Quality Wave in Healthcare – is it real or is it a mirage

July 3, 2017 by · Leave a Comment
Filed under: Healthcare, Healthcare Quality, Hospital, NABH 

IS THERE REALLY A QUALITY WAVE IN THE COUNTRY IN THE HEALTHCARE SECTOR?

Author: D.Satishkumar, Principal Consultant Value Added Corporate Services P Ltd

The healthcare sector in the country has witnessed a lot of changes over the past few years. One of the changes to have happened is in the area of quality of healthcare delivery and the necessity to introduce accreditation / certification systems to evaluate and monitor the same.

NABH Accreditation assumes larger significance in this context. Accreditation relies in establishing the technical competence of an organisation to deliver services adhering to specific standards.

The hospital accreditation program (NABH) was launched in the year 2006 in the country. Initially NABH came up with 2 set of standards, one for hospitals with more than 50 beds which was called as NABH Accreditation and another standard for hospitals between 20 & 50 beds called NABH SHCO (Small Healthcare Organistions)

Initially there were a very few takers as Quality and Accreditation were something which were alien to the healthcare sector. The first wave to go for accreditation started gaining momentum when in the year 2008 / 2009 CGHS made accreditation standards mandatory for hospitals which needed empanelment with them. Hospitals which had empanelment with CGHS and which wanted to empanel with CGHS went for accreditation but after that there was a downtrend and the numbers started stagnating. Most of the smaller facilities faced difficulties in complying to the requirements laid down by the accreditation body. NABH felt that a smaller version needs to be introduced with reduced requirements so that the small and mid-sized facilities would also start going for accreditation, there by ensure atleast some basic quality of care to patients.

This article discusses whether introduction of Entry Level Accreditation has really increased the number of organisations seeking quality.    Read More

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Accreditation must for hospitals in State Insurance Scheme

Source: The Hindu

In an attempt to establish standards of care for patients and safety in healthcare institutions in Tamil Nadu, the Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS) is contemplating making accreditation mandatory for hospitals seeking empanelment as part of the scheme.

A couple of protocols, pre-accreditation entry-level standards for hospitals and the other for smaller healthcare organisations have already been readied and issued as a circular, besides being hosted on the CMCHIS website.

“The idea is that even if the patients are not paying for the treatment, the government is. It is not charity that the hospitals are doing, and patients need to get the best,” a Health Department official said.

This is seen as the first move to bring both private and public healthcare institutions within the ambit of quality regulation, something that is achieved merely by self-motivation currently.

The standards have been evolved in consultation with the National Accreditation Board for Hospitals (NABH), and are in fact inspired by their entry-level accreditation standards that make it easier for hospitals to imbibe quality control culture.

“Earlier, hospitals which could not afford the process of quality control would just stay away. But, we are now offering them a foot in the door,” K.K. Kalra, CEO, NABH, had told The Hindu earlier.

The CMCHIS staff will first seek to orient hospitals on these standards before beginning the process of pre-accreditation, according to officials.

It is expected that at a certain point, accreditation for a hospital will become a pre-condition for empanelment in the government insurance scheme.

Existing hospitals that do not have accreditation will also be eased into the process, officials said.

United India Insurance, the insurance partner for the State government in this venture, seems equally enthused by this move.

Asha Nair, director and general manager, United India Insurance, said, “I would be very happy if this can be implemented. It means we are ensuring a minimum quality of service for all healthcare consumers across the board.”

The ideal would be to make it qualifying criteria for new hospitals that apply for empanelment.

Hospitals that have already been empanelled can be given time and a deadline to get accreditation, she said.

Tamilnadu mulls accreditation for hospitals offering health insurance

Source: The Hindu Business Line

Tamil Nadu plans to get hospitals offering healthcare services under the State-sponsored health insurance accredited for quality. The move is expected to help healthcare providers adopt standard operating procedures and free patients from needless expenditure necessitated by infection, wrong diagnosis and surgical errors.

The National Accreditation Board For Hospitals and Healthcare Providers will look at 149 objective parameters for entry-level acceptance for small hospitals. For hospitals with bed strength above 50, the board has set over 600 standards. Infection control, pharmacy management, care of patients and patient rights are among key benchmarks. Health centres need pay Rs.10,000 as certification fees, and State health officials are keen to get a good portion of the 834 government and private hospitals offering the insurance scheme.

J Radhakrishnan, Tamil Nadu Health Secretary, said smaller health centres should play a proactive role in getting their facilities accredited so that the scheme could expand further.

C Vijayabaskar, Health Minister, Tamil Nadu, said a meeting to discuss modalities of getting these hospitals accredited and estimate the associated expenditure will take place soon.

He added that the State health scheme has touched over seven lakh lives so far, spending close to Rs.1,509 crore since its inception in January 2012. Over 2.74 lakh patients have received life-saving surgeries at Government hospitals. The scheme has expanded its coverage to 1,016 diseases now, and is looking at including heart transplants.

Improved quality reduces large needless costs for all stakeholders – the insurer, the hospital and the State, said Somil Nagpal, a World Bank health specialist analysing Government health schemes in the country. He co-authored a report “Government-sponsored Health Insurance in India-Are you Covered?” It concluded saying a fourth of India’s population by 2010 was benefited by different ways from Government health schemes.

“Costs of excessive healthcare due to wrong diagnoses and mistakes during surgeries touched $41.5 billion in 2006, a number equal to total healthcare expenditure in India during the year,” he said, adding that the NABH has only 250 hospitals accredited in a country of over one lakh health centres.