Beyond the Bedside: Utilization of an On-Call Pharmacist to Bridge Gaps in Clinical Coverage for Select Critically ill Populations

Abstract

Purpose

To describe the utilization of an on-call critical care pharmacist to bridge gaps in clinical coverage for subspecialized critically ill populations.

Methods

In October 2022, a 24/7 on-call team of medical and cardiac ICU pharmacists was established to field questions regarding patients with mechanical circulatory support and pulmonary hypertension. On-call pharmacists were available via centralized telephone number Monday through Friday from 4:00 p.m. to 8:00 a.m., and at all hours on weekends. Information characterizing calls received was collected in an electronic database. A review of all database entries through March 2025 was conducted and descriptive statistics were used to quantify calls received, time spent, multidisciplinary team member engagement, and types of interventions.

Results

On-call pharmacists received 207 calls and documented 218 interventions. Calls were most often received between the hours of 4:00 p.m. and 8:00 a.m., and the median time spent per call was 10 minutes (IQR 5-20 minutes). On-call critical care pharmacists received the most calls for ECMO patients (38.2%), followed by pulmonary hypertension (26.1%) and Impella® patients (20.8%). The majority of inquiries were from pharmacists (35.7%), followed by advanced practice providers (33.3%) and physicians (21.3%). Anticoagulation and hemostasis was the most commonly cited intervention category (56.4%).

Conclusion

In the absence of an onsite critical care pharmacist, a 24/7 on-call critical care pharmacist was utilized by members of the multidisciplinary team to bridge gaps in clinical coverage. Further research is needed to determine the pharmacoeconomic and clinical impacts of on-call critical care pharmacists when onsite resources are unavailable.