Sunday, February 27, 2011

TRAVELER'S THOUGHTS - St. Vincent's Pharmacy

The Pharmacy. This is where Dr. Eric spent the bulk of his time at St Vincent’s. For such a small room (9 by 15 feet), its significance is great.

This tiny room sits down a long hallway at the end of the clinic building. It is little more than a large closet and boasts a single widow on its outer wall for light, air, and dispensing medications, a true walk-up pharmacy.

Dr. Eric doing a test drive of the walk up window

Upon first inspection, there was little room to move around. Boxes were stacked haphazardly, obstructing access to the window and part of the shelving, which spanned the right wall of this narrow space. Eric’s task was to get an understanding of the pharmacy: what medications are here, what else needs to be here to provide well-rounded care, what things are missing to be able to administer certain drugs, etc.

Given the small footprint of the room, we all expected it to be a rather simple task. We were shocked that he (and an assistant) spent nearly 12 hours in this tiny space, working his way through every bottle of antibiotics and every dose of drugs. While it wasn't complicated, it was surprisingly slow and cumbersome. Add to that the hours that Dr. Eric worked on the spreadsheet every evening and one begins to see how critical this room truly is.

Following a general review of the pharmacy, we got down to the nitty gritty. We pulled out case after case of donated pharmaceuticals and began trudging down the long road to organization. Cases were brought out into the hallway and like items were gathered into logical categories. The volume of medications and supplements present in this little room was amazing.

After identifying the contents of each box, they were restacked in some semblance of order against the wall: supplements to the right, antibiotics in the middle and analgesics toward the door, all labels facing forward. Any box that was not labeled received a hand-written label so it would be very evident what was in each box. We attempted to mirror the shelves of open inventory with cases of the same medications on the opposing wall to efficiently facilitate re-stocking.

Hard at work!

Then came the “fun” part: a full and detailed inventory. We looked in every case, documented every medicine by name, strength and administration route. We reviewed and charted all expiration dates. All data was entered into a spreadsheet. Next, we attacked the open inventory and the boxes containing various donations, some quite puzzling! Many of the donations were handfulls of this and bags of that which Eric sorted into useful organized collections. At least now all of the dressings were in one spot; all syringes and needles in another, and so on.

A number of things were surprising and sometimes frustrating. It was great to see that open shelves were stocked and labeled. However, if the same time were spent organizing and shelving items as they came in instead of simply piling boxes in the room, much time could be saved avoiding large, complicated inventories.

Mountains beyond mountains of antibiotics

During our inventory, we were absolutely shocked at the volume of certain medications. At first evaluation we miscalculated thinking that there were more than a half million 500mg Ampicillin tablets. A review of the math showed there were roughly only fifty thousand tablets (only 50,000?!!!). In addition there were 5 cases of ciprofloxacin (another 50 thousand plus doses) which has guarded use in a pediatric population. Thre were also tens of thousands of doses of other antibiotics. Dr. Eric worries that there is simply no way that even a fraction of these effective and valuable medications can be used before they expire. We are hopeful that a portion of these medications can be donated to other places that need them to further benefit the Haitian people.

We discoverd case after case of English cod liver oil. Boxes and boxes of liquid B vitamins. Canister upon canister of chocolate protein powder in cans beginning to rust.

What began as a simple inventory turned into a much larger, more meaningful goal: to generate a system that would more efficiently document what the clinic has in stock. An online system that can be accessed by medical teams in Haiti and the States to determine what the needs of the pharmacy are at all times, thus allowing donors to more effectively allocate their money and cargo space to necessary supplies.

It is our goal to help St. Vincent’s utilize their wonderful pharmacy to its fullest capacity, efficiently and effectively serving as many people as possible.

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