How Does Accreditation Enhance the Quality of Healthcare Organizations and Services?

A healthcare organization may choose to become accredited as part of a voluntary process in which qualified external reviewers assess their performance and compare it to benchmarks that have already been set. In a healthcare system which was constantly changing, significant regulatory revisions happen quickly and regularly. As a result of the accreditation process, the standard for healthcare institutions has been raised significantly, and this has led to ongoing improvements. Here are some of the ways accreditation improves the quality of healthcare organizations and services.

• The business operations of healthcare organizations can be improved through accreditation: Healthcare organizations can profit more than ever by utilizing the enormous worth of accreditation. Many people only associate accreditation with a contract and the survey experience, but with the right partner, accreditation can be the beginning of a business relationship that can help foster performance improvement, operational efficiency, and risk management—all elements of a successful business growth strategy—while upholding regulatory compliance.
• The procedure of accreditation supports a healthcare organization’s performance improvement: Maintaining performance improvement should be the major objective of certification for every healthcare organization. Maintaining all other objectives, including meeting legal obligations, obtaining higher compensation, and enhancing competitive advantage, depends on performance improvement. Many studies have shown that accreditation improves outcomes for several different medical diseases. The practice of accreditation is integrated into daily policies and procedures to enhance the quality of treatment and strengthen the organization by actively incorporating everyone in the company—from administrators and practitioners to facility engineers and human resources—in a culture of growth. The concept of quality improvement is included in all accrediting assessments. The broad issues discussed may have their roots in clinical care and patient safety, but they also serve as the foundation for an organization that performs well. Incorporating specific, quantifiable goals into each service area to establish data-driven, evidence-based protocols is one element, as is fully communicating reports to ensure engagement and establish accountability spanning from frontline staff through the governing body. Other elements include developing a universally applicable program to touch every area of an organization through data collection activities.
• The organization is better equipped for any emergency thanks to accreditation: Healthcare organizations that have taken part in the accreditation process are improving quality. Accreditation has also had an impact on the creation of policies, programs, and goals by mandating NABH awareness training, requesting infrastructure improvements, and altering the organization’s behaviour and practices. It has improved the ability to handle any situation, whether internal or external while continuing to deliver safer treatment and top-notch services. These organizations are more likely to have emergency preparedness strategies and already have policies for best practices to protect rights and the public’s health in place.
• Control Measures are supported by accreditation: Maintaining performance improvement should be the major objective of gaining accreditation for any healthcare institution, including group practice clinics, corporate entities, and hospital systems. Infection Prevention and Control (IPC) Programs are well-organized in accredited organizations. These groups provide a stronger ability to improve their disaster management strategies and are better able to handle various circumstances (from triage to inpatient).
• Efficient Communication among the staff is enhanced through accreditation: These organizations have comprehensive policies and procedures that make use of standards and enable fast and precise decision-making and reliable communication. Employees have received IPC, functional safety, risk management, protocols, and protocol adoption training. The accredited organization has receptive committees that frequently bring personnel together to obtain critical information and monitor and improve procedures. Hospitals that have earned accreditation are more inclined to strengthen their ties to professional medical staff associations.
• An enhanced framework and operational excellence are provided by accreditation: Approved businesses comply with an ingrained culture and internal procedures for quality monitoring, including appropriate data collecting, trustworthy performance indicators, and appropriate hospital accreditation documents as well as patient records and clinical data. Accreditation standards provide a framework to assist organizations in creating more effective organizational structures. Healthcare executives should make operational and strategic decisions based on the accreditation process.
• Enhancing Service Quality and Increasing Efficiencies through Accreditation: The quality of care is strongly correlated with accreditation. It has a positive association with the number of clients having mental health therapy and physical assessment, two components of treatment comprehensiveness. Operational effectiveness is essential for success since healthcare businesses have limited operating margins. Administrators and other leaders are tasked with managing and reducing expenditures while complying with a complicated system of federal and state requirements. 

What is the NABH Accreditation Process for Hospitals in India?

