National Accreditation Board for Hospitals & Healthcare Providers(NABH) is a constituent board of Quality Council of India, set up to establish and operate accreditation programme for healthcare organizations. If a patient suffers damage while under care of the accredited hospital, will not NABH be liable along with the hospital?
This is a question which has been troubling me for last few days. One of my relative is admitted in a NABH accredited hospital. She is in Intensive Care Unit(ICU) for last 25 days. During this period I have had lot of personal experience about how a NABH accredited hospital works, and the experience is far from being satisfactory.
I do not know what standards have been set by NABH and how effective is the implementation by the hospital. NABH satndard is not avialble on its website under pro-active declaration under RTI Act. This is a violation of legal rights of citizens. The Parliament of India has set out to provide a practical regime of right to information for citizens to secure access to information under the control of public authorities, in order to promote transparency and accountability in the working of every public authority. NABH standard for hospital accreditation is of particular interest to the public as it is used for providing health care services to the public, particularly disadvantaged communities and those engaged in the pursuit of education and knowledge. This public safety standard should be made available free to promote the timely dissemination of this information in an accurate manner to the public. Members of public can not be expected to buy this standard for Rs. 3000 to know about what quality of health care they should expect in a hospital and what quality of health care they are getting.
I have found many weak links in the implementation of health care system, some of them are:
a) Maintenance of ICU and regular cleaning. It is well known that hospital-acquired infections(HAI) represent the most common adverse event in ICU. Their prevalence is high and they are associated with increased morbidity and mortality. The environment plays a central role in the transmission of hospital-acquired pathogens(HAP) and in the pathogenesis of HAI. Many bacteria, especially multidrug resistant ones, can survive for several months in the hospital environment in particular in areas close to the patients. It has been proven that pathogens are transmitted from the environment to the patients. It is also not known what cleaning methods are being used in this hospital ICU and whether these are microbiologically ineffective.
b) People entering ICU do nor remove their shoes and do not follow any precautions.
c) Timely providing lab reports and their examination by the doctors is highly unsatisfactory. When my relative was in emergency, CT Scan was done but even after two days its report was not avaialble in patient's file and not examined. After seeing the film it was concluded that every thing was OK but when after two days the written report was examined it was discovered that there was a clot in the brain. This is criminal negligence.
d) Above negligence was again repeated when after few days MRI was done and report was not sent for two days.
e) The weakest link is communication between doctors and patient's attendants.
