Evaluation of a triage model for pharmacist review of medication histories collected by pharmacy technicians in the emergency department
Jennifer Abrahante, Erika Dittmar, Thomas Wolfel, Jeremy Espeut, Estela Trimino, Sara PanellaAbstract
Purpose
Medication histories are a comprehensive record of the most accurate medication list at the time of interview. The purpose of this performance improvement initiative was to assess the accuracy of medication histories gathered by pharmacy technicians following the implementation of a triage model in which pharmacists validated only medication lists meeting certain criteria.
Summary
A single-center, retrospective, institutional review board–exempt convenience sample review was conducted for the period from February to March 2025 at a 100-bed adult emergency department (ED) following the design and implementation of a triage model. Adult patients admitted through the ED whose medication histories bypassed pharmacist review were included. Patients for whom medication histories could not be obtained or with incomplete electronic health record documentation were excluded. The primary outcome was the percentage accuracy of the medication histories collected after introduction of the triage model. Secondary outcomes included pharmacist time saved as well as the type and frequency of discrepancies. Of the 150 medication histories reviewed, 143 were free of discrepancies, reflecting a 95% accuracy rate in histories without pharmacist review. The most frequently observed discrepancies were drug omission (4%), followed by drug addition (2%), incorrect frequency (2%), and incorrect dosage (1%). The time spent by pharmacists per medication history review (approximately 5 minutes) and the number of medication histories collected daily (120) were used to extrapolate the time saved over a 1-month period.
Conclusion
Implementation of a triage model for low-risk home medication lists bypassing pharmacist double review maintained accuracy. The triage model resulted in time savings, which could be reallocated to other pharmacy clinical services.