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Why most clinics are yet to be accredited by NABH?

New Delhi: While browsing through the website of the National Accreditation Board for Hospitals and Healthcare Providers (NABH), one very evidently comes across a sense of generativity that lacks precision. However, upon inspection of the requirements specified to include allopathic clinics, specific documents have to be looked at and kept handy, and these are (evidently) titled ‘documents’ on the home page. These include a general information brochure, standards for accreditation, toolkits and timelines for accreditation. Considering we’re all going digital and minimizing offline manual work, it is quite important to mention right here that it’s not very clearly etched on the NABH website for small allopathic clinics to go about an application for inclusion.

Air Force Central Medical Establishment

Now there are precisely 32 accredited allopathic clinics in India as mentioned on the NABH website, with 17 of them based in Delhi, and a few scattered about in Karnataka, West Bengal and one in Andhra Pradesh. While we also get hopeful looking at the option for Workshops under NABH, the page disappears into oblivion with a “There is currently no workshop for Allopathic Clinics Accreditation Programme.” While one would like to point out the shortcomings that might be obvious to the eye of a third person that isn’t as of now able to realize the stakes held in place, there are advantages of getting NABH accreditation for allopathic clinics, for one, there is a greater supervision of patient care and protection of their rights. NABH gets into the system of functioning in a medical structure, mediating standards of patient care and staff satisfaction.

NABH surely deserves applauds for having a journal that publishes articles on cessation of smoking, the Zika virus and the knowledge of hand sanitation among medical students. The method for accreditation is fairly simple, considering the fact that we might take note of it as a nationalised form of medical accreditation, something that has required vehemence over a lengthy period of time. One has to get the application form from the NABH secretariat in New Delhi or download the same from its website. The duly filled application form has to be submitted with an application fee. Now depending on whether it is a clinic, a polyclinic or a dispensary, one may have to pay either Rs 5,000 or Rs 10,000. Upon survey and recommendation of the Primal Accreditation Committee, one may submit the application with a signed document (that can again, be downloaded from the NABH website), called the ‘Terms and Conditions for Maintaining NABH Accreditation’.

While the research proceeded and glided along, partially hindered by the unexpected ignorance of present facilities, the author came across the verdicts of a few clinics that did have existing standards as under NABH, or the accreditation issued. Some clinics felt that in comparison to the surveillance offered to hospitals, which has extensive categorisations based on the number of beds, is more than that of allopathic clinics. The catch here, is that, hospitals are overcrowded, more often than not. And being a resident of the national capital, there are only a few other criterions I need to meet to qualify for a verdict. So it is understandable that there might be a stricter enforcement of standards, if not important provisions. However, what Dr Ajeet Jaiswal, in-charge of Bapu Dham Allopathic Dispensary at Chanakyapuri in New Delhi, wants to put forth is that he has facilities that can manage the kind of patients that come and the number in which they come. But the surveillance still deserves to be enough, for that is the purpose of putting them up for such facilities on a national scale in the first place.

“We have been accredited by the NABH for the past three and a half years now…it’s almost four years actually. We are satisfied under it. Everything is managed well, and we have around 60 patients coming in each day. Improvement harms no one, so if there were something that I’d like an improvement in, it would be the kind of supervision and its frequency. On an overall, we are pleased with NABH,” Dr Jaiswal told India Medical Times. Other dispensaries and clinics accredited by NABH, which were contacted, are also largely satisfied with the board, like the Wellness Diabetacare in New Delhi (a branch of which exists in Bangalore as well).

What becomes a plausible explanation for the scarce centric distribution of NABH accredited allopathic clinics is the fact that these are gathered around majorly developed cities (Bangalore, Kolkata, Delhi and Ahmedabad). While these dispensaries and clinics have stated and gladly expressed their satisfaction with NABH, we need to keep in mind that these were already equipped and well funded dispensaries. For a clinic tucked away in Rajasthan, of a place that can neither be located on Google Maps nor be pronounced correctly, to go online and register or to find itself knocking at the registrar behind the desk in Delhi, it takes a lot more than convincing. This, practically, may be a major reason why most clinics have not yet been accredited by NABH.

Dr B K Rana, CEO of NABH, told India Medical Times, “Allopathic Clinic should adopt accreditation standards as these are basic standards required for safe care. The process is easy wherein an interested clinic can enter into. NABH conducts awareness programmes to make clinics aware about the standards and process. NABH would be happy to conduct training programme on specific requests as well. We follow a transparent process having two way communication channel between NABH and the clinic.” Considering such cooperation and enthusiasm from the board itself, we can only hope for the better of all, of the diseased and affected to the healer and protector.

by Sriparna Gogoi

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