Dr B K Rana was one of the original founders of the National Accreditation Board for Hospitals (NABH) in 2005 and was associated with the organization till 2017. Then he set up an independent centre known as Quality and Accreditation Institute (QAI). Here he talks about his experiences in leading the quality movement in India. Excerpts from the interview:
The number of hospitals accredited with NABH is still relatively small. What could be the reason for that?
The scheme of accreditation of hospitals is voluntary even now, because of which there is hardly any incentive for hospital managements to make the effort. Some improvement has resulted after CGHS started offering financial incentives for hospitals to obtain accreditation. That too happened after NABH was recognized by ISQua (International Society for Quality). Government regulations were then altered to allow higher reimbursement rates for hospitals accredited with any organization recognized by ISQua. I was also given a position on the ISQua Board, first as the NABH representative, and later in 2017 as an individual. This was an elected position for me as an individual, for by that time I had resigned from NABH and started QAI.
What role does QAI play?
QAI has just completed two years and thus its role is expanding step by step. We started with accreditation of IVF centres and then pathology laboratories. It will thus function as a parallel body with NABL (National Accreditation Board for Laboratories), which actually precedes NABH by nearly two decades! We can now offer our own accreditation service because the union government rules allow any organization recognized by ISQua to offer these services.
In which other areas of healthcare does QAI function?
We have developed quality standards that are specific for Veterinary Health, Home Healthcare, Dialysis Centres and even Green Hospitals, that is environment-friendly hospitals. The last one is being implemented in partnership with HELP, a body affiliated with PHFI (Public Health Foundation of India). Besides, our standard for Dialysis Centres is also recognized by ISQua.
What is the significance of the IRDA mandate regarding cashless health insurance?
Some time ago, the IRDA (Insurance Regulatory and Development Authority) issued a notification that all hospitals which have at least an entry-level certification from NABH could offer cashless health services to their clients. Soon afterwards, it modified the rules to say that any healthcare quality organization that was recognized by ISQua could offer such facilities. Now, even the NHSRC (National Health Systems Resource Centre) has published its quality standards for various forms of healthcare services. Thus, the NABH monopoly on accreditation is slowly being diluted.
How has your experience been till now in the Healthcare Quality movement in India?
It has been a mixed bag with relatively few hospitals opting for accreditation, except those targeting the medical tourism market. But they prefer to go for JCI rather than the Indian accreditation bodies. No doubt, there has been some improvement in the quality of health services but we still have a long way to go. Perhaps, it is now time to start measuring the performance of accredited hospitals as per the quality parameters.