การดูงานเอดส์ในเด็กที่ไมอามี่ : รายงานสรุปการดูงาน

รายงานสรุปสิ่งที่ได้ เรียนรู้จากการดูงาน 2 เดือน 15 พค- 15 กค 2550 ที่ ไมอามี่ ฟลอริดา สหรัฐ อเมริกา

กับทีมงานของ อาจารย์ Gwendolyn B.Scott,MD

Director,Division of infectious disease and immunology

My two months visit at Division of Pediatric Infectious Diseases and Immunology University of Miami

by Dr Rawiwan Hansudewechakul Chiang Rai regional hospital, Thailand

7- 14-2007

New things that I have learned

Medical Aspect

• This is a real dedicated team, The staff are all hard working people

• They give high standard of care, patient centered care for all the HIV infected patients

• Good Comprehensive care for every patient include Monitoring growth ,Vaccination, Development, Nutrition, and Psychological problems

• Resistant cases is big trouble but manageable( I learn, understand more about PI )

• Patient right and confidentiality is very well organize and very strict here

• Sitting with Dr Gustavo and Dr Friedman I learn a lot about problems of adolescent and how to approach adolescent

• Medical records system, the form, update the information, plan of treatment, the lab and the filing system are all good.

• I am interested in Gastrostomy for feeding medication and also food in problematic cases

• I am very impressed in Family conference that Dr Scott and her team approach the patient and Family and explain the DNR( Do not resuscitate) procedure that give respect to the patient decision

• Florida law is very interesting. ( I wish to have a law like that in Chiang Rai too)

• History of HIV/ AIDS first cases, Detective way of finding valuable knowledge to others countries around the world.

• Administration from Dr Scott that there are many way to get more help.

• how to up date statistics from Ana Garcia and Ben (Adolescent Clinic)

In general

• Strong security system in the Hospital (identification card, access to computer and information system )

• Many ethnicity living together in Miami(with Love share and discipline)

• Help is every where just ask for it ,and you will get from people around

• Spanish is very important here

Things I will do in Thailand

Improve the standard of care, Strengthen the team

• I will present what I have learned here to others (my team , all the community hospital team etc)

• I will start doing patient profile summary and CBC check up in babies born to HIV mother which have never been done before.

• I will do sexual evaluation: Tanner staging ,ask about sexual active status in adolescent.

• I will improve the medical records , add more important details, set new filing system.

• I will set up a data analysis system ,and try to write something to publish (Adolescent story :as suggest by Dr Scott)

Give help

• Continue to Expand the treatment for children and give helps to increase good care for other provinces in Thailand (Try to be a better training place)

• Raise concern about patient right I will talk to all doctors and the pediatric staff in their monthly meeting about keeping confidentiality of the medical records.

• I will continue working as a consultant for PI uses at the national and regional level

Get more help

• Set up screening depression in my patients, starting with adolescent and set up a Psychologist consultation system

• Set up a consultation system with the Nutritionist

• Consult the Surgical team to do gastrostomy for some children needed.

• Set up meetings with the adolescents patients and the social workers and also the Medical Team to plan for Transition

• Continue to give presentation to open way for people who can help.

• Have more visitors of every kind (Politicians ,Newspaper, Rich people)

• Do more research to improve the care in the clinic

• Continue to link to the UM team here (To have the best consultant and partnership in treatment and care of children)

Thank you for every thing .

Everybody has been taking good care and eager to give help people around especially the patients and even a stranger like me. I can feel your love and good intention in the atmosphere around.

You have strong service mind and I think may be because you have a lot of the best Role model ever like the original one Dr Scott follow by Dr Rivera, Dr Mitchell ,Dr Chapparo, Then the social worker team leading by Ana Garcia, Then the nurse team by Christina and all the administrative team by Joseph and many other connecting teams that you have your net work with, who all work so hard.