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HEALTHCARE ACCREDITATION

Towards a Better Tomorrow

with

Indian Confederation for Healthcare Accreditation
(ICHA)


Dilemmas in Healthcare today:

Healthcare delivery has been always complex, needing interplay and interdependence of a multitude of factors and providers. However, in the last few decades especially, this complexity has multiplied exponentially. On the one hand are the technological advances requiring greater teamwork, entailing increasing costs, generating specialization and competition. While on the other hand, there are heightened expectations of all - providers as well as users, demographic changes, finance and other resources. The Healthcare 'industry' has come to stay and is the largest industry in the world, growing rapidly.

These challenges appear daunting but are also harbingers of vast opportunities.

India's vast potential is well recognised today due to the largest pool of capable and expert human resources. The National Health Policy 2002 has therefore proclaimed the agenda of making India the Health destination of the world. The economic contribution that this 'industry' can provide to make India a developed nation (Vision 2020) is more than real.

Simultaneously, the 'Industry' is also experiencing greater regulatory pressures and accountability demands that are only natural in such a vast and rapidly changing scenario.

Mechanisms to resolve these dilemmas:

Historically self-regulation has been the best way. But all over the World, it was increasingly recognised and accepted that legislative acts and regulations are a must for orderly functioning and legitimacy. However, they are inherently minimalist and are perceived as 'thrust upon'; something that needs to be 'managed' to 'get-by'. This is evidenced by the fact that acts, regulations and licensing mechanisms have not achieved their objectives fully. On the other hand, accreditation has been highly successful in all the countries where it has been implemented and has grown rapidly. World has recognised, and we experience it in our daily lives, that continuously improving Quality is the cornerstone of success and growth.

What is Accreditation:

Accreditation is the process of evaluating and recognising excellence of healthcare delivery for hospitals, integrated service delivery networks and other such systems, as well as professional activities.

It is a voluntary process of development and education through consultation, participation, professionalization and independent peer review. Accreditation derives its strength from its credibility. In fact it is a participative process of continuous improvement and recognition of excellence is the outcome. Comprehensive accreditation addresses all dimensions of healthcare delivery: Appropriateness, Availability, Continuity Effectiveness, Responsive and Caring with Safety and Risk Minimization and Timeliness.

Thus it is a mechanism to meet the challenges while bestowing all round benefits. All accreditation systems aim for the optimal, which is continually updated and improved by constantly benchmarking the possible and attainable. And this is what makes it so successful.

Why each country needs a separate system:

Even though the technical quality parameters may be similar, the world over, there are differences in local laws, social structure, access mechanisms and resource constraints. This makes it necessary for each country to have a National system. However, regional / piecemeal systems have not been successful. These National systems today integrate and share knowledge through a world body called ISQUA.

The current initiative:

In the light of the above, it was decided through a series of progressive interactive meetings since August 2002, that an autonomous organisation of all stakeholders (primarily providers, users, payers, educators and regulators) be formed with Healthcare providers forming the core of this organisation. Major Healthcare provider professional associations were convinced and came together to form the ICHA.

In view of the purpose of the ICHA and varied nature of stakeholders it was thought best to adopt the legal structure of a Section 25 Company. Section 25 Company is a special purpose not-for-profit organisation that enjoys the advantages and benefits of a "Charitable" organisation. In view of the logistic advantages, it was appreciated that the 'Registered Office' of the ICHA be located in Delhi. While the ICHA shall aim to be economically self-sustaining in the long run, initial development requires funding from various sources.

What has been achieved so far:

You are probably aware of development of "Indian Confederation for Healthcare Accreditation" on the above lines.

Appreciating the current realities and situation, coupled with the learnt experience from world over of development and establishment of Healthcare Accreditation Systems, a participative approach was chosen. It was decided through a series of progressive interactive meetings beginning August 2002, that an autonomous body of all stakeholders (primarily providers, users, payers, educators and regulators) be formed with Healthcare providers forming the core of the body. Major Healthcare provider professional associations were convinced and have come together to form ICHA. In view of the purpose of the body and varied nature of stakeholders it was thought best to adopt the legal structure of a Section 25 Company (a special purpose not-for-profit organisation that enjoys the advantages and benefits of a “Charitable” organisation). In view of the logistic advantages, it was appreciated that the ‘Registered Office’ of the company be located in Delhi.

The National Associations of Physicians (API), Surgeons (ASI), Anaesthetists (ISA), Ophthalmologists (AIOS), Pharmacists (IPA), Hospital administrators (AHA), Hospital Pharmacists (IHPA) were the initial members of ICHA, however, as of now all the major associations of all stakeholders have either joined in, or decided to join. The ICHA register may be seen on the web page for updated details of Associations & Institutions / Individuals / Organizations. While the national associations are the voting members, it is appreciated that work has to be done by individuals for whom a database is being formed. Individual organisations are also being enrolled as affiliates. This structure not only ensures credibility but also encourages apolitical contributions by all stakeholders.

What is required - Methodology:

To ensure credibility and ownership; it is essential that people who actually do the work as a team, develop processes. These are then shared widely through the website for suggestions and consensus. From these guidelines are then evolved the benchmarks which are graded as threshold - desirable - ideal. These shall get continually updated. Through training, participating organisations develop specific protocols that are implemented and self-assessed. Finally this excellence is validated through peer review and recognised through Accreditation award.

The professional associations through their nominees will provide the necessary leadership, sanctity and continued credibility; the huge amount of work involved has to be done by individual experts. For this a database, of interested individuals and individual organisations, is being formed and they are being enrolled as Affiliates of the body, for a nominal and symbolic one-time fee of Rs. 500/- and Rs. 5,000/- respectively. It is also recognised that Quality work can be done only by volunteering but must be honourably compensated and recognised. The Affiliates shall be kept updated periodically of the developments and requested to volunteer to work in the above areas.

To achieve the above it is necessary to create awareness and involve all stakeholders and as many people as possible. For this awareness campaign has begun by addressing various fora viz. Association meetings, journal publications, press and media coverage etc. However, a lot more needs to be done and everybody's contribution and support are solicited to make it truly 'our movement', which is what it is!

Conclusion:

This is a clarion call to join and contribute to this momentous but necessary movement that is our own and is of National importance that shall have Global implications.


Please send your feedback, suggestions, clarifications on any issues to:

Dr. Akhil K. Sangal,
CEO - Indian Confederation for Healthcare Accreditation
[email protected],


or write at:

D II / A - 2496, Netaji Nagar
New Delhi - 110 023 India.
or call:
Tel: 91-11-26884335, 24679272, Mobile: 9811061853.

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