What is the cost of NABH Accreditation for a hospital?

During a conversation with a hospital administrator friend of mine, I was posed with this question by him – “Apart from a consultant’s fee, am I supposed to incur any other cost to get an NABH accreditation for my hospital”?

This was indeed an interesting and thought-provoking question. This question has relevance to all the hospitals undergoing and planning for accreditation in the future.

As per my understanding, there are two kinds of cost involved in accreditation. One is the ‘cost of compliance’ (CoC) and the second is the ‘cost of the accreditation program’ (CoAP). When a hospital decides to go for an NABH accreditation, one of the first things they can do is conduct a self-assessment using the freely available self-assessment toolkit on NABH’s website. You can find the same here:

http://www.nabh.co/main/hospitals/documents.asp

The self-assessment will tell you the gap between your current processes & infrastructure and the NABH-compliant processes & infrastructure. To close this gap, you may need to invest in equipments, OT infra, personnel, signboards, civil structures, renovation, statutory compliances, safety devices, IT systems, trainings, printing information material and a few other things. So this CoC depends on the gap and will vary from one hospital to another. It can fairly be assumed that CoC for a newly setup hospital will be relatively lesser than an existing old hospital (say 10 or more years old).

Some of these components of the CoC can be recurrent in nature, for example the cost of training. Since healthcare is prone to severe attrition, the new hires would need to be trained on documented policies and procedures apart from the regular technical trainings.

The CoAP is a onetime expenditure that a hospital has to incur. If you are hiring a consultant organization to help you in your accreditation program, then you have to pay for their fee, travel and stay of their consultants. Apart from these, you may like to invest in some internal marketing where you develop promotional material to inform the staff about the new changes happening in the hospital processes because of NABH implementation, motivational messages or even other kinds of reminder signages. You might also be giving them educational materials or handy notes. Some hospitals also create incentive programs in which those employees who champion the accreditation program are incentivized financially. One another expenditure which is often overlooked is the fee to be paid to NABH for the accreditation. It has following components:

1. The Application fee and Annual fee for accreditation may vary between 1.25 to 2.5 lakhs per annum depending on the bed capacity of the hospital, as provided on NABH website.
2. There is also a one-time application fee that varies between 30 to 70 thousands depending on the bed capacity of the hospital, as provided on NABH website.
3. The hospital also has to bear the cost of travel and boarding/lodging of NABH assessors when they visit your facility.

You can find information on these costs in the NABH Application form here: http://www.nabh.co/main/hospitals/ApplicationForm.asp

NABH accreditation is based on the sound principles of patient safety and quality of care. Whatever be the cost, these principles can never be compromised. If we cut corners and try to save money using unethical ways, we end up reducing the quality of our care and putting the lives of our patients in danger.

After this discussion, my administrator friend started having second thoughts about NABH accreditation. I told him only one thing. India has close to 35-40 thousand hospitals (of all sizes) while only 131 have received NABH accreditation till date. It is a privilege that only a few hospitals enjoy. If you want to be part of the Ivy League, never think twice about the costs. After all, you are investing in quality.