Saturday, 1 December 2012

Maintaining accreditation is the challenge, not getting it

Recently I was having a discussion with my fellow quality consultant, Parul, about our experiences in NABH implementation and some of the regular challenges we face. One of the things on which we both had the consensus was the fact that the hospitals still have not realized how quality and accreditation impacts them today and tomorrow.

The journey for accreditation begins with the organization and its management affirming its faith and commitment to quality. Quality is a way of life and it requires some difficult choices to be made on how we will do business and how we plan to serve our clients, i.e. patients. Quality demands that the compromises that an organization has been making till date need to be removed. Quality expects each individual to follow highest standards of professional conduct and comply with the established policies and procedures. Compliance with quality requirements ensures the organization also complies with all the statutory and legal requirements. Quality provides the overall framework for organizational operations.

At the time of accreditation, a hospital and its team temporarily gets into an energized state and somehow achieve the compliance. At times they are backed by skilled quality consultants who provide appropriate advice to the management, thereby simplifying the accreditation process. But the real challenge begins after your hospital receives accreditation.

You would start displaying the NABH logo in all your brand communication and you would highlight that you have cracked the tough NABH accreditation in your marketing programs. But if the necessary culture has not been established and your staff is not actually committed to quality, slowly but surely non-compliance will set in. The infatuation with the accreditation will be gone and the hard reality will arrive, i.e. it is extremely difficult to follow the standards if you do not believe in them and that you don’t have the necessary culture to support quality improvement.

The surveillance audit after 18 months from the date of accreditation will be the real test of an organization's ability to sustainably implement and maintain NABH standards.

Let me also bring another reality check here. The standards themselves keep undergoing transformation. The NABH standard for hospitals is in its third edition and other standards are also under revision. In due course of time, the standards will become stricter and the quality processes are expected to mature as the standards mature. Again, if the ownership for quality is missing among the staff, the organization will fall flat in re-accreditation audits.

Therefore, it is advisable that an organization should not hurry into its campaign to achieve accreditation. Rather, it should apply thought on why it needs accreditation and what is its commitment. Is accreditation just for the show, or is it a business decision? Are you committed to upgrade your processes when the standards undergo revision? Do you have the requisite organizational resources to ensure compliance with the standards in the longer run, or are you in only for a short run?

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