Pharmacists played a critical role in helping a hospital to earn their designation as a certified primary stroke center. A certified primary stroke center, or a “PSC” is a certification designated by the dual efforts of the American Heart Association and American Stroke Association. A PSC certification for a hospital means better care for stroke patients, and can increase patient confidence in the hospital and recruit more talented healthcare professionals. In 2010, New Hanover Regional Medical Center (NHRMC) in North Carolina saw the opportunity to improve their stroke care and gain their certification and help treat more patients in an area that has higher rates of stroke mortality than any other region in America. In order to gain this certification, they made a “Code Stroke” multidisciplinary response team that included the pharmacy director and created a position for a direct patient care pharmacist. The Code Stroke team reviewed outcomes data and oversaw the creation and operations of stroke procedures. This included streamlining the care of stroke patients, from admission to discharge.
A critical element of this streamlined process was the role of the pharmacist. Pharmacists were assigned to the emergency department, ICU, progressive care unit, and outpatient pharmacy that serves to discharged patients. All the different pharmacy units used the same computerized-prescriber-order-entry system, that allowed for consultations, monitoring, chart reviews, and notification about discharges. This integration between the pharmacists was aimed at reducing dosing errors, preventing incorrect administration of alteplase, and decreasing the amount of time it takes to administer alteplase to a stroke patient. Since there is an emergency room pharmacist, they can be one of the first healthcare professionals to correctly assess the medication needed for the patient. Also, the program instituted a 24-hour emergency department pharmacist, makes sure that all pharmacists on emergency department rotations are up to date on Code Stroke duties. Ultimately, NHRMC did obtain the certification, thanks largely in part to the pharmacy unit. I think that this article shows the importance of pharmacists in clinical settings, and how pharmacists across different units of a hospital can improve care when there is adequate communication and transitions of care. By reducing medication errors and improving patient outcomes, I think that the role of the pharmacist in clinical settings will only continue to increase.
Reference: Gilmer A, Sweeney L, and Nakajia S. Pharmacists’ role in a hospital’s initiative to become a certified primary stroke center. Am J Health Syst Pharm. 2016. 73 (Supplement 1):S1-S7.