Minor ailment? Grand River Hospital's new emergency department retail pharmacy can help

Grand River Hospital has a new emergency department retail pharmacy—with an ambitious mission to see patients discharged faster, reduce readmissions, divert minor ailments from the ER and raise funds for the hospital. The pharmacy had a soft opening at the beginning of April and will fully launch later this month.While it hopes to go far beyond filling prescriptions, that core goal itself is vital, says Lashen Naidoo, operations manager of Grand River Hospital retail pharmacies and strategic partnerships. Patients are sometimes kept in the hospital until pharmacies are open to fill their prescriptions, he says, meaning that they are taking up space unnecessarily.“By having this retail pharmacy on site, there would be no unnecessary delay in the patient coming in, getting a prescription if needed and leaving,” he says. “Right now, they pretty much just camp at the hospital and are managed until 8 or 9 in the morning, when they are released to get a script filled at a community pharmacy.” Read: A new learning space prepares pharmacy students for hospital practiceThe emergency department pharmacy would be available to all patients leaving the hospital, not just those coming from the emergency department. The goal is for it to be open 24/7, though the hours are more limited. Another benefit of making prescriptions easier is encouraging patients to fill their discharge prescriptions promptly. “We know that when someone is leaving with an unfilled script, it’s sometimes a seven- to 10-day wait until they fill that prescription,” Naidoo says, which can affect patient outcomes.A 2015 study published in the Canadian Journal of Emergency Medicine spoke to 258 patients discharged from a hospital and found that 51% didn’t fill their discharge prescriptions. Nonadherent patients were also more likely to revisit an emergency department or clinic.Naidoo says the emergency department pharmacy is the fourth retail pharmacy within the hospital. They also have one in the main hospital building, another specializing in mental health, and one for oncology. With the latter, they administer oncology injections alongside a nurse to about 40 patients a week. “That freed up space in the chemo suite, where patients with more acute needs can be treated.”Read: Minor ailments schemes are working all over the world: FIPNaidoo says the hospital had been thinking about having a pharmacy in the emergency department for years, but COVID-19 meant it was put on hold. When they reassessed, they realized the pharmacy could also provide care for minor ailments. The workflow isn’t solidified yet, but it will probably include a patient coming into the emergency department and being told at triage the ailments covered under minor ailments prescribing during that intake process. If the patient has one of those minor ailments, they could go to the pharmacy instead of waiting to see a doctor. “This will help to divert patient flow out of the ED, and once we remove patients with minor ailments out of the emergency department mix, it will allow physicians to focus on patients with major issues,” says Naidoo. A 2022 study published in the Canadian Pharmacists Journal found about 4% of emergency department visits could have potentially been managed by pharmacists (determined by criteria that included having a diagnosis code that was manageable by pharmacists in one or more Canadian jurisdictions, being less urgent or non-urgent and not resulting in discharge).Naidoo is eager to collect data on the effect of the pharmacy on the emergency department after 12 to 18 months. He hopes it will inspire other hospitals in Ontario and Canada to follow suit, reducing wait times.“It’s not going to be the solution to everything, but what I’m hoping to do is have people in other hospitals think along these lines, to say, ‘let’s try this model out.’ If we see hospitals across the province doing this, inevitably, the end result is going to be a better patient experience and more timely access to care,” he says.Read: Minor ailments a conflict of interest for pharmacists? Pu-leeze!

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