Emergency Medicine Pharmacist Prescriptive Authority for Resolution of Outpatient Prescription Issues

Use of an EMP CPA, which allows for broad prescriptive authority, will assist Emergency Department (ED )workflow by preventing a significant volume of new prescriptions needing to be sent by physician and mid-level providers. Will improve rates of ED re-visits. In addition, this Collaborative Practice Agreement (CPA) will not be associated with a large volume of new prescription errors.

• outpatient prescription issues (Other): Evaluation of utility will involve describing all Emergency Medicine Pharmacist (EMP)-written prescriptions pursuant to resolution of prescription issues realized after discharge

Primary outcomes

• Number of prescriptions and medication types sent to outpatient pharmacies [2 years]: Number of prescriptions and medication types sent to outpatient pharmacies by EMPs pursuant to outpatient prescription issue resolution.

Secondary outcomes

• Number of patients returning with complaint or diagnosis related to EMP generated prescriptions [2 years]: Proportion of patients returning with a complaint or diagnosis related to index EMP-generated prescriptions at three and six-month time points

Sex: All

Inclusion Criteria:

* Patients at MCMC who had a prescription sent by an EMP between November 1, 2021 and June 30, 2023 and a progress note and documenting the reason for the call and action taken by the EMP.

Exclusion Criteria:

* CPA actions were misclassified as discharge prescription issue resolutions.
* Patients with prescriptions pursuant to late culture review, formulation changes not requiring a new prescription, prescription transfers to another pharmacy, or simple retransmission of prescriptions.
* Patients documented to have left the ED against medical advice.

• Kevin Burnham, Pharm.D., Principal investigator, Methodist Health System