We thank Tannenbaum and Tsuyuki1 for their review in CMAJ. In addition to what the authors have already highlighted, it is also well known that clinical pharmacy services improve patient outcomes and reduce mortality in the inpatient setting and that professional collaboration is key to successful clinical pharmacy service provision.2,3
An example of this collaborative practice model is the Antimicrobial Stewardship Program (ASP) at the Children’s Hospital of Winnipeg, in Manitoba. Antibiotics are commonly prescribed to children admitted to hospital, are often associated with prescribing errors, and their misuse drives antimicrobial resistance.4 ASPs help minimize inappropriate antimicrobial use, and guidelines on their development have been published.5 Accreditation Canada includes ASPs as a Required Organization Practice (ROP) in their accreditation standards. ASPs are “support” teams; core members include a physician and a clinical pharmacist with training in infectious diseases.6 Antimicrobial use is reviewed by the ASP team at both patient and system levels in order to promote safe and quality care. Teams interact with the prescribing clinician at the time of antibiotic prescribing; this face-to-face feedback from an ASP pharmacist allows for reciprocal communication in a timely, collaborative fashion, which affects the quality of care provided.
Real-world application of pharmacist-led ASPs has been shown to have the ability to lower overall inpatient antimicrobial use.7 At our institution, prescribers are open to feedback from colleagues of different professional backgrounds. We hope that this example of physician–pharmacist collaboration encourages others to explore options to synergistically improve patient care regardless of their practice setting.