Wednesday, July 21, 2010

No night service for Pharmacy and Laboratory

This is one of a kind health institution for which I considered very special. Imagine a hospital without 24 hours service of pharmacy and laboratory? In KKESH, this is just ordinary. Lets start from laboratory, after 2300H on call laboratory technician will cover the entire hospital's laboratory services. Just put into consideration, when there is an urgent procedure to be done and the person on call is living outside the hospital compound. Patients will end up frustrated waiting for the person who in turn supposed to be the one waiting for the patients to come.
Pharmacy in this hospital has one of a kind delegation of function. After 2130H pharmacy services will be closed and ER night pharmacy locker will operate. Who are the once dispensing medications after 2130H in the entire hospital? ER Nurses are expected to provide services that are supposed to be a function of a registered pharmacist. Are nurses considered pharmacist? The answer is definitely NO! but in KKESH; ER Nurses are working as pharmacist at night.They provide and on call pharmacist in case of STAT medications and code blue response. Consider the safety of patients and nurses, how will the ER Nurses handle the technicality of some medications like the composition, side effects, special medical considerations and dosage indication when they are not pharmacist? Additional workload to the ER Staff is considerable since the disruption of nursing functions were interrupted just because (2) nurses need to check and dispense medications to the patient. Talking about safety... How did the JCIA rate this institution with rotten system?

Thursday, July 8, 2010

Security at its "Best".

We are staffed with more or less 50 security guards, all of them are native saudi nationals and most of them doesnt speak english. Besides this factor, almost all of them cant even follow or understand a simple instruction as of crowd control and basic safety assistance calls. They would prefer to drink tea and talk to each other while there are some chaotic incidents in some hospital areas.
One time we had a call for a code, since all of the adjacent gates were closed, we deliberately use the hospital main gate access towards the housing intrance gate. Thanks to the generousity of one of the hospitals security vehicle, but when we are in front of the housing gate. Our vehicle wass checked by another security, the hood and engine of the car was routinely inspected. This happens in spite of our explaination that we are responding for a code!
The worst is that the driver of the vehicle is also a security of the compound. Isn't it "idiotic"...?

Wednesday, July 7, 2010

KKESH the "Tertiary" Eye Hospital

One of the pillars of KKESH is all about tertiary care treatment to all patients, which simply means that most if not all of our patients required a certain level of specialized eye care. And when I emphasized the word, "specialized", in lay mans basic understanding of English, it refers to a delicate and significantly advanced level of care. One of the pioneers would say, that during their times way back on the decade of the 80's and the 90's, only patients with referal and patients with challenging diagnosis are accepted. But as years goes by and the trend of specialized care evolved, the nature of specialized tertiary eye care printed on the basic mission of KKESH drastically loose its meaning.


As of today, we are dealing with patients with questionable health stability. As people may know, this institution was built for the sole purpose of dealing with any/if not all ophthalmic related conditions all over the kingdom. People may think that this huge center caters all kinds of eye conditions, yes it is true- but the question of medical stability is always the concern of most staff ophthalmic provider. How would you know if the patient has been treated or admitted in other medical facilities if they will not provide us with the right information.
Imagine a case of a premature baby from a far region of Saudi Arabia. It so happened that this patients' family had a "Royal Connection". Based on the fax message and brief medical bulliten of the patient, it was clearly stated that the patient is premature with low birth weight below the target acceptable birth requirement stipulated in the policy and procedure of the hospital. What happens next are part of "KKESH unstable judgement and policy". The upper executives decides to accept the case in spite of the fact that our hospital is well equiped "ONLY" with all the advance ophthalmic cases and not with a specific pediatric condition.
Finding out too late but once the bosses had their own way to twist on the policy they once sit on and follow for several years. The ending of the story is more interesting when the patient arrived in the hospital and based on eveluation by our ophthalmologists it says that there is no significant ophthalmic management to over rule the present health condition of the patient. To make the long story short, the patient was transfered to an able medically advance facility.