Infection control, doctor credentials hold up hospital accreditations

Infection control and checking the credentials and experience of doctors before they begin a medical procedure are the major stumbling blocks to accreditation of hospitals, officials from National Accreditation Board of Hospitals and Healthcare Providers (NABH) said on Thursday.

While verifying the qualification of doctors is easy, hospitals also need to check privileging of doctors, ie to check the experience and the training of the doctor before a medical procedure, said Dr Harish Nadkarni, principal consultant, NABH.

“For example, doctors from an older generation who do endoscopy now need to get training in that kind of surgery,” said Dr Nadkarni. He said that in one of the accredited hospitals, when a senior pediatric cardiologist was out of the city, the hospital sent the case to another hospital instead of letting the junior doctor operate.

“That is what we expect the hospitals to do,” said Dr Nadkarni.
Besides this, infection control is an area where tremendous work needs to be done in hospitals, said officials.  “We check the dilution of the disinfectant chemical used in the hospital and the operation theatre. We also determine if the hospital has an infection committee that reviews the antibiotic policy of the hospital. Not all hospitals have this committee,” said Dr Nadkarni. While the infection level in hospitals is generally about 4%, as per NABH, it should be less than 2%.

Dr Nadkarni and Dr Girdhar Gyani, secretary general of Quality Council of India, were at the Holy Family hospital in Bandra to hand over the accreditation certificate on Thursday. The other four hospitals in the city with NABH accreditation are LH Hiranandani, PD Hinduja, Godrej Memorial Hospital and Holy Spirit hospital. Maharashtra has only six accredited hospitals.

The criteria on which the hospitals are given accreditation are access to patients, display of services, laboratory quality, infection control, care of patients, management of medication and facility management, among others.

NABH also looks at uniform pricing as a criteria for accreditation. “It cannot be left to doctors to fix the price of services. The fee structure should be made available to patients when they are admitted. This cannot be violated,” said Dr Nadkarni.

Surprisingly, only about 20 hospitals in Mumbai have applied for NABH accreditation. “Not many hospitals want to be audited by independent auditors,” remarked Dr Nadkarni.