Gaps in the National Accreditation Standards

As a way to communicate the quality of care, hospitals in India can voluntarily obtain accreditation, granted by the National Accreditation Board for Hospitals and Healthcare (NABH). Currently, the standards mandated by NABH are the same across all specialties. This paper analyzes whether the quality standards required by NABH are appropriate for eye care, given the high demand for such services coupled with the inadequate infrastructure and incomes in the country. After a review of the various standards required by NABH and learning more about the processes at Aravind Eye Care System (AECS), we have identified a few specific ones that AECS finds onerous. Based on our analysis it seems that these standards while important for other specialties may not be critical for eye care. However mandating those standards for eye care would increase the cost of the care without any significant impact on the outcomes. It may also lead to fewer patients being serviced, which is detrimental for a county like India, given the low level of health care infrastructure and delivery. The AECS approach seems to be more holistic when one factors in the equity of care. It seems that NABH in discussion with AECS could arrive at optimum set of requirements for eye care that would be easy to implement, remove inefficiencies, lower the costs while improving quality and also cater to a larger number of patients. This is a win-win outcome that our research has identified which may be applicable to other specialties also.