AHPI Institute of Healthcare Quality

Quality in Healthcare is still in infancy in our country. This is largely on account that there still is huge gap in demand-supply of healthcare services. We urgently need to build capacity in Indian Healthcare Systems on all fronts i.e. availability, accessibility, affordability and finally the QUALITY. Government has steadily been losing its share in Health spending as corporate sector over past two decades have stepped up the investment by setting up of state of art hospitals. Alongside we have mushrooming growth of smaller hospitals/nursing homes in the private sector. Regulation over the years not being effective, have raised serious doubts in the standards of patient safety norms in the healthcare sector in the country. Consumer in general has neither the information nor the opportunity to choose particular service provider(s), in-spite of the fact that more than 70% expenses are borne out of pocket.We need to educate and empower the consumers, who can understand and demand quality. At the same time we need to enable healthcare providersto implement patient safety norms and strengthen health systemsin general, be it public or the private.

Brief history of Quality in Healthcare

Undoubtedly the first authentic work on quality came through efforts put in by Florence Nightingale, who established link between poor hospital sanitation to high (60%) fatality rate among wounded soldiers during Crimean War of 1854. Later while working as NURSE at Barrack Hospital in Istanbul, she advocated hand washing, sanitizing surgical tools, regularly changing bed linen etc. Abraham Flexner similarly introduced dramatic improvements in Medical Education in year 1910 by way of introduction of "End Result System" in the Hospital Standardization Program. In 1917, American College of Surgeons adopted the End Result System and prescribed minimum standards to inspect hospitals. In 1951, the American College of Surgeons along with American College of Physicians and American Medical Association established Joint Commission on Accreditation, bringing out, first time the quality framework based on Patient Safety and Quality of Care.

Quality in Healthcare is still in infancy in our country. This is largely on account that there still is huge gap in demand-supply of healthcare services. We urgently need to build capacity in Indian Healthcare Systems on all fronts i.e. availability, accessibility, affordability and finally the QUALITY. Government has steadily been losing its share in Health spending as corporate sector over past two decades have stepped up the investment by setting up of state of art hospitals. Alongside we have mushrooming growth of smaller hospitals/nursing homes in the private sector. Regulation over the years not being effective, have raised serious doubts in the standards of patient safety norms in the healthcare sector in the country. Consumer in general has neither the information nor the opportunity to choose particular service provider(s), in-spite of the fact that more than 70% expenses are borne out of pocket.We need to educate and empower the consumers, who can understand and demand quality. At the same time we need to enable healthcare providersto implement patient safety norms and strengthen health systemsin general, be it public or the private.

How Quality is different in Healthcare

Quality in healthcare is different in one way that it is directly linked to patient safety and therefore it plays pivotalrole in saving of human lives. Secondly Quality in healthcare does not come as on-off activity. Provider needs to establish structure, processes and monitor outcomes. Finally Quality in healthcare is result of TEAMWORK by all the categories of staff, be it Physicians/Surgeons,Nursing, Paramedics and Administration/Management. Accordingly there are three domains under which healthcare quality education/training is imparted.

  • Generic

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    Here we cover general principles of quality, starting from historical quality evolution, stages like inspection, quality assurance, total quality management etc., quality management standards including series like ISO 9000, 14000, 18000 and 22000. In this segment we also cover quality tools like 5S, Kaizen, LEAN Health, Six Sigma, Balance Score Card etc.

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    Sector Specific

    Here we look in to framework quality as applicable to Healthcare. This includes certification and accreditation standards like NABH & JCI. These standards virtually cover complete governance of healthcare organization including patient centric and organization based standards. The Patient centric standards will cover care of patients, management of medication, and control on Infection etc. The Organization based standards include leadership, dash board concept to monitor managerial and clinical indicators and their benchmarking, facility management, human resource, hospital information systems etc.

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    Specialty specific

    Here we look in to framework quality as applicable to Healthcare. This includes certification and accreditation standards like NABH & JCI. These standards virtually cover complete governance of healthcare organization including patient centric and organization based standards. The Patient centric standards will cover care of patients, management of medication, and control on Infection etc. The Organization based standards include leadership, dash board concept to monitor managerial and clinical indicators and their benchmarking, facility management, human resource, hospital information systems etc.

Need for a Quality Institute in Healthcare and its scope