Praava Health Attendant Policy

Praava Hub

As the COVID-19 situation evolves, we at Praava Health want to ensure your safety. Today, we are reaching out to let you know that we are encouraging you to stay home as much as possible.  You should only visit healthcare facilities for any urgent or pressing health issue you or your family may face. 

Our doctors at Praava are here for you and can have teleconsultations for any guidance you may require, instead of in-person consultations. We request you to prioritise this option for you and your family’s health. To learn more on Praava’s teleconsultation options, you can check out our blog post “Call Praava’s COVID-19 Hotline to assess your risk

However, if you do have to come to Praava Health for any healthcare needs during this time, we are encouraging you to bring only one attendant with you to reduce the risk of contamination of COVID-19. We understand that exceptions may need to be made and so we have created an attendant policy to ensure your safety, and physical and mental well-being. 

PRAAVA HEALTH ATTENDANT POLICY

  • As of March 19, due to the rising COVID-19 emergency, we are requesting patients who come to Praava to bring only one attendant with them
  • For the following patients, exceptions will be made to this policy: 
    • Pediatrics: Mothers coming in with a young child or children may require more than one attendant 
    • Special assistance: Patients who may require special assistance due to any form of disability or advanced age may be accompanied with more than one attendant
  • If any patient or attendant shows symptoms similar to COVID-19, s/he will be assessed by a family doctor in a dedicated assessment room and provided with all necessary information required and guided accordingly

We sincerely apologise for any inconvenience this new policy may cause you, and we hope you understand that we are doing everything we can to ensure your and your family’s safety. We appreciate your understanding during this time. 

At Praava, you are more than just a patient, you are family.

Call Praava’s COVID-19 Hotline to Assess Your Risk

As the COVID-19 situation evolves, we at Praava Health want to ensure your safety. 

Today, we are reaching out to encourage you to stay home as much as possible. If you have any of the symptoms of COVID-19 such as fever, cough, or breathlessness or you have recently traveled abroad or been in close contact with someone who has returned from abroad in the last two weeks, REDUCE YOUR RISK AND CALL 10648 TO TALK TO YOUR FAMILY DOCTOR, instead of coming to Praava.

To avoid coronavirus, wash your hands often with soap and warm water for at least 20 seconds, or use an alcohol-based hand sanitizer. Avoid touching your face, eyes, nose, and mouth with unwashed hands. Practice social distancing, which is deliberately increasing the physical space between you and others to avoid contracting or spreading illness. Staying at least 3 feet away from other people lessens your chances of catching COVID-19.

If you think you need to be tested, directly contact the government lab IEDCR at 01937000011, 01937110011, 01927711784, 01927711785. Government-approved hospitals for suspected coronavirus patients are Kurmitola General Hospital and Kuwait Moitry Hospital, Uttara. 

At Praava, you are more than just a patient, you are family.

How to Stay Calm During the Coronavirus Pandemic

Since the news of more known cases of coronavirus in Bangladesh was made public recently, and new information is emerging daily, we understand how this can cause you stress and anxiety. To learn about coronavirus or COVID19 you can check out our blog post on coronavirus and your health

For your own health and safety, it is advised to maintain social distancing. This means to avoid large gatherings or crowds. If you have to be around people, keep 3 feet (1 meter) distance between you and other people. 

Stress can cause a big impact on our immune system and we need to prioritize our own health – both mentally and physically. Hence, it is crucial to stay calm to be able to better cope with this situation.  

Why are you feeling stressed? 

Stress is the signal from your body that it is working to keep you safe. During stressful situations, your sympathetic nervous system gets into a “fight or flight” mode – meaning that you feel like something will harm you, which could be a real or an imagined threat.  

This threat is characterised by an increase in the flow of adrenalin, heart palpitations, sweating, etc. The mental association with this can make you sleep-deprived as a result of constant engagement in worrying thoughts. All of this is your body’s response to a perceived threat.  

The good news is that you can take the below measures to keep your stress and anxiety levels under control.     

How to reduce anxiety? 

