I recently travelled to a hospital with the 4 hr policy in place. I questioned a pharmacist about the policy- one of his replies probably drives the policy as much as any other. It allows administration of 3 doses per day instead of 4. Since hospitals are reimbursed by diagnoses anything that cuts costs is more profitable to the hospital. As long as the treatment is as effective why not save the hospital money? By the way, we did admin over 30 minutes in the ER. The pharmacist stated they would adjust when pt was in-patient