Year of Publication



Martin School of Public Policy and Administration

Executive Summary


The main purpose of this capstone project is to provide an objective analysis of the cost of a medication error in the emergency department. The secondary objective of this analysis is to estimate the cost avoidance impact of providing clinical pharmacy services in the emergency department (ED).

Literature review

Previous literature has described the scope of clinical pharmacy services in the ED and has, to some extent, presented economic outcomes analyses of the impact of these services (Cohen et al., 2009; Lada and Delgado, 2007). According to Cohen et al., the current literature is still lacking a formal pharmacoeconomic model for estimating cost avoidance associated with pharmacist-initiated interventions in the ED.


Two data sets, one national and one local, were used to answer our basic research questions. The Nationwide Emergency Department Sample (NEDS) was used to estimate the national median cost of a medication error in the ED, and intervention data from the ED at the University of Kentucky Chandler Medical Center (UKCMC) was used to estimate cost avoidance via the prevention of medication errors.


Based on analysis of the NEDS data, a medication error in the ED was estimated to result in a $268 increase in total ED costs. The difference in the medication error group and the control group reached a high level of significance [p = 0.0000]. By applying this result to the data on interventions recorded in the ED at UKCMC, cost 4 avoidance attributable to the presence of a clinical pharmacist in the ED was estimated to be $189,208 per year.


The results of this analysis differ from those found in previous literature due in part to differences in methodology and population/facility size. The results of this analysis suggest that the cost avoidance associated with the prevention of medication errors by a clinical pharmacist in the ED would cover a large portion of the expected salary and compensation associated with hiring a clinical pharmacist to work in the ED.