Day at the pain clinic 11/11

Monday 11/11

Today I went to the "Centro Nacional de Control de Dolor y Cuidado Paliativo" or "National Center of the Control of Pain and Palliative Care".  This clinic is one of the 29 hospitals that are part of La Caja, as is La Carit.  The pharmacy director, Doctora Claudina Aguilar Corrales, was very inviting and excited to have me there for the day. She is a friend of the pharmacy director at La Carit. We started off the day with a tour of all their facilities. Here are some pictures of the pharmacy.

Where they type up the prescriptions to make labels.

One of the pharmacists checking the prescriptions.

The window where the PCTs drop off prescriptions and pick them up when they're filled.

The outpatient window to serve the patients of the clinic.

One of the filling counters.

Because the hospital is in the city, they have many buidlings that are rented and located around the corner or up the street. While on the tour, I learned all about the types of patients who come to the clinic from all over Costa Rica, for pain management referrals, chronic pain referrals, terminal cancer, for first time visits if they live nearby, or for end-of-life care. First, we went to their storage room to learn about the purchasing process with their purchasing technician. They are trying to move this "bodega" or warehouse to a location closer to the pharmacy because it is currently in a building 1 block away from the pharmacy of the pain clinic. I learned about the purchasing process and how they must use the money given to them by the Caja before the end of the year or it is gone. The are really pushing to move the bodega to another location because the current building in which it is has a leaky roof that they're afraid will affect the storage of the medications. They had interesting moisture absorption buckets shown below.

Then I went for a tour around the clinic including where the patients wait, where they are seen by the doctors/nurses, administration, and the pharmacy. I stayed in the pharmacy for most of the day working with the pharmacists mostly. I learned how they must check the scripts for controls/narcotics in a certain way. They also fill non-control medications at this pharmacy as well. In the afternoon, I met with the director again when she gave me her presentation about the rules La Caja has for which pain meds can be used in which order (first line, second line, third line). The director also explained to me that they are working to become more interdisciplinary in terms of pharmacist involvement. I also learned there are interdisciplinary teams that do house calls for patients too sick to come to the clinic. Overall it was a great day, and I loved the pharmacists and technicians I worked with! Here is a nice picture of our group.