Use of the 2008 basel consensus statements to assess, realign, and monitor pharmacy practice at a tertiary care hospital in northern Uganda: illustrative case study.

Pharmaciens sans frontières (also known as Pharmacists Without Borders—Canada or PSF-Canada) has an ongoing collaboration with St Mary’s Lacor Hospital (Lacor Hospital) in the Gulu district of northern Uganda. Founded by a group of Comboni missionaries in 1959 and developed by 2 physicians, Dr Lucille Teasdale and Dr Piero Corti, Lacor Hospital has grown from a small 30-bed institution to its current capacity of 483 beds and hosts an average of 600 inpatients and 500 outpatient visits each day. In addition to the main hospital compound, Lacor Hospital owns and operates 3 peripheral health centres, each with a 24-bed capacity. Because of its size and reputation as the best tertiary care hospital in Uganda, Lacor Hospital serves as a training ground for various health care professionals: it is a teaching site for the Gulu University Faculty of Medicine, as well as for the Lacor School of Nursing and the Lacor School of Laboratory Technology. One of the challenges identified by the executive team at Lacor Hospital has been the need for the hospital’s Department of Pharmacy to establish optimal strategies for logistic support and technical assistance with regard to medication management. This objective aligns with the call for optimizing patient safety through the judicious, safe, efficacious, appropriate, and cost-effective use of medications, while making responsible use of limited health care resources and assuring the integrity of the medicine supply chain, as defined by the joint World Health Organization and International Pharmaceutical Federation (FIP) statement on good pharmacy practice. As a result, PSF-Canada was contracted by the hospital’s executive team to provide pharmacy support, knowledge exchange, and knowledge translation at the Lacor Hospital Department of Pharmacy. This collaboration has been in place since May 2009, and, with the help of the hospital’s pharmacists and other employees, PSF-Canada has been able to streamline day-to-day pharmacy operations, as well as the organization and inventory control of medications at Lacor Hospital. A major influence on the actions and recommendations of PSF-Canada to optimize pharmacy practice at Lacor Hospital has been the 2008 Basel consensus statements on the future of hospital pharmacy. These consensus statements were developed by an international consortium of pharmacists to reflect the pharmacy profession’s shared vision of hospital pharmacy practice. Their development was prompted by the varied roles that pharmacists play in different countries; for example, hospital pharmacists in some countries practise patientoriented pharmaceutical care, whereas those in other countries focus on maintenance of the medication supply chain. Results presented in the 2006 FIP Global Pharmacy Workforce and Migration Report on the diversity of pharmacist roles, along with discussions with hospital pharmacy leaders, led to the distillation of essential characteristics desired in hospital pharmacy practice. In this age of increasing medical complexity, increasing risk, and increasing cost of medications, the 2008 Basel consensus statements strive for a measure of agreement, across borders and across cultures, about the vision of hospital pharmacy practice. They cover all areas of medication management in the hospital setting, including procurement, preparation and delivery, prescribing, and administration, as well as monitoring of patient outcomes and human resources. Since publication of the Basel consensus statements, there has been no description in the literature evaluating their validity in guiding the development of pharmacy services in a tertiary care hospital. The aim of this article is to illustrate the use of these consensus statements in assessing, realigning, and monitoring pharmacy practice at the Lacor Hospital in Uganda. The actions taken to meet the 2008 Basel consensus statements will also be described.