Accreditation must for hospitals in State Insurance Scheme

Source: The Hindu

In an attempt to establish standards of care for patients and safety in healthcare institutions in Tamil Nadu, the Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS) is contemplating making accreditation mandatory for hospitals seeking empanelment as part of the scheme.

A couple of protocols, pre-accreditation entry-level standards for hospitals and the other for smaller healthcare organisations have already been readied and issued as a circular, besides being hosted on the CMCHIS website.

“The idea is that even if the patients are not paying for the treatment, the government is. It is not charity that the hospitals are doing, and patients need to get the best,” a Health Department official said.

This is seen as the first move to bring both private and public healthcare institutions within the ambit of quality regulation, something that is achieved merely by self-motivation currently.

The standards have been evolved in consultation with the National Accreditation Board for Hospitals (NABH), and are in fact inspired by their entry-level accreditation standards that make it easier for hospitals to imbibe quality control culture.

“Earlier, hospitals which could not afford the process of quality control would just stay away. But, we are now offering them a foot in the door,” K.K. Kalra, CEO, NABH, had told The Hindu earlier.

The CMCHIS staff will first seek to orient hospitals on these standards before beginning the process of pre-accreditation, according to officials.

It is expected that at a certain point, accreditation for a hospital will become a pre-condition for empanelment in the government insurance scheme.

Existing hospitals that do not have accreditation will also be eased into the process, officials said.

United India Insurance, the insurance partner for the State government in this venture, seems equally enthused by this move.

Asha Nair, director and general manager, United India Insurance, said, “I would be very happy if this can be implemented. It means we are ensuring a minimum quality of service for all healthcare consumers across the board.”

The ideal would be to make it qualifying criteria for new hospitals that apply for empanelment.

Hospitals that have already been empanelled can be given time and a deadline to get accreditation, she said.

Draft Minimum Standards for Various Categories of Clinical Establishments

The Clinical Establishments (Registration and Regulation) Act, 2010 has been enacted by the Central Government to provide for registration and regulation of all clinical establishments in the country with a view to prescribing the minimum standards of facilities and services provided by them. The act has already taken effect in 4 States and all Union Territories since 1st March 2012 vide Gazette Notification dated 28th February 2012.

Keeping in view to implement the act across the country the National Council for Clinical Establishments under the Chairmanship of Director General of Health Services, Government of India in consultation with various stakeholders has prepared draft minimum standards for various categories of Clinical Establishments for implementation of the Clinical Establishments Act.

The comments, suggestions, objections, including deletions /additions if required in the draft documents are invited from public at large, including the stakeholders like hospitals and other clinical establishments, consumer groups etc.

The draft standards for various categories of clinical establishments is available and can be downloaded from the link below


The comments may kindly be sent to Dr. Anil Kumar, CMO(AK) Room No.506 ‘D’ Wing, 5th Floor, Nirman Bhawan, New Delhi-110018 at his email- id with in one month of publication of this Notice on the website. A copy of the same may also be endorsed to

The last date for sending the comments is 20/04/2014.

Blood stored for more than 3 weeks may be harmful

Transfusion of donated blood more than three weeks old may result in impaired blood vessel function, a new study of hospital patients has found.


Although blood banks consider six weeks to be the maximum permitted storage time of blood for use in transfusion, but recent studies have suggested transfusing blood stored for more than a few weeks has adverse effects in patients undergoing cardiac surgery or critical care.


The new finding suggests a mechanism explaining why older blood might be detrimental to patient health: a deficiency in nitric oxide, a short-lived chemical messenger that relaxes blood vessels.


In the study, 43 patients at Emory University Hospital were set to receive cross-matched red blood cells for clinical indications.


Members of the group were in hospital for various reasons, such as cancer treatment and surgery. They were randomly chosen to receive either fresh (less than ten days old) or aged (more than three weeks old) red blood cells. On average, they received the equivalent of two units. A unit is 450 millilitres of blood, Science Daily reported.


Robert Neuman, cardiovascular research fellow from the Emory Clinical Cardiovascular Research Institute and his colleagues tested blood vessel function by measuring flow-mediated dilation (FMD).


By ultrasound, they tested how much a blood vessel in the arm opens up after a blood pressure cuff is first tightened then removed. Flow-mediated dilation is an indicator of the health of the endothelial lining of the blood vessels and is a process that is dependent on nitric oxide.


Healthy, younger individuals can have flow-mediated dilation of up to 10 per cent — the average for the hospitalised group was 5 per cent.


