Quality Assurance

//Quality Assurance

State Quality Assurance Wing - Department of Homoeopathy

State Quality Assurance Wing – Department of Homoeopathy

Quality of healthcare service delivery is pivotal to the development of our nation as the quality movement gains momentum across the globe. Patient safety concerns, effective as well as efficient healthcare delivery and affordability of services are key enables at this juncture. Poor quality of services in health sector will not only lead to dissatisfaction of patients but will also result in alarming outcomes. Ensuring the quality of services being provided in Government run healthcare machinery can be really challenging, given the constraints in terms of resource crunch. Optimum utilization of available resources to reach maximum efficiency will serve as the guiding principle. Strategic plans have to be devised to impede the cascading of change management waves to the field level.

The State Quality Assurance wing of the Department of Homoeopathy, Government of Kerala is committed to support and facilitate a sustainable Quality Assurance Programme with the main focus on bringing delights in the minds of patients who are the ultimate end users. Controlled documentation, hassle free implementation & transparent social auditing will become the cornerstones of this process.

Timeline

The National Rural Health Mission (NRHM) launched in 2005, which was operational in the state from 2009 onwards paved the foundation for quality improvement activities. With the advent of two parallel running missions viz, National Health Mission (NHM), launched in 2013 & National AYUSH Mission (NAM) in the subsequent year (2014), the quality movement gained momentum in each of the respective departments of Health & AYUSH. State Programme Management Unit was established in Kerala to hasten & monitor the implementation of erstwhile centrally sponsored schemes in mission mode. The minimum requirements of AYUSH infrastructure at par with Indian Public Health Standards (IPHS) were annexed in the operational guidelines of NAM.

The National Accreditation Board for Hospitals & Healthcare providers (NABH), autonomous body constituted under the Quality Council of India (QCI) has already rolled out separate Accreditation Standards for Hospitals under each system of AYUSH (Ayurveda, Yoga-Naturopathy, Unani, Siddha & Homoeopathy). The first edition of the standards was published in 2009 & the second edition in 2016.

As a handholding exercise in the success journey towards national & international benchmarks of excellence, Government of Kerala framed the Kerala Accreditation Standards for Healthcare (AYUSH) in 2014.

Ministry of AYUSH, GoI had issued directions to all AYUSH Educational Institutions to complete the process of NABH Accreditation to their hospitals within one year & NAAC Accreditation to their colleges within two years. To comply with the deadline, the preparation for accreditation process has to be initiated on war footing in the Government Ayurveda & Homoeopathic Medical Colleges.

Insurance Regulatory Authority of India (IRDA) vide the Modified Guidelines on Standards and Benchmarks for hospitals in the provider network dated 27th July 2018 had notified that all the existing Healthcare Providers shall, within twelve months from the date of notification of these modified guidelines, obtain either Pre-entry level Certificate (or higher level of certificate) issued by NABH or State Level Certificate (or higher level of certificate) under National Quality Assurance Standards (NQAS).

Central Council for Research in Yoga & Naturopathy has also made it mandatory that a certificate from the NABH / Inspection report of the council is to be furnished for sanctioning grant-in-aid for the subsequent years under the scheme of providing financial assistance to NGOs for establishing & running Naturopathy & Yoga clinics / hospitals.

Trainings

One day sensitization workshop on NABH Standards for AYUSH Hospitals was conducted in Thiruvananthapuram on 29th November 2017. The programme was attended by almost 200 participants including all DMOs (ISM), all DMOs (Homoeopathy), all Hospital Superintendents / Chief Medical Officers of Ayurveda, Yoga Naturopathy, Siddha & Homoeopathy Hospitals in the state along with Engineering Consultants of NHM & representatives of empanelled construction agencies.

Another one day workshop on sensitization of NABH standards for AYUSH Medical College Hospitals was conducted at Palakkad on 20th December 2018. The programme was attended by almost 70 participants including delegates from Ayurveda Colleges, Siddha & Homoeopathy Medical colleges.
Training of Trainers cum External Auditors were conducted in Thiruvananthapuram (South Zone) from 12th – 14th December 2018 & Kozhikode (North Zone) from 16th – 18th January 2019.

The organisational framework

In order to manage quality assurance activities, the following organisational framework need to be established & strengthened at various levels with the roles and responsibilities defined for each level.

State level
  • State Quality Assurance Committee (SQAC)
  • State Quality Assurance Unit (SQAU)
  • Internal Quality Assessors (IQA)
District level
  • District Quality Assurance Committee (DQAC)
  • District Quality Assurance Unit (DQAU)
Institution level
  • Institutional Quality Assurance Committee (IQAC)
State level Quality Assurance Committee (SQAC)

The broad responsibility of this committee will be to oversee the quality assurance activities across the state in accordance with the national & state’s guidelines, and also ensure regular and accurate reporting of the various key indicators.

Composition

  1. Director (Chairperson)
  2. Dy. Director
  3. Technical Asisstant
  4. State Nodal Officer (Quality Assurance) (Convener):
State Quality Assurance Unit

SQAU is the working arm under SQAC that will be responsible for undertaking various activities as per ToRs of the unit, and other tasks, as entrusted to them from time to time by the SQAC.

Composition

  1. State Nodal Officer (Quality Assurance) (Chairperson)
  2. State Convenor (Seethalayam)
  3. State Convenor (Janani)
  4. State Convenor (Sadgmaya)
  5. State Convenor (AYUSHmanbhava)
  6. State Convenor (Punarjani)
  7. State Convenor (RAECH)
  8. State Convenor (Palliative care)

Accreditation phases & action plan

Planning phase
  1. Policy decision regarding implementation of NABH Accreditation to Government AYUSH Hospitals by Government of Kerala.
  2. Sensitization trainings to all key stakeholders
  3. Design and approval of action plan, timeline & strategy
  4. Financial requirements to be outlined.
Pilot Implementation phase
  1. All Government Ayurveda & Homoeopathic Medical Colleges in Kerala to be selected for implementation.
  2. Two district hospitals each under ISM & Homoeopathy Departments to be identified for implementation.
Full roll out phase
  1. All remaining AYUSH Medical Colleges in Kerala to be selected for implementation.
  2. All remaining Govt. AYUSH Hospitals in Kerala to be selected for implementation.
Surveillance & monitoring phase
  1. Continuous Quality Improvement activities to be co-ordinated.
  2. Other International Quality standards to be pursued.
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