Importance of herd quality in healthcare

COVID has taught us the importance of herd quality in healthcare

Dr. Atul Mohan Kochhar, CEO, NABH reminisces how the body coped with the unprecedented challenge of COVID-19, and the lessons learnt on role of technology and standardization.

When the pandemic struck out of the blue, we were struggling to cope with the sudden surge in patients seeking diagnosis and treatment – from the mildest to the most critical cases. We had to quickly change, adapt and adopt.

Another major lesson was that ours is not one country, but 36 countries rolled into one. We are a united federal structure with a big & diverse population in several aspects. That makes healthcare delivery all the more complex, especially in situations like COVID-19.

India had already showed the world that it could leapfrog in technology and execution. We witnessed this with the UIDAI or Aadhaar card. And amidst this pandemic, we have seen India seamlessly deliver 200 crores plus dosages seamlessly, ensuring a 100 crore-plus fully vaccinated population.

This showed that technology was the only answer to our health infrastructure deficiencies–lack of doctors, beds, critical care, etc. Like every other organization, NABH decided that we have to put all hands on deck, using the already available technology for all our stakeholders.

For example, we provide accreditation certificate and empanelment services to about 14,000 hospitals currently and counting. These certifications or accreditation also come with a co-linked incentive provided by IRDA. We deployed available technology – Microsoft Teams, Zoom etc. to continue with patient safety initiatives. We started conducting all assessments online and with well-defined policies. Hospitals also stepped up and cooperated.

It was also observed that whichever hospital followed SOPs – whether big or small, whether NABH or JCI, performed better. They could limit morbidity of patients as well as staff. Suddenly the very basic tenets of patient safety and quality in health care, such as hand hygiene, surgical safety checklist, mock drills of donning and doffing of PPE, how to wear a mask correctly, became very important. Hospitals already in compliance performed better, even as guidelines were constantly changing.

So that is a very strong case to institute SOPs in every domain of healthcare, whether they go for NABH certificate or not. The basic framework of patient safety revolves around having process centered care not person specific care.

One more important learning was that we cannot be complacent anymore as new challenges keep coming up. We cannot get away by creating islands of excellence. It is necessary to empower our tier 2/3/4/5 setups. Otherwise, we are as weak as the weakest link in the chain. India needs to create a culture of quality, which I would like to label as herd quality down to every nook and corner of our big and diverse country.

Furthermore, we run a very robust AYUSH program. This pandemic showed us that there is no absolute right. Even the most developed countries had some of the worst-case fatality rates. We all have to reinvent and rethink. AYUSH therapies were already there for 5,000 years, and are now looking extremely promising in ensuring holistic healthcare. But now we realize the importance of developing these traditional practices in a very structured way with accreditation, so they are accepted more in Western countries.

NABH is also very committed to empower our stakeholders through Digital Health initiatives. For this, it has joined hands with National Health Authority (NHA) to accredit and rate the Ayushman Bharat Digital Mission (ABDM) integrated healthcare solutions (public and private) on various parameters. This initiative will help citizens get better and more timely healthcare and help India become one of the leaders in digitization of healthcare in the world.

India has already become a leading and attractive destination for medical tourism. As the Government is emphasizing on both Heal in India and Heal by India, NABH has collaborated with Ministry of Health & Family Welfare (MoHFW) for “Heal in India” initiative. This is to promote international medical tourism and cater to more patients for their treatments in India. The government is making a portal, where all big hospitals, especially the NABH Accredited Hospitals and Medical Value Travel Facilitator (MVTF) Empanelled providers will find space and will be registered.

NABH has given the country national standards or desh ka standard, and these are totally Atma Nirbhar. We must take them to every PHC, CHC and district hospital. Only then can we fulfil the idea of a healthy India, because India is at the forefront of Heal in India, Heal by India. NABH is dedicated to its mission to take quality to the last man in the line, and create a holistic ecosystem of quality in healthcare.