Introduction The emergency department (ED) is often considered the first point of contact for many patients. 1 It is a gateway to our health system due to lack of primary healthcare. It is one of the most sensitive and critical areas of the healthcare system and provides essential care to the ill and injured patients. 1,2 In modern healthcare systems, there are numerous challenges within the ED, such as over-crowding, long waiting hours, diminished resources and increased demand. 3 Moreover, patient's expectation for quick and accurate assessment in ED, cost-effective care and timely disposition are on the rise. 4 Both overcrowding and over- expectation leads to delays and dissatisfaction for both patients and physicians and increases chances of error. 5,6 Implementation of an effective emergency care system could benefit in reducing the disability and mortality rate by one-third to half in low and middle income countries (LMICs), according to the estimates of the Disease Control Priorities Project (DCPP). 1 One of the best strategies to improve therapeutic outcome among critically ill patients is to reduce the time between the onset of symptoms and the initiation of therapy. 3 Therefore, provision of timely and effective care can reduce complications and hospitalisation among the critically ill patients visiting ED. 7,8 It has been observed that devising medication standardisation prescribing and dispensing system could help both physicians and pharmacists to save time and effort in ED with increased patient influx. Medicine order sets are the essential tools that can save time, improve working efficiency, reduce hospitalisation and help to overcome potential errors. 9 The current study was planned to assess the impact of disease-based standard order sets in reducing the time of physicians and the pharmacist in prescribing, processing and dispensing medication order. Materials and Methods The pilot study was conducted as part of a retrospective clinical audit using pre- and post-intervention design comprising data from July to September 2013 of the ED of Aga Khan University Hospital, Karachi, which has an estimated annual ED turnover of more than 65,000 patients. After approval from the Department Heads of Pharmacy, ED, Patient and Therapeutic Committee (P&TC) and the institutional ethics review committee, processes evaluated were medicine order entry, processing and dispensing time of eight common emergency conditions that were selected jointly by the P&TC and the departments of Pharmacy, Emergency and Information Technology (IT) by consensus Vol. 70, No. 12-A, December 2020 2159 RESEARCH ARTICLE Implementation of disease-based standard order sets in emergency department of tertiary care hospital, Pakistan — a novel approach for enhancing patient care Feroza Parveen, 1 Asif Khaliq, 2 Nadeem Ullah Khan, 3 Zainab Mazhar, 4 Aisha Akram, 5 Khusro Shamim 6 Abstract Objectives: To evaluate the efficacy of disease-based standard order sets in reducing time of order entry, order processing and medication dispensation in emergency department of a tertiary care hospital. Methods: The pilot study was conducted as part of a retrospective clinical audit using pre- and post-intervention design comprising data from July to September 2013 of the emergency department of a tertiary care hospital in Karachi. Data collected related to the reduction in medicine order entry, processing and dispensing time of eight common emergency conditions with standard order set. Subsequently, standard medication orders for the selected medical conditions were developed together with physicians of emergency and other specialties. Post-intervention data was collected and the two data sets were compared using SPSS version 23.0. Results: Mean medication order entry and processing time from the physician end reduced from 67.7±22.7 seconds to 20.5±7.1 seconds. Mean medication order processing and dispensing time at pharmacist end reduced from 70.0±22.4 to 20.6±8.8 seconds. The difference between pre- and post-intervention values was significant (p<0.001). Conclusion: Implementation of disease-based standard order set significantly improved efficiency. Keywords: Standard, Order sets, Emergency department, Disease, time efficiency. (JPMA 70: 2159; 2020) DOI: https://doi.org/10.47391/JPMA.1281 1,4,5 Department of Pharmacy Services, 2 Department of Peadiatrics and Child Health, 3,6 Department of Emergency Medicines, The Aga Khan University Hospital, Karachi, Pakistan. Correspondence: Asif Khaliq. Email: asifkhaliq7@gmail.com