Comprehensive pharmaceutical services in the emergency room.

A decentralized pharmaceutical service functioning in a hospital emergency room from 4 p.m. to midnight daily is described. Start-up costs were determined to be less than $2,200 for the system which includes a mobile medication cart stocked with a limited inventory of prepackaged medications. Approximately 94% of the prescriptions originating from the emergency room from 4 p.m. to 8 a.m. can be filled from the cart. Results of a nine-month survey indicated that an average of 20.6 prescriptions were filled on the 4 p.m. to midnight shift each day, producing an average daily profit over drug expense of $60.51, which was more than the salary expense of the pharmacists providing the service. The time required to provide traditional prescription services has not interfered with the provision of clinical services or opportunities for educating undergraduate pharmacy students who rotate through the area. Implementation of clinical pharmaceutical services with a traditional component is suggested as a cost-effective method of providing such services.