Adequate sleep 

Getting enough sleep is essential to reduce anxiety and it is crucial that you get proper rest. Adequate sleep helps our bodies to perform best and to steer clear of potential viruses.  

While you may be tempted to stay up late to catch up on the latest news, it’s more important to let your body rest. Getting adequate sleep will allow your body to perform at its very best and fend off potential viruses. 

We understand that stress might make it harder for you to sleep. If you are having trouble sleeping and think you may need to speak to a professional, call 10648 and our family doctors can help you. 

Regular exercise 

High levels of the stress hormone cortisol can cause our immune system to be compromised. Exercise helps to reduce the level of this hormone while releasing endorphins which elevates our mood and happiness. 

We know that you should refrain from close contact with others during this time. If you do choose to go to the gym, please be extra mindful to wash your hands or hand sanitize thoroughly before and after using any shared equipment, and do not touch your face or eyes during your workout. If you choose to avoid the risks of going to your gym, you may opt to go for a run at a relatively less crowded road or park, bicycle, or engage in exercises that you can do at home.  

Remember – the key is movement, so even walking up a few flights of stairs or moving your body to your favorite tunes in the comfort of your room can help. It will also help you sleep better. 

Maintain a healthy diet

In moments of stress, we may often turn to our comfort food which isn’t always nutritious. It’s easy to let your diet slide and turn to less nutritious comfort foods. When it comes to managing your anxiety, however, a balanced diet is vital for your health. As we usually recommend, focus on eating fresh, unprocessed, whole foods in order to maintain a strong immune system.

Limit nicotine and alcohol consumption 

It is very common for smokers to light up a cigarette when stressed or anxious, and some may also turn to alcohol to take the edge off. However, both nicotine and alcohol can disrupt sleep and have adverse effects on your mood. Therefore, it is best to limit the consumption of nicotine, alcohol, or any other substances.

If you need help reducing your nicotine or alcohol consumption, Praava can help. Call 10648 to talk to one of our family doctors.   

Stay connected with friends and family

Although it is advised that you avoid public gatherings or even large gatherings of friends and family, it is important to stay in touch with your loved ones. You can simply chat over a voice or a video call, or meet up with your friends and family in smaller groups.

Research shows that being in close connection with the people you care about can increase your happiness level.  

The best part is that you don’t even have to talk about COVID19! Talk about the latest movies you’ve watched, books you are reading, or anything that makes you feel good or laugh. 

Don’t forget – laughter is the best medicine after all!  

Worried about Coronavirus? Explore customized awareness programming for Corporate Clients

As Bangladesh reported its first incidents of coronavirus (COVID-19) on March 8, 2020, and with a couple of more cases that have been confirmed recently, we know many of you and your colleagues are worried right now. We are here to help you navigate this situation by raising awareness on the coronavirus and how to prevent its spread. 

There is currently no vaccine to prevent coronavirus. The best way to prevent this illness is to avoid being exposed to the virus. To learn about coronavirus, its symptoms, measures of prevention, and what to do if you fall sick, check out our blog post on coronavirus and your health.  

We are offering the below options for you and your colleagues during this global pandemic.

  1. Telehealth consultations:

As you know, coronavirus is highly contagious. Please educate your colleagues that if they or their family members have fever, cough or cold symptoms, or think they may be at risk for the coronavirus, to call Praava at 10648 (8am-10pm, every day) and consult with our family doctors from home, instead of visiting a clinic or hospital. This will ensure everyone’s safety and reduce the chances of contamination. 

  1. Virtual awareness programming: 
  • 30-minute virtual awareness session with our doctor to learn more about coronavirus and measures of prevention
  • 30-minute virtual training session on how to disinfect and clean your office and home
  • These guidelines are focused on global practices & prevention methods of contamination of the coronavirus

Remember – the best way to avoid exposure to coronavirus is to wash your hands often with soap and warm water for at least 20 seconds, or use an alcohol-based hand sanitizer. And avoid touching your face, eyes, nose, and mouth with unwashed hands.

