Overview:

Bangladesh is one of the most densely populated countries in the world, estimated at just over 168 million people in 2019 according to the United Nations. Bangladesh is a small country in South Asia, nestled within the northeast corner of India. Square Hospitals Ltd (SHL) is located in Bangladesh’s capital of Dhaka. It was established in 2006 by the Square Group and is one of the largest private hospitals in Bangladesh. It has 400 inpatient beds and is capable of serving 1800 outpatients per day in a variety of outpatient clinics, including hemodialysis and oncology. Currently the SHL employs a clinical pharmacist. Its clinical areas are currently limited to the intensive care units of Square Hospital. However, the pharmacist provides clinical knowledge upon request to various other departments.

Objectives:

During October 2019, PSF-Canada has conducted an evaluation mission at Square Hospitals Ltd. This mission consisted of two parts. 

The first part was the evaluation of the pharmacy department using the International Pharmaceutical Federation (FIP) Basel Statements (2015).

Specifically,  these are 65 consensus statements created by members of the international hospital pharmacy community in regards to the standardization of hospital pharmacy practice. They consist of 7 focus areas: procurement; influences on prescribing; preparation and delivery; administration; monitoring of medicines use; human resources, training and development; and overarching statements. 

A large number of services are provided in both hospital and outpatient settings.  The results of the evaluation using Basel Statements (2015) are as follows: 10 respected, 30 partially achieved, 14 not yet achieved, 11 not applicable to this collaboration. Statements identified as "not met" and "partially met" provide PSF-Canada with a framework for areas of future collaboration with SHL.

The second part was to evaluate the current clinical pharmacy practice at SHL. Specifically, there would be evaluation of the current structure, strengths and weaknesses of the program, and the requirements for further develop and growth. 

• The central pharmacy has a very organized and systematic drug identification and distribution process.

• The electronic prescription review system is very innovative and advanced

• Overall, the central pharmacy provides a very impressive medication distribution system that guarantees rapid medication delivery to patients.

• There is good collaboration between oncologists and oncology pharmacists, and excellent advice to patients by pharmacists.

Team Members:

• Jaime Nead, BSc PharmD RPh

• Katlyn Taylor BSc BSCPharm ACPR

• Md. Jahidul Hasan

Future Endeavors:

Due  to the pandemic, the planned mission in June 2020 was put on hold. However, the Bangladesh team is currently working on a virtual mission where PSF-Canada provides training webinars on various topics, including patient counselling.

Based on the initial evaluations,  objectives for future missions were created. This included assisting in the further development of SHL’s Antimicrobial Stewardship Program and developing a patient counselling standardized model for training pharmacists about how to interact with their patients to encourage more clinical-based work among pharmacists at SHL. 

The 4 priority areas identified for future collaborations are:

• Antimicrobial management program

• Integrated clinical pharmacy practice

• Pharmacovigilance and adverse drug reactions

• Patient counselling (standardized model)