Overview:

St Mary’s Lacor Hospital (Lacor Hospital), located in the Gulu District of Northern Uganda, was founded in 1959 by a group of Comboni missionaries and was later developed and expanded by a Canadian surgeon, Dr Lucille Teasdale, and an Italian pediatrician, Dr Piero Corti.1 The hospital grew from a 30-bed hospital to a 483-bed health care centre, providing care to about 500 inpatients and 800 outpatients daily. Lacor Hospital also supports and operates 3 peripheral 24-bed health centres, each about 10 km from the hospital, to serve the villages surrounding Pabbo, Opit, and Amuru.

The hospital has become a training ground for various health care professionals, including students from the faculties of medicine and pharmacy and the midwifery programs of Gulu University, Makerere University, and Mbarara University. In addition, the Lacor School of Nursing and Lacor School of Laboratory Technology were developed within the hospital. In 2009, the hospital’s executive team identified the need for the Department of Pharmacy to establish optimal strategies for logistical support and technical assistance with regard to medication management and pharmacy practice.

The challenges highlighted at Lacor Hospital parallel the vision of the World Health Organization (WHO) and the International Pharmaceutical Federation (FIP) of optimizing patient safety, utilizing health care resources responsibly, and ensuring the integrity of the medication supply chain. In 2009, Pharmaciens sans frontières (also known as Pharmacists Without Borders—Canada or PSF-Canada) was contracted by the Teasdale-Corti Foundation and the Lacor Hospital executive team to provide pharmacy support, knowledge exchange, and technical assistance to the Lacor Hospital Department of Pharmacy.

Two PSF-Canada pharmacists conducted the initial on-site evaluation, which resulted in 24 recommendations aligned with the FIP’s 2008 Basel Statements on the future of hospital pharmacy. The recommendations presented by PSF-Canada served as an action plan for interventions and a guiding document for the PSF-Canada pharmacists and the Lacor Hospital pharmacy management team to achieve the vision of the 2008 Basel Statements for hospital pharmacy practice.

The first PSF-Canada pharmacist began working at Lacor Hospital in May 2010.

In total, the mission consisted of 9 deployments of Canadian pharmacists over the period 2010 to 2015. The mission ended in October 2015. Seven PSF-Canada pharmacists were deployed for periods of 3 to 8 months. Once on site, each PSF-Canada pharmacist was presented with a work plan by the PSF-Canada mission leader, who was located in Canada. The plan included specific goals for the deployment that would advance the mission toward meeting the strategic goals of the PSF-Canada action plan. Every 1 to 2 weeks, the mission leader would connect with the on-site pharmacist, via social media, to review progress and reprioritize goals if required. Details of how each intervention was put into action were not documented, but annual assessments were performed.

To track progress, and to ensure continuity and momentum, the annual mission assessments were conducted annually or biennially from 2010 to 2015. For these assessments, each of the 2008 Basel Statements was ranked as met, partially met, not met, or not applicable. In addition, each of the PSF-Canada recommendations was ranked according to level of completeness (not started, discontinued, in progress, or completed). After evaluation of each of the 2011 and 2013 assessments, 5 new recommendations were recognized and added to the PSF-Canada action plan, for a total of 10 new recommendations.

Each assessment was conducted by the PSF-Canada mission leader, the head pharmacist at Lacor Hospital, and the PSF-Canada on-site pharmacist.