If you have any queries, please feel free to email us at praavamarketing@praavahealth.com.

Thank you for choosing Praava Health to be your trusted healthcare provider. We hope to support you however possible especially during this time.

In good health, 

The Praava Health Team

Coronavirus and Your Health – a note from Praava Health

As a part of the Praava family, your health is our top priority. We recognize there is continuing concern around coronavirus and that you likely have many questions. 

Our medical team is sharing what we know about coronavirus, prevention tips, and ways to best stay healthy. 

What is COVID-19?

COVID-19 is a new strain of virus in the coronavirus family. Coronaviruses are not new; they are a family of viruses that have infected animals and humans leading to a wide range of respiratory conditions, from simple cold-like illnesses to more severe respiratory infections.

Where do I go for more information?

IEDCR, the World Health Organization (WHO), and the Center for Disease Control (CDC) are all providing updates regularly. 

We are also monitoring the situation closely and will continue to keep you informed.

To learn information about coronavirus, please do not trust all the information you are finding on the internet. Please refer to the WHO and CDC only for the latest up to date information on what we know about the virus.

Is there Coronavirus in Bangladesh?

Today, Bangladesh reported its first three incidents of coronavirus. Especially since Bangladesh has at least 10 million workers living abroad, there is a risk that people coming back from abroad could carry the virus.

The government’s Institute of Epidemiology, Disease Control and Research (IEDCR) recommends avoiding travel to countries that have known cases of the virus. IEDCR is requiring that all people who return from foreign countries remain in quarantine for at least 14 days, which is the amount of time it can take for the virus to show symptoms. 

What are the symptoms of Coronavirus?

Coronavirus symptoms are similar to a cold or flu. Symptoms may appear as soon as 2 days or as long as 14 days after exposure. Symptoms which have been seen in confirmed cases include:

  • Fever
  • Cough
  • Shortness of breath

How do I prevent illness?

  • Wash your hands often with soap and warm water for at least 20 seconds. You can also use an alcohol-based hand sanitizer.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Avoid close contact with people who are sick.
  • Stay home when you are sick, to protect yourself, co-workers and others you’re in contact with.
  • Cover your cough or sneeze with a tissue or into your elbow, then throw the tissue in the trash and wash your hands.
  • Clean and disinfect frequently touched objects and surfaces.
  • Keep your immune system strong. This includes getting a flu shot to help you from getting the flu, getting enough sleep, and eating well.
  • There is currently no vaccine to prevent COVID-19. The best way to prevent illness is to avoid being exposed to the virus.

What do I do if I feel sick?

If you are feeling sick or think you may be at risk for the coronavirus, you are not alone. You can call Praava Health through our short code 10648 or message us on WhatsApp at +880188655520. We can help you determine whether testing is needed. 

If you have an upcoming visit with a Praava Health doctor and are feeling sick or want to avoid public spaces, you can always change your appointment to a call.

You can also contact the IEDCR directly through their hotlines: 01937000011, 01937110011, 01927711784, 01927711785.

How does Coronavirus spread? 

The virus is thought to spread mainly from person-to-person via coughing or sneezing. Because of this, it spreads easiest between people who are in close contact with one another (within about 2 metres). 

It may be possible for a person to become infected by touching a surface or object that has the virus on it and then touching their own mouth, nose or eyes. Contact with fecal matter from an infected person may also transmit the virus.

Should I wear a mask?

If you’re not already sick and you’re not a health-care worker, you do not need to wear a mask. Common surgical masks keep someone who is infected with the virus from spreading it to others, but do not prevent what’s already in the air from reaching a healthy person. Following the instructions above is a better way to prevent illness. 

Thank you for trusting us with your healthcare.

In good health,

The Praava Health Team

Emergency & Critical Care in Bangladesh

An emergency is a situation that poses an immediate threat to life, health, property, and environment. Emergencies, particularly health emergencies, are nothing new to mankind and over time we have developed means to deal with these situations with the knowledge and resources available. Assisted by research, this has eventually been organized into a systematic approach combining experience, knowledge, and need. Treatment approaches such as herbal, homeopathy, allopathy, and several other forms of alternative medicine for emergency management have been developed. As allopathy treatment system is the most widely used, I will primarily talk about it.

