- What is NABH?
National Accreditation Board for Hospitals and Healthcare Providers (NABH) is a constituent board of Quality Council of India, set up to establish and operation accreditation program for healthcare organizations. NABH is structured to cater too much desired needs of the consumers and to set benchmarks for progress of health industry.
- What are the benefits of NABH?
NABH is Public Recognition of achievement of accreditation standard by a healthcare Organization, Demonstrated through an independent external peer assessment of that organizations level of performance in relation to the NABH standards.
Though NABH is integral part of Healthcare service providers as it’s pre-requisite to get empanelled for various government facilities and insurance facility, as it provides access to reliable and certified information on facility. The Insurance Regulatory and Development Authority of India (IRDA) have directed healthcare providers offering cashless services for allopathic treatment to meet National Accreditation Board for Hospitals (NABH)’s pre-accreditation entry level standards.
NABH Accreditation benefits all stake holders, Patients are the biggest beneficiary, it ensures high quality of care, along with that it also emphasize over safety of caregivers. It stimulates continuous quality improvement to a health care organization. With all that safety measures NABH also be helpful in competitive advantage.
- What is Entry Level NABH:
NABH and QCI jointly released Pre-accreditation Entry Level Certification Standards after healthcare organization, especially small hospitals, as they found full Accreditation standards highly challenging to start with in both way financially and space constraints. It standards has lesser requirements in comparison to full accreditation.
- How to Design an NABH Compliant Hospital?
Upcoming hospitals and healthcare organization need to develop hospital in such a way that are compliant with the NABH standards, though infrastructure wise But NABH Complies with the laws of land. Usually Indian Hospital designer follows the NBC (National Building Code of India) It serves as a Model Code for adoption by all agencies involved in building construction works. The Code mainly contains administrative regulations, development control rules and general building requirements; fire safety requirements; stipulations regarding materials, structural design and construction (including safety); building and plumbing services; approach to sustainability; and asset and facility management.
Apart from that Operation theatre and CSSD must have Suitable location and layout which leads unidirectional flow and zoning. Sufficient space need to plan to ensure that the activities can be performed properly. HISI (Hospital Infection Society India) and HTM Guidelines are usefull. stp
- How to get NABH Design Compliance for Existing old set ups?
For Existing hospitals it is quite challenging to meet with all standers especially in structural requirements stipulated by NABH in their running set up. Existing hospital may required some design changes to fulfill minimum requirement in order to provide quality healthcare services for both patient as well as staff. Most of the old hospitals get non compliances in total floor area per bad requirement, Clean & dirty doors separation.
Realizing that smaller players find it tough to stick some of its size norms, NABH has eased its stipulation for OT rooms. “In all fairness, not all surgeries really called for the erstwhile minimum 400 sq ft. However, they still insist on engineering standards for OTs that often doesn’t add up” NABH not only focuses setting up quality in healthcare setups but also in operational way too.
Imaging services shall have adequate space and equipment to meet its defined scope of services which shall include Physical space, MEP requirements. AERB guidelines could be used as a reference document for radiation based imaging.
Timely repair of civil structure like walls, servicing of furniture must be carried out.
- Any Specific Reuirement for Medical equipement & fixtures installation ?
For Medical Gases it is advised to refer HTM 02-01 or NFPA’s Medical Gas and Vaccum system installation Handbook. Appropriate safety measures like alarm unit valve boxes at various location and 24×7 monitoring of plant alarm unit to control gas pressure.
Standby equipment and supplies facilities must be available in all critical areas.
Alternative source for electricity and water are provided as backup for any failure/shortage.
It is preferable that separate Civil, Electrical, Plumbing HVAC, and piped medical gas drawings are maintained.
Equipments are inventoried and proper logs must be maintained.
- In what time period a new hospital can get Accreditation?
Accreditation totally depends on compliances with set standards by NABH, though it focuses more over operational compliances a new hospital can apply after 6 month of its operation, after that all its depend over organizational compliances with the stands, but generally it takes 6 to 8 month to get acreditated. Compliances probability can be increase by following standards from starting of hospital with staff training.
- What are main challenges faced by organization in accreditation process?
The main challenge in our industry is getting and retaining medical expertise. India has a scarcity of specialized and super-specialized doctors. New hospitals coming up make retaining doctors more difficult as they offer attractive packages due to which doctors switch hospitals once in every 2 to 3 years. While in case of nursing and paramedical staff their attrition rate is very high, due to which during whole training module staff remains changing. New staff who haven’t attended previous module need to get trained again, in this situation for a consultant continuous online trainings may helpful and same time here responsibility of HR department increases in both way to retain trained staff as well as to scheduling properly.
As large number of hospitals face challenges and difficulties in implementing all the Accreditation Standards, NABH developed pre-accreditation entry level certification standards, in consultation with various stake holders in the country, as a stepping stone for enhancing the quality of patient care and safety.
The aim is to introduce quality and accreditation to the hospitals as their first step towards awareness and capacity building.
Once pre accreditation entry level certification is achieved, the hospitals can then prepare and move to the next stage – progressive level and finally to full accreditation status. This methodology provides a step by step and staged approach, which is practical for the hospitals.
- What are the key areas to emphasize for designing a NABH Compliant Hospital?
- Infrastructure for fire emergencies like fire water tank, fire alarm, fire exit route.
- Patient safety alarms, fall prevention measures for elders, anti-skid tiles, grab bars, ramps with railings for disabled.
- Accessible bathrooms for physically challenged.
- Central waste collection area.
- Proper zoning in OT’s and CSSD.
- An ambulance should have a demarcated space/parking area. It should also have stock of medicines and necessary equipments.