1 PRESENT STATUS OF AYURVEDA Grey areas: Lack of effort to - - PDF document

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NABH Accreditation for AYUSH system of medical practices in meeting the challenges of 21st century.

• Dr. NIRANJANA MURTHY. M.D.(Ayu.)

M.D.- PENTACARE AYURPHARMA, Bangalore.

Sincere thanks to

• Dr. Vikram Kashyap, Neurosurgeon,

Bangalore

• Dr. Malati, Manipal Hospital, Bangalore.

Dr.Bhawna Gulati, Asst. Director, NABH.

AYUSH

Ayurveda, Yoga, Unani, Sidda & Homeopathy.

Roots of Ayurveda:

From sages with intuition, meticulous observation of rich bio- diversity & compassion for human life.

Detailed, documented & scientific system evolved. (Eight branches with detailed description of Dosha, Dhatu, Malas, Agni, Ama, Srotas, Drugs, Preventive & Curative medical care etc.) Part of Vedic tradition & sub-branch of Atharvaveda.

“It is only for the sake of Dharma & not for fulfilling personal desires & lusts that the science of Ayurveda was brought to the light by sages”

Charaka, Sutra, 1st Chapter.

PATIENT CENTRIC MEDICAL SYSTEM Medical success = Physician, Drug, Nurse & Patient

Good physician: Ref.: Charaka, Su, 29-6,7 & 8.

Well read, good practical experience, skillful, pure, whose medical prescriptions & surgical operations are infallible, with healthy sense

• rgans & character, with excellent knowledge of anatomy,

physiology, pathology, signs & symptoms, good prognostic knowledge, in-depth knowledge of pharmaceutics ………..

Source of Medicines:

It should be examined with respect to Nature, qualities, specific action, place of growth, season of collection, mode of collection, method of preservation, method of processing, dosage in which employed, its curative strength in various patients for the same disorder ……………. Strict regulatory procedures led to quackery Quacks: Like thorns they torture people ………….and are traitors and they may thrive due to lack of vigilance on the part of the rulers.

Department of AYUSH :

• Research councils [4]
• Central Council for Research in Ayurveda and Siddha (CCRAS)
• Central Council for Research in Unani Medicine (CCRUM)
• Central Council for Research in Homoeopathy (CCRH)
• Central Council for Research in Yoga and Naturopathy (CCRYN)
• National Institutes (Education in Indian Medicine)[5]:
• National Institute of Ayurveda, Jaipur (NIA)
• National Institute of Siddha, Chennai (NIS)
• National Institute of Homoeopathy, Kolkata (NIH)
• National Institute of Naturopathy, Pune (NIN)
• National Institute of Unani Medicine, Bangalore (NIUM)
• Institute of Post Graduate Teaching and Research in Ayurveda, Jamnagar, Gujarat (IPGTR)
• Rashtriya Ayurveda Vidyapeeth, New Delhi (RAV)
• Morarji Desai National Institute of Yoga, New Delhi (MDNIY)
• Indian Medicine Pharmaceutical Corporation Limited (IMPCL), Mohan, Uttaranchal (a public sector

undertaking)

• Professional councils
• Central Council of Homoeopathy (CCH)
• Central Council of Indian Medicine (CCIM)
• Pharmacopoeia Commission
• Indian Pharmacopoeia Commission
• Pharmacopoeia Commission for Indian System of Medicine
• Traditional Knowledge Digital Library (TKDL)

PRESENT STATUS OF AYURVEDA

Bright areas:

Renewed interest among young practitioners in the

private sector.

Great demand for quality medicines and therapy across

the globe.

Safe & effective management of chronic & life style

disorders.

Unique methods of medical management with equal

emphasis on internal cleansing & preventive care.

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PRESENT STATUS OF AYURVEDA Grey areas:

Lack of effort to understand & apply the true

spirit behind the time tested science.

Majority public still unaware of the relevance of Ayurveda

for their health care.

Lack of confidence in the youngsters to invest in clinical

• establishments. due to scarcity of role models.

Much of the activities are confined to government

institutions & negligible support for upcoming young physicians.

Present Challenges Present Challenges

Re-establish the glory of patient centric approach as taught by Acharyas

like Charaka, Sushruta, Vagbhata & others.

To bridge the wide gulf between quality of medical care the community

expects & deserves and what AYUSH actually delivering.

To establish AYUSH centers which ensures critical patient benefits;

primarily

• 1. efficacy,
• 2. informed care,
• 3. safety.

