This is a picture of a tank that somehow makes sterile IV medications. I'm not quite sure how it works except that all of the different parts of the IV are placed inside the tank and the machine selects the correct volumes of each and mixes them. Again, I have no idea if the meds are placed in certain compartments or filled somewhere else and piped into the tank. It was being explained to me in very simple English - the language barrier was a little hard to overcome in this small village hospital. Once the IV is mixed, it is sent through a pipe that runs up the wall, across the ceiling and into the next room's sterile hood where it is filled into a bag and labeled. I couldn't witness the process because this hospital is being renovated and all of their IVs and chemo are being shipped from a larger hospital 30 km away.

This was one of the main differences I could see from the few inpatient pharmacies I've seen in America. Otherwise, it runs pretty much the same way other small hospital pharmacies are run. They have med closets on all of the units that contain most of the fast movers most patients use. If the patient requires a med that the closet doesn't contain, an order is sent to the pharmacy. They fill a weeks worth of the particular medication and place it in a bin marked with the room number of the patient.

One other thing I found interesting is that the entire patient chart is sent to the pharmacy for the orders to be input. Each hour, someone drops off charts and retrieves new charts with new orders - I don't think that would ever happen in a US hospital. They also didn't have a pharmacist present. Pharmacy assistants (that have four years of education in pharmacy) run the entire pharmacy. A pharmacist is supposed to be there, however, for at least a couple hours but just like pharmacies in the US, budgets are getting tight in the Netherlands as well.