The Government of India established the National Accreditation Board for Hospitals and Healthcare Providers (NABH) in 2005 to improve the country’s healthcare quality. The Quality Council of India (QCI) governs this autonomous agency, which is in charge of developing policies and maintaining QCI standards. Some international healthcare standards, such as the Japan Council for Quality in Health Care, the Australian Council on Healthcare Criteria, and the United States National Committee for Quality Assurance, are identical to the NABH accreditation standards.

To minimize medical errors, NABH requires hospitals to follow standardized SOPs (standard operating procedures). Additionally, SOPs enhance healthcare quality, efficiency, waste reduction, and employee happiness. NABH accreditation is only granted to hospitals that follow the SOPs. Let’s take a closer look at NABH and the stages involved in the NABH accreditation process for hospitals.

To get NABH certification, hospital administration must establish an action plan and choose an individual or organization to handle all accreditation-related activities. The steps for qualifying for NABH accreditation are as follows:

1. The hospital seeking accreditation must hire a quality assurance officer who is familiar with the existing system. This assists the officer in identifying flaws and areas for improvement.
2. The officer must have a comprehensive understanding of the NABH accreditation process. 
3. The selected officer must confirm the implementation of higher standards in the hospital. 
4. Before completing the application form, the hospital shall conduct a self-assessment against NABH criteria.

As a result, some of the processes that enable NABH accreditation for hospitals, which is a seven-step processes. The steps for obtaining NABH accreditation in India are as follows:

Step 1: Application Submission to NABH: After following the NABH standards for at least three months, the hospital should apply to NABH using the required application form. The following information is contained in the application form:

1. Self-declaration of terms and conditions described by NABH
2. Self-assessment, as suggested by NABH 
3. Hospital manual/ quality standards as per prescribed NABH standards 
4. Relevant documents to be uploaded with the application

Step 2: Review of Application by NABH: Following the submission of the NABH application, the NABH officers will review the forms as well as any documents. Before issuing accreditation, the department will ask the applicant to explain or correct any anomalies it finds in the form. If the application is appropriate and complete, the department will issue a letter of acknowledgment and a special reference number to the hospital.

Step 3: Pre-Assessment: The NABH department assigns a principal inspector or assessment team to pre-assess the hospital within three months of fee deposition as the next step in the accreditation process. Pre-assessments can be completed on-site, remotely, on a desktop, or in a hybrid format. The following are the same’s objectives: –

1. Evaluate the hospital’s preparation for the final assessment
2. Determine the number of assessors required and the duration of the accreditation process
3. Review the authenticity of NABH documents / SOPs of the hospital
4. Explain the practice to be adopted for the evaluation of the hospital

Step 4: Final Assessment: Within six months of the fee being deposited, the final assessment is completed in an onsite, remote, desktop, or hybrid format. It contains a thorough analysis of all the duties and products the hospital provides. To address any discrepancies or questions identified during the pre-assessment, the prospective hospital must take the appropriate corrective action.

Step 5: Review of Assessment Report: The chief assessor examines the assessment report after the last assessment. The following grading on a scale of 0, 5, and 10 is used to evaluate the assessment report and acknowledged some Conditions for qualifying for NABH accreditation:

1. Compliance with the requirement
2. Partial compliance with the requirement
3. Non-compliance with the requirement

To be eligible for NABH accreditation, an organization must completely comply with all applicable regulatory and legal criteria. No individual standard may include more than one zero, and the average score for each standard cannot be less than five. The ultimate average score for all criteria must be greater than seven and the average score for each chapter cannot be less than seven.

Step 6: Approval and Issue of certification by Accreditation Committee: Within three months after the final evaluation, the accreditation committee approves and issues a certification of accreditation to the hospital if it meets the requirements for NABH accreditation. Also, the NABH accreditation certificate is effective for three years.

Step 7: Reassessment and Surveillance: Upon the announcement of the certificate of accreditation, the NABH team will perform annual surveillance and reassessments for the following three years. At least six months before the NABH accreditation’s validity expires, the hospital must apply for renewal of accreditation.