Inpatient Pharmacy

This past week I had the chance to see how the inpatient pharmacy operates at SGH.  There is only one inpatient pharmacy that takes care of the entire 1600 bed hospital so of course there are a lot of pharmacists here.  My preceptor told me at any given time there are usually about 40 staff pharmacists with clinical pharmacists coming down to the pharmacy to help during the peak discharge hours.  The pharmacy is actually partially decentralized with a separate building across the street that is used to make aseptically prepared medications and TPNs.  Another group of inpatient drug info pharmacists sit in this building as well and somehow, every day the communication back and forth between the main, the satellites, and the floors runs smoothly.  A lot of hospitals also have a tubing system to get meds up to floors quickly but here there is an overhead trolley system that travels throughout the complex to deliver anything that fits inside a container the size of a cash box.  The system is quaint and not very fast so a lot of techs will walk over stat medications.  The hospital is very concerned with cost cutting which I think could be why only part of the hospital is air conditioned and there is still no full EMR despite being the largest institution on the island.  In some respects the healthcare facilities here are outdated but the teams still practice solid evidence based medicine which is impressive given the limitations.