According to the World Mortality 2017: Data Booklet of United Nations, globally 156,000 deaths and 360,000 births occur every day. A considerable number of the 156,000 deaths occur from preventable emergencies. Sepsis, cardiac, pulmonary events, and trauma are the major causes of emergency deaths. Not all deaths due to these causes are preventable but through extensive research and the development of emergency management, we are now at a stage where if proper effort is given, many of these deaths can be prevented. In the West, the efforts in saving emergency patients are profound due to affordability, R&D, and insurance support. However, in the East such support are either not readily available or are not availed due to a lack of knowledge.

During an emergency that cannot be managed at home, a patient must immediately be taken to the Emergency Room (ER) of the nearest hospital. Some hospitals in Asia are very well equipped to take care of such patients. Unfortunately, in Bangladesh most ER’s do not have adequately trained medical professionals, a proper set up including electronic medical monitoring instruments, and logistics. I would like to talk about what to do in a situation where emergencies are not addressed appropriately.

Recently, Emergency Medicine (EM) has been developed as an independent subject which allows ER doctors to be better equipped to handle most emergency cases. Emergency Medicine consists of two parts. The first is out of hospital, also known as Pre-Hospital Care or Emergency Medical Service (EMS). This handles patients at the site where the emergency took place and transfer them to a health facility. The second part is that during the transfer, patients need to be stabilized in a well-designed EMS ambulance. In Bangladesh and some neighboring countries, these ambulances are merely medical vans with no support service or equipment inside.  

I have been working with Praava Health as a Senior Medical Advisor from the planning stage and have helped to create a facility where patients are treated with empathy and respect along with accurate diagnosis. The primary reason behind my interest in joining Praava was the vision and concept of family medicine doctors, which our Founder & CEO Ms. Sylvana Sinha was determined and passionate to introduce to our health sector. Although Praava is an outpatient facility, there are instances where we do need to manage patient related emergencies. I have worked extensively with our doctors, nurses, and allied health professionals, including all of our patient facing staff, to train and guide them on how to properly address and manage emergency cases. One of the vital skills required during an emergency is the ability to perform CPR. It is a challenging training in Bangladesh which we continually conduct for all our staff.

In Bangladesh, Emergency Medicine is still not a recognized specialty and sadly, no FCPS or MD courses have been introduced yet. Doctors and nurses need to be trained for Pre-Hospital Care and ER management and this requires advanced level of education and training. It is a core reason behind why our Emergency Rooms are not supervised by properly trained professionals. In an attempt to overcome this, a few colleagues from different specialties and I, have introduced Bangladesh Society of Emergency Medicine. We are still striving for recognition and development of this specialty. However, FCPS and MD courses are yet to be developed.

In emergency cases, patients who only require first-aid are released after ER management, some may require hospital admission, out of whom a few may need ICU admission – meaning they are either critically ill or could end up in a critical condition.  

Critical Care Medicine deals with patients with respiratory failure, heart failure, severe stroke, and sepsis with single or multiple organ failure. In Bangladesh, critical care management is fairly new but available in many hospitals in Dhaka, while being almost absent in most of the peripheral districts. It is often perceived that if one is admitted in the ICU it means they would eventually expire. This is not true. According to the Society of Critical Care Medicine, USA, mortality ranges between 10% to 29% depending on the severity of illness. In my own ICU, we found the mortality rate to be 35%, meaning 65% patients survived and was discharged from the ICU in a stable condition. Also, not all patients in ICU require life support or ventilation. Many require intensive nursing care, some require close monitoring only, while a few need shock management. The rest may require intervention such as intubation, non-invasive, or invasive ventilation. Terminally ill patients also get benefitted from staying in an ICU, especially those with cancer.

