Holis Renata Vesela, Garcia Beate Hennie, Lehnbom Elin C, Johnsgård Tine, Fagerli Marie, Majeed Ashrak, Zahl-Holmstad Birgitte, Svendsen Kristian, Ofstad Eirik Hugaas, Risør Torsten, Walter Scott R, Waaseth Marit, Skjold Frode, Elenjord Renate
Hospital Pharmacy of North Norway Trust, Parkveien 95, Bodø 8005, Norway.
Hospital Pharmacy of North Norway Trust, Tromsø, Norway.
Ther Adv Drug Saf. 2025 Aug 21;16:20420986251361609. doi: 10.1177/20420986251361609. eCollection 2025.
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.
To investigate how the introduction of clinical pharmacists affects ED junior physicians' work-time distribution, with particular focus on medication-related tasks.
A stepped-wedge design was employed, introducing pharmacists across three Norwegian EDs over a 9-month period, with each ED starting at staggered intervals.
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 pharmacists present and 287 h in the intervention period, pharmacists present. The proportion of time spent on different tasks was compared between the two periods.
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% pharmacists present. Face-to-face interactions with pharmacists accounted for less than 2% of the junior physicians' work time in all EDs.
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.
急诊科为各类患者提供紧急护理。对安全诊断和治疗至关重要的与药物相关的任务，往往未得到充分关注。临床药师作为药物管理方面的专家，能够改善治疗结果并降低成本。
调查临床药师的引入如何影响急诊科初级医师的工作时间分配，尤其关注与药物相关的任务。
采用阶梯式楔形设计，在9个月的时间里，在挪威的三个急诊科引入药师，每个急诊科以交错的时间间隔开始。
使用按活动时间进行工作观察法（WOMBAT），我们观察了三个急诊科初级医师的活动。鼓励药师适应急诊科环境，融入团队，并找出有效应用其专业知识的方法。药物重整成为他们的主要关注点。在药师在场期间记录了251小时的观察时间，在干预期间（药师在场）记录了287小时。比较了两个时期花在不同任务上的时间比例。
初级医师将其工作时间的81.0%用于与药物无关的任务，11.6%用于待命/移动，8.7%用于与药物相关的任务。没有证据表明总体时间分配受到干预的影响。然而，在急诊科2，花在与药物相关文件记录上的时间比例从6.1%降至2.5%，而待命时间从6.1%增加到13%（药师在场时）。在所有急诊科，与药师的面对面互动占初级医师工作时间的比例不到2%。
在挪威的三个急诊科，初级医师的工作时间主要用于与药物无关的任务，只有8.7%用于与药物相关的任务。临床药师的引入并未显著影响初级医师的总体工作时间分配。进一步的研究应调查药师对急诊科护理质量和效率的影响。
