Saturday, 21 July 2012

Thinking about NABH implementation in your hospital? First observe the aviation industry.

During a recent NABH training session at one of our client hospitals, we got into an interesting discussion which generally happens in most hospitals that are planning to go for the accreditation. The point of discussion was: While one can get all the hospital staff to comply with the various NABH standards and requirements, it is nearly impossible to get all the doctors to follow the standards and protocols. They have such high egos and they do not listen to anyone. If you try and change their ways, either they blast you or they threaten to leave your hospital. It’s a waste to time to talk to them about quality and accreditation.

I have heard this discussion many times. I have been on the other side, been an administrator and heard such tales from one and all. A closer look at ‘Remarks’ in objective elements of many NABH standards will reflect that those elements require participation from doctors too. So whatever be the problem your hospital faces in convincing doctors, NABH wants you to get them to comply. So how should you tackle this issue?

To this group of audience, I gave the example of aviation industry. Most people in the audience had travelled by air and agreed with me that each one of them had to go through the mandatory physical check, baggage check, ticket check and many such little checks before finally boarding the flight. Even when someone was late for the flight and his/her name was being called, nowhere that individual was allowed to skip any of the security checks. And if you forget to carry your tickets or ID at the airport entrance, you won’t be allowed to enter the airport, forget entering the flight.

Even CEOs, bureaucrats and politicians, whatever may be their status, need to go through these checks. The pilots and the flight crew also have to go through checks and all these procedures are followed to ensure safety of everyone during the flight.

So my point is that if aviation industry can follow strict protocols for every human being involved, why can or should the hospitals not follow strict patient and staff safety protocols? The safety risks are much higher in healthcare because of the infection risks which can affect patients, visitors and the healthcare professionals alike.

I think we need to involve doctors in a dialogue without any pre-conceived notions about their willingness to participate in a quality program. If the benefits of engaging in a quality program are clearly understood, everyone, including doctors, would agree to go through the rigorous process of the accreditation and compliance to the standards thereafter. More than anything, conviction, patience and ability to connect with a varied set of healthcare professionals should be the hallmark of a Quality professional. Right outcomes are the by-product of the right approach.

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