Managing emergencies should only be considered under the following conditions:

  • No time to save life is justified with positive Risk: Benefit ratio
  • No help or assistance from a health facility is expected within an hour  
  • Some experience in dealing with emergencies
  • Emergency apps assisted performance is strictly followed

Praava’s holistic approach to patient care centered around family medicine is a concept that is the first of its kind in Bangladesh. This system which is widespread in the West could unfortunately not even be introduced by our Ministry of Health. Yes, there are numerous challenges that we had overcome to initiate this system and there will be many more ahead of us to establish the importance and need of family medicine.

I utilized my expertise in emergency medicine and care at Praava to ensure that regardless of any situation, a patient is provided with the highest level of care during an emergency. My hope is that by successfully continuing to deliver our promise to patients and also taking proper care of them during emergencies, Praava will help set an example and encourage other healthcare providers to be better trained and equipped to manage emergencies.

All of this effort to empower, educate and train health professionals in emergency medicine, is for the patients to get the right service and care during an emergency and reduce fatality. Afterall, it is all about the people of our country who deserve proper treatment.    

Disclaimer: Despite taking all the right measures taken, there might be instances where a patient’s life cannot be saved.

By Dr. Raghib Manzoor, MBBS DA

Operational Excellence: The Key To Affordable Healthcare in South Asia

Years ago, when I was in my late teens, my uncle was diagnosed with epilepsy – a chronic disorder characterized by seizures. Back in the day, most people weren’t aware of this condition and didn’t even know how to identify it. I was living in Hyderabad, India, where I am originally from, and witnessed the hardships that my uncle had to face along with my family in dealing with this disease. I can still remember taking him to several hospitals and neurologists across town. None could provide proper treatment or care required. At one point, my family members began giving him home remedy treatments, which we later found out had adverse effects on his health. After 10 years of desperately trying to get proper treatment, we finally found a competent neurologist who informed us that it was too late for a permanent cure, and we would have to manage his condition with high doses of medication.

That incident opened up my eyes to the vast need for improvement in the healthcare industry. It is true that, in this sub-continent, India is leading in terms of healthcare services, but even then there remains a shortage of proper diagnosis and timely treatment. I eventually pursued a Master’s degree in Business Administration, but my uncle’s ordeal was always at the back of my mind. After a decade and a half in the telecom sector, I had an opportunity to work in healthcare, and I knew immediately that this was my true calling.

I joined Apollo Clinics in India as the Head of Operations and Service Delivery, responsible for overseeing all the pan-India Apollo Clinics. During my tenure, I saw that processes were not being followed by most professionals in this sector, and standards of quality were not being maintained – which is vital for patients and doctors alike. To streamline this, I created 55 SOPs for smooth functioning of the daily operations at the clinics.  

Earlier this year, I met Ms. Sylvana Sinha, Founder of Praava Health, during one of her visits to India. When she talked about the lack of effective and trusted healthcare in Bangladesh, I came to know more about our neighboring country and the need for proper healthcare. When I learned about Praava Health and its values and mission, it struck me as the kind of company that I could be a part of and have an impact in peoples’ lives. Given my experience of working for a market leader in India, I knew I could utilize my knowledge to contribute and benefit the people of Bangladesh.

Healthcare is a sector that directly affects the lives of people. There is no room for operational errors. Hence, it is all the more important for healthcare providers to devote more management focus towards operational excellence to boost patient centricity, quality treatment, and productivity enhancement.   

A multi-pronged approach that puts hospital and patient care at the heart of performance transformation efforts can help health systems deliver more financially sustainable and patient oriented care. Healthcare personnel must actively participate in performance improvement efforts and be open to changes. The continual improvement not only aids operational excellence but also quality patient care, patient satisfaction, as well as staff satisfaction.

Operational excellence in healthcare deploys a variety of process improvement and change management concepts and approaches to increase operational efficiency and reduce clinical variability. The eventual goal is to reduce total medical care costs while improving quality.

