Hospitals aiming for national accreditation find the going challenging but worthwhile

A patient who walks into a hospital for treatment must emerge from it happy and satisfied. This is the ultimate goal of the National Accreditation Board for Hospitals and Healthcare Providers (NABH), the body authorised to provide information, educate, inspect and license hospitals.

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The standards for hospitals developed by the NABH have been accredited by the International Society for Quality in Healthcare (ISQua). Thus, a healthcare facility with NABH accreditation will be recognised internationally and boost medical tourism.

The NABH aims at bringing in an effective regulatory framework for healthcare in our country which will ensure discipline, according to Giridhar J. Gyani, chief executive officer, Quality Council of India. The accreditation, along with the Clinical Establishment Act of 2010, could bring some discipline, ensuring that even laboratories are set up only in the right environment, he says.

When the 77-year-old paediatric facility, Dr. Mehta's Hospitals, applied for NABH accreditation, it had to consider expensive modifications in its structure. “The accreditation took over two years and it was a process-oriented approach which was quite expensive and challenging,” says Sameer Mehta, Director, adding that the hospital ran at a loss in that period to account for the changes. “We spent Rs.2.5 crore on capital modifications such as converting operating theatres (to effectively control microbes), changing entrance designs, air management and effluent treatment facilities.”

Mr. Mehta says the hospital recorded a 30 per cent increase in operating costs since the accreditation. “Initially, only NABH-accredited hospitals were supposed to have access to the State's insurance coverage but now all hospitals have been permitted. This harms NABH hospitals since the quality of their service is much higher,” he says.

The hospital opted for accreditation hoping to attract patients from abroad and insurance companies.

Frontier Lifeline's NABH coordinator Usha Raghavan Subramanyan recalls that the decision to go for accreditation was based on the need to enhance quality and safety of patient care. “We decided to go for it as it would add value to the existing infrastructure and make it a preferred destination for national and international patients.”

Dr. Usha adds that since the facility had already complied with many standard requirements, few changes were needed. “The Central Government Health Scheme and the Ex-servicemen Contributory Health Scheme had made NABH accreditation mandatory for their approval of payment. But there is still no uniform recognition for such hospitals across the country. The patient should demand quality care and seek treatment from only NABH accredited Hospitals,” she says.

Among the government hospitals, the Namakkal district headquarters hospital, followed by the Sholingar facility, set the trend. It took the Namakkal facility three years to systematise the processes. Besides reducing patient-waiting time, providing facilities such as fan, drinking water and toilets, the hospital had to ensure that doctors spent enough time with patients. The ultimate goal was patient satisfaction, says S. Selvakumar, coordinator, Tamil Nadu Health Systems Project, Namakkal district. He is also actively involved in helping the Padmanabhapuram hospital achieve accreditation. According to him, the Pallipalayam hospital ranks the best in using the computerised management of patient data.

Namakkal hospital's achievement is exemplary considering it was once a hotbed of HIV infection. Getting the accreditation is just the first step, Dr. Selvakumar says. To maintain it requires not just effort but dedicated manpower and funds.

It will be a while before the city's government hospitals are even enthused to consider accreditation. Though all four major hospitals have begun performing transplantations and the new buildings have complied with requirements such as fire safety and barrier-free environment, senior hospital authorities say the huge flow of patients and the variety of ailments treated are by themselves a hurdle.

According to Dr. Gyani, a hospital or nursing home built with appropriate infrastructure will not have to spend much on maintaining its accreditation. “In fact, it can help save money in the long run. An accredited hospital will ensure infection control and, in turn, result in reduced average length of stay which will benefit the patient as well as the hospital. Similarly, it minimises wasteful processes and reduces chances of adverse incidences,” says the expert.

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