Emergency departments (EDs) provide urgent care to diverse patients. Medication-related tasks, crucial for safe diagnosis and treatment, often receive inadequate attention. Clinical pharmacists, experts in medication management, can improve outcomes and reduce costs.</p><p><strong>Objectives: </strong>To investigate how the introduction of clinical pharmacists affects ED junior physicians' work-time distribution, with particular focus on medication-related tasks.</p><p><strong>Design: </strong>A stepped-wedge design was employed, introducing pharmacists across three Norwegian EDs over a 9-month period, with each ED starting at staggered intervals.</p><p><strong>Methods: </strong>Using the Work Observation Method By Activity Timing (WOMBAT) methodology, we observed junior physicians' activities in three EDs. The pharmacists were encouraged to adapt to the ED setting, integrate into the team, and identify ways to apply their expertise effectively. Medication reconciliation became their primary focus. We recorded 251 h of observation in the period <i>without</i> pharmacists present and 287 h in the intervention period, <i>with</i> pharmacists present. The proportion of time spent on different tasks was compared between the two periods.</p><p><strong>Results: </strong>Junior physicians spent 81.0% of their work time on non-medication-related tasks, 11.6% on standby/movement, and 8.7% on medication-related tasks. There was no evidence that the overall time distribution was affected by the intervention. However, in ED2, the proportion of time spent on medication-related documentation was reduced from 6.1% to 2.5%, while standby time increased from 6.1% to 13% <i>with</i> pharmacists present. Face-to-face interactions with pharmacists accounted for less than 2% of the junior physicians' work time in all EDs.</p><p><strong>Conclusion: </strong>In three Norwegian EDs, junior physicians' work time was predominantly spent on non-medication-related tasks, with only 8.7% dedicated to medication-related tasks. The introduction of clinical pharmacists did not significantly impact junior physicians' overall work-time distribution. Further research should investigate pharmacists' impact on ED care quality and efficiency.</p>","PeriodicalId":23012,"journal":{"name":"Therapeutic Advances in Drug Safety","volume":"16 ","pages":"20420986251361609"},"PeriodicalIF":3.4000,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374042/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impact of clinical pharmacist involvement on emergency department physicians' work-time distribution: a comparative analysis.\",\"authors\":\"Renata Vesela Holis, Beate Hennie Garcia, Elin C Lehnbom, Tine Johnsgård, Marie Fagerli, Ashrak Majeed, Birgitte Zahl-Holmstad, Kristian Svendsen, Eirik Hugaas Ofstad, Torsten Risør, Scott R Walter, Marit Waaseth, Frode Skjold, Renate Elenjord\",\"doi\":\"10.1177/20420986251361609\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Emergency departments (EDs) provide urgent care to diverse patients. Medication-related tasks, crucial for safe diagnosis and treatment, often receive inadequate attention. Clinical pharmacists, experts in medication management, can improve outcomes and reduce costs.</p><p><strong>Objectives: </strong>To investigate how the introduction of clinical pharmacists affects ED junior physicians' work-time distribution, with particular focus on medication-related tasks.</p><p><strong>Design: </strong>A stepped-wedge design was employed, introducing pharmacists across three Norwegian EDs over a 9-month period, with each ED starting at staggered intervals.</p><p><strong>Methods: </strong>Using the Work Observation Method By Activity Timing (WOMBAT) methodology, we observed junior physicians' activities in three EDs. The pharmacists were encouraged to adapt to the ED setting, integrate into the team, and identify ways to apply their expertise effectively. Medication reconciliation became their primary focus. We recorded 251 h of observation in the period <i>without</i> pharmacists present and 287 h in the intervention period, <i>with</i> pharmacists present. The proportion of time spent on different tasks was compared between the two periods.</p><p><strong>Results: </strong>Junior physicians spent 81.0% of their work time on non-medication-related tasks, 11.6% on standby/movement, and 8.7% on medication-related tasks. There was no evidence that the overall time distribution was affected by the intervention. However, in ED2, the proportion of time spent on medication-related documentation was reduced from 6.1% to 2.5%, while standby time increased from 6.1% to 13% <i>with</i> pharmacists present. Face-to-face interactions with pharmacists accounted for less than 2% of the junior physicians' work time in all EDs.</p><p><strong>Conclusion: </strong>In three Norwegian EDs, junior physicians' work time was predominantly spent on non-medication-related tasks, with only 8.7% dedicated to medication-related tasks. The introduction of clinical pharmacists did not significantly impact junior physicians' overall work-time distribution. Further research should investigate pharmacists' impact on ED care quality and efficiency.</p>\",\"PeriodicalId\":23012,\"journal\":{\"name\":\"Therapeutic Advances in Drug Safety\",\"volume\":\"16 \",\"pages\":\"20420986251361609\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-08-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374042/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Therapeutic Advances in Drug Safety\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/20420986251361609\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"PHARMACOLOGY & PHARMACY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutic Advances in Drug Safety","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/20420986251361609","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
Impact of clinical pharmacist involvement on emergency department physicians' work-time distribution: a comparative analysis.
Background: Emergency departments (EDs) provide urgent care to diverse patients. Medication-related tasks, crucial for safe diagnosis and treatment, often receive inadequate attention. Clinical pharmacists, experts in medication management, can improve outcomes and reduce costs.
Objectives: To investigate how the introduction of clinical pharmacists affects ED junior physicians' work-time distribution, with particular focus on medication-related tasks.
Design: A stepped-wedge design was employed, introducing pharmacists across three Norwegian EDs over a 9-month period, with each ED starting at staggered intervals.
Methods: Using the Work Observation Method By Activity Timing (WOMBAT) methodology, we observed junior physicians' activities in three EDs. The pharmacists were encouraged to adapt to the ED setting, integrate into the team, and identify ways to apply their expertise effectively. Medication reconciliation became their primary focus. We recorded 251 h of observation in the period without pharmacists present and 287 h in the intervention period, with pharmacists present. The proportion of time spent on different tasks was compared between the two periods.
Results: Junior physicians spent 81.0% of their work time on non-medication-related tasks, 11.6% on standby/movement, and 8.7% on medication-related tasks. There was no evidence that the overall time distribution was affected by the intervention. However, in ED2, the proportion of time spent on medication-related documentation was reduced from 6.1% to 2.5%, while standby time increased from 6.1% to 13% with pharmacists present. Face-to-face interactions with pharmacists accounted for less than 2% of the junior physicians' work time in all EDs.
Conclusion: In three Norwegian EDs, junior physicians' work time was predominantly spent on non-medication-related tasks, with only 8.7% dedicated to medication-related tasks. The introduction of clinical pharmacists did not significantly impact junior physicians' overall work-time distribution. Further research should investigate pharmacists' impact on ED care quality and efficiency.
期刊介绍：
Therapeutic Advances in Drug Safety delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies pertaining to the safe use of drugs in patients.
The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in drug safety, providing a forum in print and online for publishing the highest quality articles in this area. The editors welcome articles of current interest on research across all areas of drug safety, including therapeutic drug monitoring, pharmacoepidemiology, adverse drug reactions, drug interactions, pharmacokinetics, pharmacovigilance, medication/prescribing errors, risk management, ethics and regulation.
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