In Quest for Holy Grail of Quality Care Continuum in Indian Healthcare

Mumbai: As if congregation of eminent health professionals from leading hospitals and diagnostic labs were eager to face it.

So, when Bollywood belle Sonali Bendre, a recent cancer survivor, conceded she went to US for treatment keeping in mind assurance of quality care and good clinical outcome and she did not want to take any chances of getting treated in India, it was not a ‘curve ball’ at all for them.

The health professionals took her potentially embarrassing words in their stride. In fact, the suave anchor Dr Narottam Puri seemed deliberately nudging her to strongly make point of quality care which is not as yet a defining component of Indian healthcare, though leading Indian hospitals have been going to town with claims of ability to deliver world class care for quite a while. Accreditation in India is still seen more as an embellishment for marketing than a mandate for quality care in the real sense of the term.

In 2 day CAHOCON 2019 starting on April 13, the fifth gathering towards mission quality in Sahara Star Hotel in Mumbai, the legendary Dubbawala of Mumbai gave them yet another run for their money by showcasing its impeccable lunch delivery system. That quality has become a craving for Indian healthcare professionals, thanks to CAHO (Consortium of Accredited Healthcare Organizations)’s mission of inculcating a culture of quality care across Indian hospitals, was evident from the fact that they wanted to learn a lesson or two from even Dubbawala, though processes of lunch delivery system and healthcare are poles apart. Arvind Tadekar, the spokesperson for Dubbawalas, gave a presentation in English enlisting its qualities a la sigma six. One of its enviable high points was its almost non- existent error in its lunch delivery operation. Mr Tadekar said Dubbawala’s error rate is one in 16million transactions. Juxtapose to this thousands of medical errors resulting into deaths in India.

In the inaugural session, the maverick news TV Journalist and high decibel host in Rebublic TV debate, moved and shook the assembly by his shrill pitch for making Ayushman Bharat a success at all cost ( though ‘at all cost’ did not go down well with doctors). Hospitals are contesting the rates of treatment packages in Ayushman Bharat stipulated by the government. Mr Arnab appealed doctors to do utmost to make quality healthcare accessible to poor patients of the country. Mr Arnab in turn was appealed by Dr Narottam to mediate between central government and hospitals for reasonable rates.

Nonetheless, it amply reflected in CAHOCON 2019 that CAHO has undoubtedly proved infectious in its 4 year run. CAHO tag has now become indispensable for any hospital in India with all big and leading health providers making a beeline to be part of the quality coalition. It was evident that CAHO has certainly instilled a motivation for attainment of quality in delivering healthcare leading to safety of patients and best outcomes. Over 40 eminent speakers and 550 National and international delegates spoke a volume about the growing acceptability and clout of CAHO’s role. Panel discussions and workshops were all very useful, participants said.

The leadership of Dr Vijay Agarwal, the incumbent President of CAHO, came in for all round praise. A preconference Master class on April 12 in which 13 hospitals participated and brain stormed for ways to make quality care leading to best outcome an abiding component of healthcare delivery in India was a valuable exercise. The hospitals which partnered in Master class were leading hospitals of Mumbai namely Nanavati Super Specialty Hospital, Hiranandani Hospital, Bombay Hospital, Kokilaben Dhirubhai Ambani Hospital, Hinduja Hospital, Saifee Hospital, D Y Patil Hospital and Wockhardt Hospital. Topics like Process Re-engineering, Hospital planning, Nursing Communication, Cyber Security and Infrastructural Safety were covered.

This CAHOCON 2019 was themed around ‘Healthcare Quality Should Impact Outcome’ and ‘Impact of Accreditation on Quality and Outcome. The conference mooted innovative pathways to attain quality healthcare outcomes. Opportunities of quality healthcare in India and steps to change medical education to improve healthcare were other moot points.

