Worldwide, the Standardization of Healthcare Delivery System has become the focus. In India health care delivery system has remained largely fragmented and uncontrolled. The focus of accreditation is on continuous improvement in the organizational and clinical performance of health services, not just the achievement of a certificate or award or merely assuring compliance with minimum acceptable standards.

Definition
 “A self-assessment and external peer assessment process used by health care organizations to accurately assess their level of performance in relation to established standard and then to implement ways to continuously improve it”.

”Market forces, such as medical tourism, insurance and corporate sector have accelerated the demand for quality in healthcare services. As a result, there is a growing demand from consumers for better healthcare as the lack of quality assurance mechanisms limits their access to appropriate health services" - Mr. Girdhar J Gyani, CEO, National Accreditation Board for Hospitals & Healthcare Providers India.

Why Accreditation?

Ensures a Quality Index for Health Consumers.
A growing number of hospitals in India are turning to accreditation agencies worldwide to both standardize their protocols and project their international quality of health care delivery. 
It is a Public Recognition of the achievement of accreditation standards by a healthcare organization, demonstrated through an independent external peer assessment of that organization's level of performance in relation to the standards.

 Attract foreign patients

The process of accreditation is envisaged to result in a process of fundamental change in the technical procedures of service delivery, in the appropriate use of available technologies, in the integration of relevant knowledge, in the way the resources are used, and in the efforts to ensure social participation. Quality Assurance helps improve effectiveness, efficiency and in cost containment, and accountability and the need to reduce errors and increase safety in the system.

Advantages of Accreditation:

Accreditation benefits all Stake Holders.
Patients are the biggest beneficiaries. Accreditation results in high quality of care and patient safety. The patients get services by credential medical staff. Rights of patients are respected and protected. Patient satisfaction is regularly evaluated. 
Accreditation to a Hospital stimulates continuous improvement. It enables hospital in demonstrating commitment to quality care. It raises community confidence in the services provided by the hospital. It also provides opportunity to healthcare unit to benchmark with the best. 
The Staff in an accredited hospital are satisfied lot as it provides for continuous learning, good working environment, leadership and above all ownership of clinical processes. It improves overall professional development of Clinicians and Paramedical staff and provides leadership for quality improvement within medicine and nursing. 
Accreditation provides an objective system of empanelment by insurance and other Third Parties . Accreditation provides access to reliable and certified information on facilities, infrastructure and level of care.

1. Joint Commission International (JCI)

Joint Commission International (JCI) is a division of Joint Commission Resources (JCR), the subsidiary of The Joint Commission working since more than 50 years from now. 
The Largest accreditor of health care organizations in the United States.
 It surveys nearly 20,000 health care programs through a voluntary accreditation process.

The Joint Commission and its subsidiary are both not-for-profit corporations.

Accreditation by JCI in various Countries
 

Joint Commission International (JCI), the leading healthcare accreditation agency in the United States has accredited eight hospitals in India till date. The JCI accreditation is likely to be limited to only to bigger players owning to its high cost.

India: JCI Accreditation Hospitals

1. Apollo Hospital, Chennai
2. Apollo Hospital, Hyderabad
3. Asian Heart Institute, Mumbai
4. Fortis Hospital, Mohali
5. Indraprastha Apollo Hospital
6. Satguru Partap Singh Apollo Hospital, Punjab
7. Shroff Eye Hospital, Mumbai
8. Wockhardt Hospital, Mumbai

2. Internationally Acclaimed? Healthcare Accreditation Organization

 The Joint Commission on Accreditation of Health Care Organizations
 (JCAHO),USA.

 The Canadian Council on Health Service Accreditation (CCHSA), Canada.

 The Australian Council on Healthcare Standards (ACHS), Australia.

 Health Quality Services (HQS). The King's Fund Centre, England.

 Council on Health Services Accreditation? for South Africa (COHSASA).

 The Malcolm Baldrige National Quality Award, USA. (Including the Swedish and European versions and the version modified for health care evaluation, USA).

Accreditation by various National health agencies in their respective Countries

Accreditation Body in India
National Accreditation Board for Hospitals & Healthcare Providers (NABH)

National Accreditation Board for Hospitals & Healthcare Providers (NABH) comes under the purview of board of Quality Council of India, set up to establish and operate accreditation programme for healthcare organizations. The board is structured to cater to much desired needs of the consumers and to set benchmarks for progress of health industry. The board is functionally autonomous in its operation. Currently it accredits Hospitals & Nursing homes, and is expected to accredit ate Blood Banks, Diagnostic Centers (Imaging), Dental Centers and Ayurvedic Hospitals/ Clinics in future.

NABH Accreditation Hospitals

1. B.M. Birla Heart Research Centre, Kolkata
2. MIMS Hospital (MIMS Ltd.), Calicut
3. Kerala Institute of Medical Science, Thiruvananthapuram
4. Max Super Speciality Hospital, New Delhi
5. Max Devki Devi Heart & Vascular Institute, New Delhi
6. Moolchand Hospital, New Delhi
7. Narayana Hrudayalaya, Bangalore
8. Dr. L. H. Hiranandani Hospital, Mumbai
9. Fortis Hospital, Noida
10. Sagar Apollo Hospital, Bangalore
11. Columbia Asia Medical Centre – Hebbal, Bangalore

And as per latest figure, 45 hospitals have further applied for NABH Certification.

Assessment Process in general
 
Accreditation is a voluntary process. Its standards are usually regarded as optimal and achievable. It provides a visible commitment by an organization to improve the quality of patient care, to ensure a safe environment and to continually work to reduce risks to patients and staff. Accreditation has gained worldwide attention as an effective quality evaluation and management tool.

Benefits of Accreditation:
• Greater Efficiency
• More Accountability & Responsible governance in hospitals
• Overcome quality of care deficiencies in their practices
• Prevents negligence

References

1. Quality Council of India
2. Organisational framework for hospital accreditation system in India (Submitted To Ministry of Health & Family Welfare Government of India, New Delhi), by Sunil Nandraj, Sri vidya,Anagha khot, Who India
3. NABL Website
4. British Medical Journal
5. An Introduction to the US Healthcare System; National Report on Health Services Accreditation Performance 2003-2006, ACHS
6. www.planningcommision.nic.in
7. www.achs.org.au
8. www.jointcommissioninternational.com

9. Hospital Accreditation in India - Standardising healthcare, Girdhar J Gyani, CEO, National Accreditation Board for Hospitals & Healthcare Providers, India
Asian Hospital & Healthcare Management
http://www.asianhhm.com/Knowledge_bank/articles/healthcare_accreditations_india.htm