Siriraj Hospital

Hello everyone!

My name is Maddie Pryor and I too am in my final year of pharmacy school at UNE. This is my fourth APPE and I am so excited that I have the opportunity to be here in Thailand to learn about pharmacy while simultaneously gaining exposure to a brand new culture. 

For the past two days I have had the opportunity to tour and learn more about the services at the largest and oldest hospital in Thailand, Siriraj Hospital. My team, which consisted of Dr. Krebs, Casey, and myself, were able to get a better understanding of health care in Thailand throughout these past few days and gain insight in order to improve our practices in the US. 

Just to gain some perspective, Siriraj Hospital has over 2,000 beds, 5,000 outpatients a day, 113 wards, 200+ pharmacists, and fills over 3,500 prescriptions daily. In other words, this is a massive hospital with countless opportunities for pharmacists to learn and practice in and impact the lives of millions of patients yearly. While at this hospital, we met pharmacists from and toured the pediatric unit, adverse drug reaction monitoring, medication reconciliation, warfarin ambulatory clinic, transplant clinic, drug information and poison control center, general medicine floors, oncology, and the inpatient pharmacy. The pharmacists, students, and pharmacy assistants all welcomed us with open arms and were willing to set aside time throughout the day to explain their services and answer any questions we had. We were blown away by their hospitality and I admire the devotion they have to the practice of pharmacy and improving patient lives. 

Overall, there were many similarities between the duties of pharmacists in both the US and Thailand. For example, we are both responsible for therapeutic drug monitoring such as with vancomycin or warfarin, verifying doctor's orders, answering drug information questions, completing medication reconciliations, making recommendations to doctors for changes in drug therapy, and more. However, there were numerous differences that left an impact on our team. The pharmacists here were much more interactive with patients and had fantastic resources for patient education. This area could definitely be improved in the US as many patients are rushed out the door of the hospital and do not have a basic understanding of their healthcare. Additionally, pharmacists are in charge of discharge counseling , which should be a priority in the US. There usually isn't enough time or resources for pharmacists to educate patients and complete discharge counseling but now I see the value in this service and because of this experience, I will advocate for all hospitals to improve upon this. 

One major challenge they have in Thailand is the lack of electronic charting in the hospital. There are more drug errors as a result and could be prevented by switching over to computerized order entry, which is a lot easier said than done. Additionally, many drug manufacturers do not register their products so there is no all inclusive resource for pharmacists to identify medications that patients bring into the hospital. This becomes a major challenge for pharmacists and doesn't necessarily guarantee the best possible care. 

Overall, throughout these past few days I have learned a lot and am grateful for my time at Siriraj Hospital. This experience was extremely valuable because not only did I learn how to improve patient care in the future, but we were able to teach them about how the healthcare system is in the US and hopefully they have gained some insight from our visit. I would recommend visiting and learning from this hospital to anyone and I truly appreciated the experience! 

Until next time!

Maddie