Patients receiving aged blood saw their FMD halved to 2.4 per cent 24 hours after the transfusion, while patients receiving fresh blood saw no significant change in FMD.


This effect of older blood on blood vessel function is similar in size to that of eating a fatty meal, or the long-term effects of a cardiovascular disease risk factor such as smoking or diabetes.


Healthy flow-mediated dilation reflects sufficient production of nitric oxide, which is generated by the blood vessels’ endothelial lining and causes them to relax. Nitric oxide is also important for delivery of oxygen by haemoglobin.


Red blood cells carry nitric oxide bound to haemoglobin, and play a critical role in recycling the nitric oxide. Over time in storage, the nitric oxide is lost. Transfused red blood cells last a couple months in the patient. The Emory team did not measure FMD beyond 24 hours.



Source : The Hindu  dt March 11, 2013



Blood banks of Fortis, Escorts get NABH accreditation

March 20, 2009, 0800 IST -Source : ePharmail of For more info, visit

The blood banks at Fortis Hospital Noida (FHN) and Escorts Heart Institute and Research Centre (EHIRC) have been awarded the National Accreditation Board for Hospitals and Healthcare Organizations (NABH) accreditation from the Quality Council of India (QCI). The blood banks at FHN and EHIRC are among the seven NABH accredited blood banks in India. The NABH standards for blood banks provide framework for quality assurance and quality improvement for blood banks. The soul focus of the standards is to maintain high end patient safety measures and quality of the care being provided. The QCI follows a continuous process where regular monitoring and stringent corrective action plan leads to the building of a strong culture at all levels of operations and functions. The standards are applicable to blood banks in the government as well as private sector. “There has been a growing concern on how accessible and safe is ‘Safe Blood’. The Indian government is also laying stress on state-of-the-art blood bank facilities at every hospital either in the private or public sector healthcare centres. To maintain the standards in the quality of blood bank services and safe blood banking, it is desirable that a blood bank is accredited from a national or international governing organization like QCI,” said Dr Narottam Puri, president-medical strategy and quality Fortis Healthcare Limited. “QCI conducted rigorous quality and standard checks for seven months at both the hospitals and after complete the process successfully the accreditation was awarded to both the blood banks. Fortis Healthcare’s team is proud of its transfusion services for providing critical and life saving support to our patients,” he said in a release here.

NABH launches accreditation programme for blood banks, transfusion services

February 24, 2009, 0800 IST -Source : ePharmail of For more info, visit

With a view to ensure quality and safety in blood transfusions which can cause spread of deadly virus in the absence of quality standards, the National Accreditation Board for Hospitals and Health Providers (NABH) has launched an accreditation programme for blood banks, blood centres and transfusion services.

After the agency under the Quality Council of India launched the accreditation programme on January 25, as many as seven centres have been given the certificates while process to accord accreditation for three other applicants are in different stages, NABH sources said.

“The accreditation programme strives to the quality and safety of collecting, processing, testing and transfusion of blood and blood products. The basis for assessment of blood bank includes compliance with the accreditation standard and statutory/regulatory requirements. The accreditation programme assesses the quality and operational systems comprehensively in place with facility, before issuing accreditation certificate,” sources said.

NABH standards for blood banks have been drafted by technical committee of NABH and contain complete set of standards for evaluation of blood banks for grant of accreditation. The standards provide framework for quality assurance and quality improvement for blood banks. The standards focus on patient safety and quality of care. They call for continuous monitoring and comprehensive corrective action plan leading to building of quality culture at all levels and across all the functions. The standards are equally applicable to blood banks in the government as well as in the private sector.

Wockhardt Hospitals Blood Bank, International Hospital Ltd., Department of Transfusion Medicine, Noida, Escorts Heart Institute & Research Centre, New Delhi, Moolchand, New Delhi, Dr Hedgewar Blood Bank, Akola, NTR Memorial blood bank, Hyderabad and Max Blood Bank, Max Heart & Vascular Institute, New Delhi have been given accreditation so far.

Applications have been received from Department of Transfusion Medicine, Fortis Flt Lt Rajan Dhall Hospital, New Delhi, KMC Hospital – Blood Bank, Mangalore and Blood Bank of Max Balaji Hospital, New Delhi. The applications are under different stages of processing.

EQAS for Blood Bank Accreditation

QCI has introduced Proficiency Testing Program/EQAS for Blood Bank Accreditation. The General Information Brochure & Application Form for the same are available in the QCI website. Please log onto You can send email to for more information on the same.