Inefficiencies are the major barriers to excellence. There are various types of inefficiencies, and they can be identified and addressed with eye for inadequacies and awareness of continual improvement. Several tools & concepts of Operational Excellence (OE) such as Value Stream Mapping (VSM), Inventory Management, 5S, Visual Management, Standardized Work, and Poka Yoke – Error Proofing in health facilities can lead to dramatic results. Many healthcare companies across the world have adopted such operational excellence frameworks.

Implementating operational excellence concepts helps to address a number of issues concerning patient care and management, such as:

  • About 40% of time spent at OPD can be reduced through work balancing and improved patient flow.
  • Streamlining the layout and reorganizing can help to reduce the distance covered by patients by 20%.
  • Space utilization can be increased by 60%.
  • Inventory management modules based on scientific calculations can lead to improvement in medicine inventory management to avoid stock outs and over stocking (near to expiry scenarios), reduction in stock taking time, huge cost savings in inventory costs, etc.
  • 95% reduction in the time nurses spend searching for supplies and equipment.
  • Housekeeping and hygiene standards can be maintained through physical workplace improvement tool 5S.

In countries like India or Bangladesh, quality healthcare is still not affordable for the middle class. That is a core issue that Praava Health is addressing. Praava also aims to excel in service standards.

It’s time the healthcare industry in Bangladesh takes a leap. If not now, then when?

Bringing healthcare innovations to Bangladesh

My obsession with health, particularly mental health, began at a very young age. I was told that two of my maternal uncles and a cousin were pagols (mad people in Bangla). My relatives warned me that pagols can be dangerous so I should be vigilant, especially of my cousin who was locked up in a room for over 35 years. Sometime in my teens, both my uncles passed away within 3 months of each other. It was presumed that my older uncle passed away from shock and depression 3 months into the death of his younger brother. A few years later, my cousin passed away as well, thus ending an era of pagols in my family.

Even today, there are myths around mental illnesses. If a person is showing signs of psychiatric disorders, the person is said to be possessed or else has become a victim of black magic.

Mental health has been largely neglected in Bangladesh and needs to be addressed with utter urgency. As per the WHO-AIMS 2007 report on Mental Health System in Bangladesh, a National Mental Health Survey conducted in 2003 to 2005 showed that about 16% of adults in Bangladesh suffer from mental disorders. The report also states “The total number of human resources working in mental health facilities or private practice per 100,000 population is 0.49.”  

The Praava team plans to set a new standard for healthcare in Bangladesh by bringing in some of the market innovations to Praava Health. Current trends in the healthcare industry include the following:

Health mobile applications

Mobile apps are effective tools that patients can use for self-management of health conditions, particularly chronic diseases. For example, various diabetes mobile applications have been developed that provide diet plans, exercise routines and health advice based on a patient’s diabetes profile.

Healthcare data analytics

Data analytics can substantially improve the practice of medicine as it can lead to disease-specific research, modeling health profiles, early detection of health conditions, prediction and management of disease outbreaks and much more.

Artificial Intelligence (AI)

AI in medicine is the ultimate goal as we continue to build medical databases. Machine learning in medicine is a process such that the machine improves its ability to accurately reach a conclusion about a medical condition by accumulating vast amounts of historical medical data. For example, if a machine has sufficient data on a rare medical condition, this expert machine can assist the doctor in coming up with the diagnosis of this rare medical condition very quickly once the symptoms are entered into the machine. Another example of machine learning is image recognition and interpretation. If a large number of medical scans have been fed into a machine, it can accurately interpret an imaging scan based on historical data of identical images. It is a way to mimic the human brain whereby humans learn by repetition and experience that enables them to accurately diagnose patients.

When I first met the Founder of Praava Health about 2 years ago, I was excited to hear about her vision of providing quality healthcare in Bangladesh. I was particularly drawn to Praava because of the Founder’s enthusiasm on offering innovative services such as annual membership plans, mental health, preventive care, electronic medical records etc.

I am an actuary by profession with many years of experience in the insurance sector, particularly health microinsurance. In Bangladesh, there are only a handful of private health insurance schemes. Most of these schemes do not cover outpatient services because of the high probability and high frequency of outpatient claims. At Praava, we plan to bridge this gap by offering annual membership plans whereby patients can avail specific Praava services for a year. Furthermore, we also plan to partner with private insurers to bundle Praava annual membership plans with inpatient health insurance so that we are able to offer a holistic product to Praava customers.

