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Integrating a pharmacist into the perioperative setting.

This paper describes the integration of a pharmacist into a perioperative environment and the ensuing quality and economic benefits. Deficiencies were identified in medication management in operating theatres (OT) at a large tertiary hospital. A perioperative pharmacist was employed for a 6-month pilot period, with permanent funding dependent on demonstration of agreed economic benefits. A multidisciplinary committee set goals, drove strategic initiatives and was accountable for delivery of outcomes. Pharmaceutical expenditure was analysed and high expenditure items targeted. Cost savings and staff satisfaction were measured at 6 months. Savings of A$63884 were achieved during the pilot period, resulting from optimised pharmaceutical unit pricing, OT medication stock on hand (imprest) review and redesigned medication management strategies. Improvements in medication management included better access to medications in the OT, rationalising available products to minimise wastage and implementation of guidelines and protocols for high-cost and high-risk medications. At 6 months, 97% of theatre staff supported continuation of the role; the project was extended with demonstrated cost savings of A$157265 at 12 months. The integration of a perioperative pharmacist resulted in cost savings and medication management improvements in the OT setting. A permanent position was funded.What is known about the topic?Medication use in OTs involves high volumes of high-risk and high-cost medications. Historically, there has been little pharmacist involvement in OTs, even though evidence has shown that hospital pharmacists can reduce medication errors, improve patient safety and reduce costs.What does this paper add?This paper provides an overview of the process of establishing a perioperative pharmacist role in an adult tertiary hospital. It takes readers through the journey from pre-implementation audit to trial development, stakeholder consultation and specific medication and process targets.What are the implications for practitioners?Hospitals and practitioners are faced with the challenge of improving service delivery within the constraints of a finite budget. This paper allows readers to learn from our experience and apply these learnings to their local hospital setting, ultimately improving both patient care and staff satisfaction through the development of a perioperative pharmacist service.