Impact of preceptor counseling on medical resident prescription writing

A collaborative study was conducted by pharmacists and the clinical preceptor of the otolaryngology outpatient clinic of the University of Texas Medical Branch (UTMB). This study focused on decreasing the percent of legal or procedural errors made by resident physicians. During the study period all prescriptions written by house staff were reviewed by a pharmacist for compliance to previously established criteria. Noncompliant prescriptions were photocopied by the pharmacist and recorded for review by the resident's clinical preceptor. After an 8-week period of baseline data collection, residents were counseled privately by the clinical preceptor and critiqued on their ability to write a legally and procedurally correct prescription. The residents were made aware of their major deficiencies to enable them to correct the problems. During an unannounced 4-week period, beginning 5 months after preceptor consultation, resident prescription writing was again audited. The result, an overall decrease of 78.5% in noncompliant prescriptions, illustrates that establishing lines of communication between pharmacists and physicians can demonstrably improve health care services. If this change in the quality of prescription writing could be achieved in all of the institution's ambulatory care clinics, an annual conservation of at least $57,000 in pharmacist salaries would be realized.