What a patient feels about the treating hospital. Why are they not happy with the service offered by this hospital? What is the reason behind the poor service in this hospital? 

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Rationale for this blog post

Many patients express dissatisfaction about the services offered at hospitals. But hospitals do not have control over that. What hospital can control and implement is self regulated policies or adopt to any of the Quality Accreditation practices and with that such dissatisfactions can be minimised. 

Macula Healthcare is analysing this case study and help the hospitals and general public to understand and see the services in a holistic manner. We try to educate both, so that we could create a sense of balance between service providers and seekers.

Note

The feedback was originally posted in Quora and Quora allows to embed the answers in any of the webpages. By placing the feedback in our website, we are not violating any terms and name of the hospital in the feedback is been mentioned by the anonymous user as per Quora.

 

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Reviewer

A review with the name would have carried more weightage than with anonymity. But if the feedback is genuine, hospital should consider it for continuous quality improvement.

Right approach

The feedback has to be given to the hospital management so that they could take some action to prevent repeating such incidents. Expressing in platform like Quora, will not benefit to anyone as the service providers may not even get to see this.

Trending NABH in Indian hospitals

In the recent years, there is a trend among the healthcare service providers to get accredited with NABH. This is a quality accreditation process for Hospitals in India and more and more people are opting services from such accredited hospitals.

Our observations

We drive through the patient’s opinion, so that it will be easier to related to each of those concerns.

  • NABH hospitals are mandated and trained to manage used needles and its segregation to avoid cross infection. This will cover Point 1. 2, 9 and 10.
  • NABH hospitals has right manpower resources. It will make sure their employees do their best and hence practice working time directives as per the law. Some small hospitals in Tier 2 and 3, find it difficult the trained nurse and also manage with available nurses and sometimes due to shortage of nurses, they are requested to work for longer hours. This will cover Point 3
  • General Etiquettes, comes with the principle of nursing. All healthcare service providers should be taught with basic infection control practices that are very generic in nature. These are the must for any healthcare service providers. If this is not met, it shows the ignorance of the staff to maintain basic standards in a hospital environment. This will cover Point 4.
  • Based on the type of hospital, they will create a space for their employees. In general, only doctors will be provided a room for relaxing as they will be working for long hours. Others will have a shift based work and during their shift, they will have enough work and ideally, they will not take rest. This covers Point 5.
  • NABH standards has specific chapter for Patients’ Rights and Education. In this, the hospital will provide all the information pertaining to their condition. A nurse to know all these in general, but NABH make sure that the nurse knows and communicates the same to patients. This will cover point 6 and 11
  • Patients’ comfort goes with their expectations. Few hospitals may have limited facilities and charge accordingly. There is no such mandatory provision of facilities to the patients. 

One thing what was not included in the feedback was the cost of treatment. With that we assume that the patient was comfortable with the fee part.

Challenges in the process of NABH accreditation

In small towns, doctor promoters invest into hospitals that is just sufficient to offer care service. They do wish to offer good nursing or other care service, but lack time to make sure this happens on daily basis. In the process, they will miss out the key service areas and that results to patients dissatisfaction.

There are many hospitals in India where competent doctors venture into hospital business but do not find other professionals to make the care complete & to suffice patients expectations. If such hospital decides to go in for NABH, without doubt, they will not be qualified to apply for the process. But if somehow, they decide to go in for NABH, the have to identify such specialised resources who understand the NABH standards, follow & implement it. It needs special skillset to adopt NABH standards and such resources are relatively costly. Though in long run, NABH is a cost effective initiative, but initially to get the certificate, hospital has to re-engineer itself and spend a lot to get the right resources.

QCI has brought in NABH Entry level accreditation to encourage small and medium size hospital to take an initiative to adopt themselves to Quality standards. But still the acceptance in slow as it needs additions efforts from the team and this is a challenge in hospitals especially in rural area.

There are hardly finger countable NABH accredited Government hospitals in India, because it takes some extra effort and understanding for the employees to adopt themselves to NABH. One can witness the service in Government Hospital without NABH to get to know the difference.