IJSTR >> Volume 9 - Issue 2, February 2020 Edition

[Full Text]

AUTHOR(S)

Ajayan Kamalasanan, Gurumoorthy Sathiyamoorthi, Arun Vijay Subbarayalu

KEYWORDS

Leadership, India, Quality of Health Care, Quality Improvement, Hospital Accreditation

ABSTRACT

Aim: To study the role played by the leaders and the challenges faced by them to build and sustain quality standards in order to attain accreditation of the hospitals in India. Method: The study is based on the exploration of challenges encountered by the leaders to accomplish the quality standards of hospitals in order to meet the target of various national and international accreditations. The research carried out a detailed analysis of literature on various challenges faced by the leadership in managing quality to attain hospital accreditation. Results: The potential challenges were identified as inadequate infrastructural facilities, financial constraints, compliance with all regulatory and professional requirements, insufficient human resources, lack of training, complexities in the documentation, and adoption of information technology are identified as the major challenges faced by the healthcare leadership in managing quality & accreditation of Indian Hospitals. Conclusion: The study enlightens the challenges faced by the leadership in various aspects of quality management to attain accreditation of hospitals in India. The study identified 12 major challenges and provides appropriate strategies to be developed and addressed by the leadership for handling the different aspects of quality management in healthcare settings. Since this study is based on the review of literature, further research is warranted to ascertain the effectiveness of suitable measures to overcome these challenges in improving the quality of healthcare.