CAHOCON 2019 proved watershed in this journey of quality because of the fact that it got endorsement from International Society for Quality in Healthcare (ISQua) and Asian Society for Quality in Healthcare (ASQua) and Quality Council of India. The presence of officials of JCI (Joint Commission International), the ultimate global accreditation agency was icing on the cake. JCI’s John Yoon, Managing Director, Asia Pacific, Marin Tan, International Manager, Asia Pacific and Thomas W. Kozlowski, PhD, Principal Consultant, International Services expressed satisfaction on CAHO’s pitch for inculcating a culture of patient safety, quality care and best outcomes. Talking to Medicare News, Marina Tan said, ‘Mere getting accreditation does not suffice. The quality of care needs to be perpetuated. CAHO will for sure go a long way in making accreditation in India worth its salt. JCI is taking note of this quality phenomenon in India and willing to partner with CAHO. She stressed the need for hospitals to get accreditation and follow through in continuing quality. ’

Dr Vijay Agarwal, president, CAHO, said, ‘CAHO has brought accredited hospitals on one platform so that they can share best practices, create benchmarks, training programmes and contribute to capacity buildings. We want to promote quality in the real sense of the term. We want hospitals to go beyond accreditation. Like accreditation agencies have an army of assessors, we have created more than 1000 quality implementers as foot soldiers to take CAHO’s mission forward. In last 4 years, it has made tremendous progress. These quality implementers are real implementers of intent and objectives of accreditation process.’

Dr Agarwal further said, ‘“CAHOCON is a great platform to make hospitals process-oriented and increase the quotient of patient safety. Hospital’ care over the last few years has become very complex and error-prone. In such a scenario, it is imperative that hospitals understand this changing scenario and the need for understanding to work as a team with the requisite processes.’

Dr Giridhar J Gyani, founder Director General of Association of Healthcare Providers of India (AHPI) and former Secretary General of Quality Council of India, said, ‘CAHO is scripting a new era in Indian Healthcare where patient safety and quality care continuum will be abiding norms. The movement it has initiated is reaching fruition. The movement of quality is spreading far and wide across thousands of hospitals in India. Considering that millions of medical errors are being reported in developing countries, spreading this movement is need of the hour.’

Dr PM Bhujang, president, Association of Hospitals, said, ‘accreditation per se is an excellent thing to improve processes, documentation and also measuring your own standard of healthcare delivery. It is unfortunate that some of the hospitals use accreditation as a marketing tool rather than a mandate for making quality a culture in commensurate with accreditation. If that culture instils in hospitals accreditation will prove a boon and it will help patient care and patient safety and in the long run it will bring down cost of care too.’

Lt Colonel Dr Puri, Director, Army Healthcare Services said, ‘ In today’s evolving times, it is important that quality is monitored to ensure quality outcome. We must find ways so that processes and infrastructure result into better quality and outcomes.’  Dr Aparna Jairam, Joint Organising Secretary, CAHOCO and Founder and Director, Dr Aparna’s pathology said, ‘CAHOCON is a platform to accelerate process of excellence in healthcare. Quality should be an integral part of healthcare. Time is evolving and patients come empowered with a lot of information, so much so that quality for patients starts from reception.’ Mr Yatish Bahal, Executive Director, Nayati Healthcare spoke at length about how it is delivering quality healthcare in 2 and 3 tier towns to utmost satisfaction of patients.

Mr. Joy Chakraborty, COO, P D Hinduja Hospital & Medical Research Centre, Dr. Hiren Ambegaokar, CEO, S L Raheja Hospital, Dr. Sujit Chatterjee, CEO, L H Hiranandani Hospital, Dr. Anupam Karmakar, CEO, D Y Patil Hospital and Dr. Deepak Patkar, Medical Director, Nanavati Super Speciality Hospital, Dr Harish Pillai, CEO, Aster Medcity, Kochi and Dr Rajendra Patankar, COO, Nanavati Super Specialty Hospital, were prominent among speakers. Creating positive outcomes for quality healthcare and upgrading patient safety standards in India was the key agenda of CAHOCON 2019.  All speakers said all hospitals should strive to get accredited and CAHO’s mission of quality should percolate down to tier 2 and 3 towns.

CAHO, an association of all accredited hospitals and laboratories, has embarked on a mission of quality promotion across the country. Towards its journey in improving quality and safety of healthcare services, CAHO organises an annual event CAHOCON in collaboration with all stakeholders. The aim of this conference is to bring all stakeholders across the healthcare spectrum on a common platform.

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