At Praava, we will focus heavily on management of chronic illnesses. Annual membership plans for specific conditions like diabetes, heart diseases will be offered. For example, a diabetes annual membership plan will include a number of routine doctor consultations over the year, diagnostic tests to monitor diabetes indicators, consultations with nutritionist, and access to health coaches who will work closely with diabetic patients to manage their condition. After all, with the right information and tools, sufferers of chronic disease such as diabetes can lead fulfilling, normal lives.

Praava will ensure that all medical records and data are digitally captured from the onset. The aim is to build comprehensive and reliable medical databases over time that can shape the future of medicine in Bangladesh through research and artificial intelligence.

Given my interest in mental health, experience with health insurance, strength in quantitative analysis, and a sense of responsibility of contributing to the development of the country’s health sector, it made perfect sense for me to join the Praava Health family and embark on this journey to provide innovative, revolutionary healthcare services in Bangladesh.

Accredited Quality in Laboratory Service Excellence

Quality healthcare service is not only the expectation but also the right of the patient. There are many different components that work together to provide accurate diagnosis and proper treatment for a patient. Laboratory results play a crucial role in this process and are often the defining factor in planning treatment. In the U.S., for example, 70% of medical decisions are made according to the laboratory results. Unfortunately, in countries like ours, patients and even medical professionals are often not confident about the accuracy of laboratory test results they receive. It is particularly alarming when doctors have to reconfirm test results with more than one facility when treating a critical patient. This process takes time and can pose dire risks to a patient’s condition. Patients mostly lack trust in local healthcare facilities and those who are affluent tend to travel abroad for healthcare.

Ensuring reliability, increasing efficiency, reducing risks, and providing cost effective services are the major challenges facing clinical laboratories. Only sound quality management will engender test results that are internationally accepted. This quality product is directly related to a company’s credibility and business promotion.

The best way to ensure that a laboratory is performing at its optimal level, with the highest possible accuracy, is by obtaining international accreditation. The first step to achieve this is to implement a quality management system.

What is Quality Management System?

quality management system (QMS) is a formalized system that documents processes, procedures, and responsibilities for achieving quality policies and objectives. It aids in coordinating and directing an organization’s activities to meet customer and regulatory requirements and improve its effectiveness and efficiency on a continuous basis.

The following are the goals of QMS:

• Meet regulatory requirements and operate efficiently and effectively through laboratory organization, staff training, quality assurance, sample collection, transportation, processing, analysis, reporting and customer satisfaction.

• Ensure all employees understand their responsibilities and the timeline required to complete their activities.

• Continuous improvement through systematic review, evaluation of effectiveness, implementation of quality indicators, training, and development.

• Accreditation of laboratories.

Laboratory Accreditation:

Laboratory accreditation is a means of determining the technical competence of laboratories to perform specific types of testing, measurement and calibration. It also formally recognizes competent laboratories and enables customers to identify and select reliable testing while measurement and calibration services are able to meet their needs. Accreditation is not just a one-time achievement; to maintain this recognition, laboratories are periodically re-evaluated by the accreditation body to ensure their continued compliance with requirements and to determine that their operational standards are being maintained. One set of specified requirements for medical laboratories is the ISO-15189 standards.

So, what does it take to get an accredited lab? The following are a list of the high-level steps required for acquiring accreditation:

  • Training
  • Situation analysis: baseline assessment
  • Laboratory management committee
  • Document preparation (quality manual, technical document and forms)
  • Document review and approval  
  • Implementation and training
  • Internal audit
  • Pre-assessment audit
  • Deficiency correction
  • Final assessment

Benefits of Accreditation:

Accreditation brings about benefits to all stakeholders in healthcare, from patients to doctors and employees. Once a medical laboratory is internationally accredited, patients who come for laboratory investigations will trust that results will be accurate; consequently, they are assured that those test results guarantee medical treatment of the highest standards, reliability, and service.

