After finishing the bootcamp, we took a break and went to visit Arenal Volcano. Along the way we stopped at Sarchi and saw the largest oxcart in the world and a park in Zarcero with very fun shrubbery. Then we had a delicious lunch with the best pineapple juices followed by an argument with our guide over what “climb” and “walk around” entailed in terms of actually visiting the volcano. While we didn’t get to do what we had expected, we did have a fun time soaking in the local geothermal pools before the long drive back to San Jose.
The morning after our adventure, we started our clinical needfinding bootcamp. The bootcamp consisted of a Zoom meetings and hospital visits. We had the opportunity to visit the downtown and Santa Ana locations of Clinica Biblica, a private Costa Rican hospital. While there, we observed the pharmacy, radiology, laboratory, and emergency departments. Given that our first day was a Sunday, everything in the downtown hospital was relatively quiet.
In the Downtown location, Katy and I started in the hematology lab where we saw lots of opportunities for improvement. The space itself was not organized in a user friendly way and there were lots of single person checks on things that could cause subsequent medical errors. One of the most egregious things I observed was a woman spilling expired blood from the blood bank fridge and cleaning it with just paper towels. After that we stopped in the pharmacy which was an absolute madhouse. There was only one pharmacist checking each prescription assembled by four pharmacy techs with multiple calls and visits from techs from the ER. It was interesting to see how the pharmacy managed the urgent vs standard priority cases with the huge volume they had to process. From here, we visited radiology which was absolutely dead at 4pm on a Sunday but it was interesting to see a much more organized and almost calming space.
In the Santa Ana location, Laurel and I hung around the ER to start. It also was relatively quiet and was interesting to hear one of the doctors talk about how they were monitored for following PPE protocols by one of the internal security cameras. Our next stop was the most interesting. We got to see some X-rays but most importantly we saw a breakdown in the hospital system. A patient had been scheduled for a CT for possible pancreatic cancer and was told not to eat or drink prior to coming in. However, he was not told that the test would be 3 hours long. While his family was livid at this lack of communication, the man was relatively calm and started drinking the 5 cups of contrast diluted in water required for the study. From here, we saw the laboratory which was so organized it was shocking to think it was a part of the same network as the one was saw the day before. Finally, we finished in the pharmacy where everything seemed from more logically organized and better managed than the other pharmacy. It was interesting to bring all our observations to the meeting in the afternoon and compare experiences and develop needs statements based on what we saw.
As a group we had a farewell dinner for Asma and I and all got to bed early before the gang started their internships and we headed home. Detouring for a quick tour of the Starbucks Casa Alsacia Coffee Plantation, Asma and I had a wonderful last morning and easy trip back to the US. I am very excited to hear about everyone’s internships when they are back and to start classes in August!
