The medium-sized hospital I work at is looking at closing for several hours at night. This is due more to staffing issues than patient population. Our question is about the on-call pharmacy. Does the law require the pharmacist on-call to be able to get to the hospital in a certain amount of time?
State pharmacy law (in every state Pharmacy Law Source is aware of) requires a hospital to have a pharmacist on-call when the pharmacy is closed. PLS is unaware of any specific time or distance limit for these pharmacists. Obviously, the pharmacist needs to only be a reasonable distance from the hospital.
(PLS knows that hospitals also usually have a procedure by which an authorized night shift person may enter the pharmacy for needed medication, document when and what was taken. However, this question relates to services only a pharmacist could provide)
PLS is aware of a couple of lawsuits regarding the time it took an on-call pharmacist to respond to being called in.
In Case #1, pharmacist lived 45 minutes away, but drove straight to the hospital. The director of pharmacy was aware of the time required for that pharmacist to reach the hospital.
In Case #2, pharmacist lived only 8 minutes from the hospital. But, on the way in, pharmacist encountered a train stopped on the tracks at a railroad crossing. Pharmacist tried two other possible crossings but the train also blocked those. The pharmacist waited a few minutes as the next closest way around the train would add substantial time to her drive. After a few minutes, she gave up and took the longer way around, arriving at the hospital 50 minutes after being called in.
In both cases, the patient required pharmacy services only the pharmacist could provide. Due to the time required for the pharmacist to arrive, both patients died–it was alleged–from lack of treatment. The families of both patients sued.
In Case #1, the hospital and pharmacy were found liable. The court held that a pharmacist had to be only a reasonable distance from the hospital, and 45 minutes away was unreasonable. However, the court would not specify what constituted the maximum time a pharmacist would have to travel that would be reasonable. Such specificity, the court stated, belonged to the profession.
In Case #2, the hospital and pharmacy were not found liable. The pharmacist lived within a reasonable distance and had made reasonable efforts to circumvent unusual circumstances (the train had stopped when the engineer had noticed a split track ahead). There was no history of train/railroad crossing issues during the history of the hospital utilizing on-call pharmacists. This event was not foreseeable.
So, while the law requires an on-call pharmacist, the distance the pharmacist may reside and the time to travel to the hospital has no legal standard in most states but instead must be reasonable (and under 45 minutes). While specificity on these factors is not usually seen in the law, many hospitals have set such limits in their policy and procedures. Some of these hospitals go as far as providing a bed for a pharmacist who lives beyond the P&P limits.
To answer your question, while no legal standard exists, PLS recommends an on-call pharmacist be able to reach the hospital within 15 minutes in order to prevent liability based on a time/distance lawsuit.