Documentation of clinical interactions: quality of care issues and economic considerations in critical care pharmacy.

Pharmacists employed in the critical care area in a 350 bed, community-based, Class II trauma facility demonstrated cost savings through documentation of clinical interactions. Data collection took place between January 1, 1986 and December 31, 1986. Four areas of potential cost savings to the hospital were identified: 1) interactions that resulted in drug cost avoidance of $26,580 per year; 2) detection of excessive doses, toxic serum concentrations and electrolyte imbalances resulting in maximizing quality drug therapy; 3) unnecessary or inappropriate laboratory tests, which avoided $3930 in patient charges due to 80 fewer tests; 4) reduced inventory from the critical care area allowing $5209 in medication to be relocated. Under current prospective reimbursement programs, cost containment and quality care are of primary concern for pharmacy departments. The presence of a critical care satellite staffed by qualified pharmacists can provide these measures.