Understanding the Cost of Compliance to NABH standards

As an NABH consultant, one of the challenges I face everyday is the hospital management's attitude towards compliance cost. The general feel I get from the clients is that once they pay the fee of their NABH consultant, they feel assured of getting the accreditation without incurring any other cost.

I write this post specifically to educate my colleagues who are in healthcare quality about the importance of estimating the cost of compliance.

There are many kinds of cost you would come across while implementing NABH standards. While many of these may seem basic, but the fact is that generally hospitals cut corners in many areas to keep their costs low and keep themselves profitable. Once the same hospital decides to go for accreditation, all such costs come to surface.

Think about some of these:

1. The increase in usage of gloves for infection control.
2. The need for fire extinguishers for compliance to fire safety norms.
3. The renovation needed in OT as per NABH guidelines.
4. The expenditure on patient education material and posters.
5. Printing of new forms, thereby leading to the dumping of inventory of all older forms.
6. The amount of stationery required for data collection for computation of performance indicators.
7. The expected reduction in the numbers of beds because of existing cramped up spaces.
8. The loss of clinicians’ time in treating patients because of their involvement in conducting clinical audits, in meetings for analyzing the data and in strategy meets for improving quality of care.
9. The additional HR professionals required to create and run an NABH-mandated recruitment and appraisal system.
10. The need for setting up a proper medical records department which will finally lead to an investment in an EMR.
11. The number of AMCs a hospital has to roll out to cover preventive maintenance of electrical and medical equipments.
12. The salaries for full-time quality professionals.

I can go on and on in identifying these costs which invariably a hospital has to incur to achieve compliance. But unfortunately most hospital managements overlook these costs or we quality professionals are not able to communicate the need for budgeting these expenses to the management.

I think there is a dire need for us to develop models to estimate this cost of compliance when we start any accreditation program otherwise managements lose their interest in accreditation mid-implementation because they are not ready to or they are not able to afford these costs. We can drastically improve the success rate of accreditation programs if we can help managements budget these expenditures pragmatically and not lose time and interest in the quality implementation programs.