Doctors can also be confident in using the results of an accredited laboratory to either confirm or rule out a diagnosis. Laboratory personnel and management can feel confident that the rigorous systems and processes are accountable and confirmed by the international assessment body. They are also assured of the quality of the investigations and accuracy of results.

An internationally accredited laboratory boosts a healthcare company’s reputation as well. The company is also more accountable and less dependent on external support, as competent personnel and mechanical integrity ensure capital effectiveness. By earning international recognition, the company also gains access to the global marketplace for business development purposes.    

Let us look forward to a day when all medical laboratories achieve the highest possible standards and are maintaining them strictly. Praava Health is committed to facilitating that change.

Evidence Based Medicine

For a relatively young country, Bangladesh is one of the most densely populated in the world. The country has been experiencing an average GDP growth of 5.72% from 1994 to 2016, with an all-time high of 7.05% in 2016, making it the one of the fastest growing major economies in the world. Although there has been significant development over the years, when it comes to healthcare, Bangladesh still has a long and hard path to overcome.

Born in London to parents of Bangladeshi origin, I spent most of my adult life residing in the UK and worked as a doctor in the National Health Service for the last 12 years. I had always pondered of ways in which I could contribute to Bangladesh’s health care sector but was unable to find any project that I believed in or could relate to.

Earlier this year, during a visit to Bangladesh, I had a rather unpleasant experience. My cousin was admitted to a renowned hospital in Dhaka and was misdiagnosed and provided wrong treatment for a simple case of appendicitis. I was quite baffled and appalled by the entire situation and the desire to ensure that people have the right to proper healthcare in Bangladesh grew stronger than ever.  

It was around this time that I heard about Praava Health from common friends and had the opportunity to meet with the Founder and CEO, Ms. Sylvana Sinha. After our first encounter, I was very intrigued by the concept and the idea she had to bring about a change in healthcare for Bangladesh. I knew that this was definitely something I wanted to be a part of and decided to explore it further. Six weeks after having met Sylvana, I decided to return to Bangladesh and become a part of Praava Health and hopefully a revolution in healthcare in the country. I currently work as the Senior Medical Director at Praava Health.

Praava Health aims to provide world class healthcare service at a price point that is affordable to the middle class. We believe that every individual deserves access to quality healthcare services and should be treated respectfully and with empathy – something that we so direly need in our country.

Medicine for me is a constant state of learning, and one aspect that I always focus on is Evidence Based Medicine. You might be wondering what exactly that means – let me explain it to you with my own experience. Soon after I completed medical school at Imperial College, many of the medical facts that I had learned were already obsolete. Medical professionals, such as myself, need to constantly stay updated with the latest developments in medicine to provide informed and accurate treatment. “Evidence Based Medicine” is the systematic use of current available evidence, including international medical journals or websites and applying strict criteria for the validity of the evidence. Sackett et al, 1996 describe evidence based medicine as “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.” The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systemic research.

It is absolutely vital for any clinician or healthcare professional to practice evidence based medicine. This means that the decisions taken or policies made should be based on evidence to the greatest extent and not on assumptions. 

Numerous areas of research have increased awareness of the potential weaknesses in medical decision making at the level of both individual patients and populations, paving the way for the introduction of evidence based methods. Evidence quality can be assessed based on the source type (from meta-analyses and systematic reviews of randomized clinical trials with concealment of allocation and no attrition at the top end, down to conventional wisdom at the bottom), as well as other factors including statistical validity, clinical relevance, currency, and peer-review acceptance.

In Bangladesh, the practice of evidence based medicine is not extensive and that is something that I deeply believe needs to change. From my experience as a practicing surgeon in the UK and interning in Japan and Saudi Arabia, I have learned that the best possible care that one can provide is possible through evidence based medicine, and I hope to strictly follow that with Praava Health. There could be nothing more important than one’s health and there is nothing more important for a doctor than to ensure that it is taken care of.