Is your pharmacy providing 24/7 coverage?

November 20, 2006

At most large tertiary care hospitals and academic medical centers, around-the-clock pharmacy service is relatively common. But in some small and rural hospitals, 24-hour, seven-day-a-week pharmacy coverage is not economically feasible or practical. How are pharmacy services provided in those facilities? And how do health-system pharmacists feel about a Joint Commission on Accreditation of Healthcare Organizations proposal that would require all hospital pharmacies to provide 24/7 service?

Drug Topics commissioned a survey to understand how hospitals provide comprehensive pharmacy services off-hours and on weekends.

Here's a summary of the findings.

Of those respondents who said their hospital has 24/7 pharmacy service, an overwhelming 87.9% indicated that their hospital had its own pharmacists on site 24 hours per day, while 6.4% reported that they used a pharmacist in a remote location to review drug orders during off hours. Only 5.7% of the respondents said that pharmacy services are provided by "other" means, but they did not elaborate.

According to pharmacists who do not have 24-hour pharmacy service, 93.8% stated that they use automated dispensing cabinets in the off hours, while 6.3% said that their hospital uses a locked cabinet with medications.

Of those respondents who do not have 24/7 pharmacy service, 88.4% said that their hospital has no plans to implement a 24/7 service next year, but 11.6% said that they intend to initiate such a plan.

When asked to rate their satisfaction with their pharmacy department's current 24/7 service, 27.7% of the respondents who have such pharmacy coverage said that they were extremely satisfied, 39.8% were very satisfied, and 29.5% were satisfied. Only 2.7% said that they are not satisfied with their current service and a mere .3% said that were not at all satisfied.

Thirty-two percent of the respondents said that their pharmacy operated on day and evening shifts but was closed overnight, while 10.5% reported that the pharmacy operated only from Monday through Friday but was closed on weekends.

Of the respondents who said that their hospital does not offer 24/7 pharmacy coverage, 35.6% reported that hospital staff members are allowed to access medications when the pharmacy is closed. However, 64.4% said that the practice was prohibited.

Of those hospital staff members who are allowed to access medications after-hours, 73% are nurses, 4.9% physicians, 1.6% paramedics, and 19.7% fell into the "other" category. Forty-two percent of respondents who reported that hospital staff members are allowed to access medications after-hours said that they can do so by using an automated dispensing machine outside of the pharmacy. Only 4.8% said that no arrangement has been set up for nonpharmacist personnel to access meds when the pharmacy is closed.