To galvanize the preparedness of AYUSH systems to meet the demand

• f surging affluent class seeking alternative medical care in the era of

internet & pro-active communication media.

Who will bell the cat ????

Is there any certification body, with no commercial

interest & who accredits purely on merit ?

Is there any system to validate the claims made by an AYUSH center

in order to safeguard the interest of patients ?

Is there any organization with well qualified & well groomed medical

professionals as assessors ?

Is there any organization which defines & validates different aspects

• f HCO ?

Is there any organization whose stamp of approval is recognized &

respected across the globe ?

Is there any organization which believes that the

quality system is quite adoptable even by AYUSH systems & is making sincere effort for the same ?

Quality Council of India

National Accreditation Board for Certification Bodies (NABCB) National Board for Quality Promotion (NBQP) National Accreditation Board for Testing and Calibration Laboratories (NABL) National Accreditation Board for Education & Training (NABET) Quality Information and Enquiry Service National Accreditation Board for Hospitals & Health Care Providers (NABH)

Overview of STANDARDS for HOSPITALS

Requirements that define a patient’s expectation with respect to

• Structures
• Processes
• Outcomes

that must be substantially in place to improve safety and quality

• f patient care

10 Chapters , 98 Standards & 489 Objective elements

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N A B H Stds 1.Structural Standards 2.Clinical Standards 3.Managerial Standards Structural Standards

Basic structure of the hospital Resources required Equipment Manpower Space

Patient-Centred Standards

1.

Access, Assessment & Continuity of Care-AAC

2.

Care of patients-COP

3.

Management of medication-MOM

4.

Patient (& Family) rights & education-PRE

5.

Hospital Infection Control-HIC

Management Centred Stds.

1.

Continuous Quality Improvement -CQI

2.

Responsibilities of Management-ROM

3.

Facility Management & Safety -FMS

4.

Human Resources Management -HRM

5.

Information Management System (Medical records, Statistics) -IMS

WHY N A B H Std ?

Applicable to all Hospitals in India, regardless of system. Creates common minimum standards across the system

to provide unified & std. care of pts.

Periodic surveillance & monitoring. Brings in discipline & ensures documentation. Specific AYUSH standards. Clinically oriented & practical. Ensures patient safety and quality of care. Evidence based medicine. Makes the system legally compliant.

Benefits of NABH accreditation to PATIENTS

Pts are the primary beneficiaries. High quality care and patient safety. Pts cared through credentialed staff. Rights of patient; respected & protected. Pts satisfaction; regularly evaluated.

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Benefits of NABH accreditation to AYUSH centers.

Stimulates continuous improvement. Enables to demonstrate commitment to quality service,

cleanliness, pt friendly approach.

It raises the community confidence on the organization thro

transparency & professional management.

Accreditation serves as an assurance of quality service from a

reliable, safe & quality conscious organization.

It provides opportunity to benchmark with the best & enhances

the respectability & trust.

It positions the organization in the global league of quality

medical establishments.

NABH accreditation benefits to STAFF

Provides opportunity for continuous learning. Good environment. Leadership & ownership of service processes. Improves the overall professional development of the

staff.

Provides leadership for quality improvement in various

techniques.

NABH accreditation benefits to PURCHASING CORPORATE

Provides an objective system of empanelment by third

parties like insurance services, Corporate etc.

Accreditation provides access to reliable and certified

information on facilities, infrastructure and level of care.

Challenges to NABH

To enroll 2000 odd AYUSH centers to follow & adopt new “documented &

system driven” approach.

Immediate benefits of accreditation is not seen. Large number of established private hospitals are family driven (>90%) and

are vary to adopt the new system.

• “Establishment & running cost” of accreditation is high compare to returns,

as on today, in the context of small and upcoming hospitals.

Urgent need to rework to include “day care centers” which are much

prevalent.

• COP & MOM are two very sticky wickets. Diversity – place to place, region, individual.

Lack of protocol to comply text based medical management. Diversity in medicines & medications. Unpredictable quality of medicines & lack of transparency in disclosure

TAKE HOME MESSAGE

The new chapter on quality care has begun. NABH has taken up, what Acharyas emphasized 2000 years before:

High standard, ethical, transparent & service centric medical practice.

Creates validated & structured approach in AYUSH systems Accreditation process documented medical practice

Clears the myth that Ayurveda is “not-evidence based” Motivates young graduates & PG’s to reinvent & reorient Motivating factor for students with caliber to take up the science.

thank you thank you