Take-Home Naloxone Program Implementation: Lessons Learned From Seven Chicago-Area Hospitals.

Despite consensus recommendations from the American College of Emergency Physicians (ACEP), the Centers for Disease Control and Prevention, and the surgeon general to dispense naloxone to discharged ED patients at risk for opioid overdose, there remain numerous logistic, financial, and administrative barriers to implementing "take-home naloxone" programs at individual hospitals. This article describes the recent collective experience of 7 Chicago-area hospitals in implementing take-home naloxone programs. We highlight key barriers, such as hesitancy from hospital administrators, lack of familiarity with relevant rules and regulations in regard to medication dispensing, and inability to secure a supply of naloxone for dispensing. We also highlight common facilitators of success, such as early identification of a "C-suite" champion and the formation of a multidisciplinary team of program leaders. Finally, we provide recommendations that will assist emergency departments planning to implement their own take-home naloxone programs and will inform policymakers of specific needs that may facilitate dissemination of naloxone to the public.

A Survey of Staff Perceptions of an Emergency Medicine Pharmacist Program in a Community Hospital: A Brief Report.

STUDY OBJECTIVE: For an emergency medicine pharmacist to become a well-integrated multidisciplinary team member, his or her services need to be accepted by the emergency department (ED) staff. There have been 2 published studies attesting the value of the emergency medicine pharmacist by ED staff: at an academic medical and trauma center in 2007 and a large academic medical center in 2011. The aim of this study is to determine whether the emergency medicine pharmacist's value, as perceived by ED staff, would be similarly accepted at a smaller community hospital with limited clinical pharmacist services. METHODS: This prospective, descriptive survey examined the perceptions of ED providers and nurses in regard to the emergency medicine pharmacist at a 26-bed Level II trauma center with 65,135 annual visits. RESULTS: Of the 90 participants polled, 50% (45) responded. Overall, the ED staff's perceptions of an emergency medicine pharmacist were positive. Eighty-six percent of all participants surveyed had consulted the emergency medicine pharmacist at least once in their last 5 shifts. Thirty-one percent answered that being available for consultation was the most important aspect of the emergency medicine pharmacist's role, whereas attending codes (22%) and patient education (20%) were the next most important activities. Providers consulted with the emergency medicine pharmacist most for antibiotic stewardship (including guided empiric therapy and culture callbacks) drug-drug and drug-disease state interactions, and dosing of pediatric medications. Nurses referred to the emergency medicine pharmacist most for compatibility consultations, medication retrieval, and high-risk medication verification. CONCLUSION: As was previously found in academic settings, an emergency medicine pharmacist is an invaluable addition to the health care team and can be incorporated into an existing pharmacy staffing model at a small, community hospital.

Value of the Pharmacist in the Medication Reconciliation Process.

Involving pharmacists in the process of comparing the medications that should be ordered for a patient with the new medications that are currently ordered and resolving differences improves accuracy, decreases mortality, and improves transitions of care.