REFERENCES

[1] Jesani A. Laws and health care providers. Mumbai, India: Centre for Enquiry into Health and Allied Themes. 1996.
[2] Rahat N. “Healthcare accreditation in India-Key factors & challenges”, paper presented to the Proceedings of International Conference 2017, TMIMT, Moradabad
[3] NABH Accredited Hospitals, 2109; NABH website https://www.nabh.co/frmViewAccreditedHosp.aspx (accessed on 13 December 2019)
[4] Cleveland, E.C., Dahn, B.T., Lincoln, T.M., Safer, M., Podesta, M. and Bradley, E. (2011), “Introducing health facility accreditation in Liberia”, Global Public Health, Vol. 6 No. 3, pp. 271-282
[5] Hemphill, J.K. and Coons, A.E. (1957), “Development of the leader behavior description questionnaire”, in Stodgill, R.M. and Coons, A.E. (Eds), Leader Behavior: Its Description and Measurement, Bureau of Business Research, Ohio State University, Columbus, OH, pp. 6-38.
[6] Rauch, C.F. and Behling, O. (1984), “Functionalism: basis for an alternate approach to the study of leadership”, in Hunt, J.G., Hosking, D.M., Schriesheim, C.A. and R., Stewart (Eds), Leaders and Managers: International Perspectives on Managerial Behavior and Leadership, Pergamon Press, New York, NY, pp. 45-62.
[7] Cohen, W.A. The Art of a Leader, Jossey-Bass, Englewood Cliffs, NJ; 1990.
[8] Al-Sawai, A. “Leadership of healthcare professionals: where do we stand?”, Oman Medical Journal, 2013,Vol. 28 No. 4, pp. 285-287
[9] Agarwal, R. A guideline for quality accreditation in hospitals. Quality digest, 2010, available at: www.qualitydigest.com/inside/twitter-ed/guideline-quality-accreditation-hospitals.html# [accessed 13 December 2019]
[10] Bolman, L.G. and Deal, T.E. (2003), “Reframing leadership”, in Gallos, J.V. (Ed.), Business Leadership, Jossey-Bass, San Francisco
[11] Joint commission international (JCI) (2017), “Joint commission international accreditation standards for hospitals including standards for academic medical center hospitals 6th edition”, available at: www.jointcommissioninternational.org/jci-accreditation-standardsfor-hospitals-6th-edition/ (accessed 12 July 2019).
[12] NABH Accredited Hospitals, 2109; NABH website https://www.nabh.co/frmViewAccreditedHosp.aspx (accessed on 13 December 2019)
[13] Shaw, C., Kutryba, B., Crisp, H., Vallejo, P. and Sunol, R. (2009), “Do European hospitals have quality and safety governance systems and structures in place?”, Quality & Safety in Health Care, Vol. 18, pp. i51-i56
[14] Quality Council of India. National Accreditation Board for Hospitals & Healthcare Providers (NABH). Available from: http://www.qcin.org. [Last accessed on 2019 Jul 03].
[15] Fischer EA, Jayana K, Cunningham T, Washington M, Mony P, Bradley J, Moses S. Nurse Mentors to Advance Quality Improvement in Primary Health Centers: Lessons From a Pilot Program in Northern Karnataka, India. Glob Health Sci Pract. 2015 Dec 17;3(4):660-75.
[16] Fuentes, C., Benavent, F., Moreno, M., Cruz, T. and Val, M. (2000), “Analysis of the implementation of ISO 9000 quality assurance systems”, Work-Study, Vol. 49 No. 6, pp. 229-241
[17] Kirsten Brubakk, Gunn E. Vist, Geir Bukholm,Paul Barach and Ole Tjomsland. A systematic review of hospital accreditation: the challenges of measuring complex intervention effects. BMC Health Services Research 201515:280
[18] Mumford, V., Forde, K., Greenfield, D., Hinchcliff, R. and Braithwaite, J. (2013), “Health services accreditation: what is the evidence that the benefits justify the costs?”, International Journal for Quality in Health Care, Vol. 25 No. 5, pp. 606-620
[19] Nandraj S, Khot A, Menon S, Brugha R. A stakeholder approach towards hospital accreditation in India. Health Policy Plan. 2001 Dec;16 Suppl 2:70-9
[20] National Patient Safety Implementation Framework (2018-2025). Ministry of Health & Family Welfare, Government of India
[21] Needle, David (2004). Business in Context: An Introduction to Business and Its Environment. 5th Edition; South-Western Cengage Learning
[22] Bent R, Seaman EA, Ingram A. staff motivation in small food manufacturing enterprises. Br Food J. 1999;101:654–67
[23] Steers RM, Porter LW. Motivation and work behavior. 5th ed. New York: McGraw-Hill; 1999
[24] Deal T. E. and Kennedy, A. A. (1982, 2000) Corporate Cultures: The Rites and Rituals of Corporate Life, Harmondsworth, Penguin Books, 1982; reissue Perseus Books, 2000
[25] Tsai, Y. “Relationship between Organizational Culture, Leadership Behavior and Job Satisfaction.” BMC Health Services Research. 2011; BMC Health Serv Res (11)1, 98
[26] Green, J. and Thorogood, N. (1998), Analysis of Health Policy: A Sociological Approach, Longman, London
[27] Casida, J. and Pinto-Zipp, G. (2008), “Leadership-organizational culture relationship in nursing units of acute care hospitals”, Nursing Economic, Vol. 26 No. 1, pp. 7-15
[28] Shortell, S., O’Brien, J. and Carman, J. (1995), “Assessing the impact of continuous quality improvement/total quality management versus implementation”, Health Services Research, Vol. 30 No. 2, pp. 377-401.
[29] Bhaskar Purohit, Dharmen Patel, Surabhi Purohit. A Study of Organizational Values in Government Run Primary Health Centres in India. Volume: 16 issue: 2, page(s): 303-313
[30] Park, I.T., Jung, Y.Y. and Suk, S.H. (2017), “The perception of healthcare employees and the impact of healthcare accreditation on the quality of healthcare in Korea”, Journal of Hospital Administration, Vol. 6 No. 6, pp. 20-27
[31] Saadati, M., Yarifard, K., Azami-Agdash, S. and Tabrizi, J.S. (2015), “Challenges and potential drivers of accreditation in Iranian hospitals”, International Journal of Hospital Research, Vol. 4 No. 1,pp. 37-42
[32] Rahat, N., “Healthcare accreditation in India-Key factors & challenges”, paper presented to the Proceedings of International Conference 2017, TMIMT, Moradabad
[33] World Health Report. Working Together for Health. 2006; WHO: Geneva. http://www.who.int/whr/2006/whr06_en.pdf
[34] Priya Sinha and Sigamani. Key challenges of human resources for health in India. Global Journal of Medicine and Public Health. 2016. Vol. 5, issue 4
[35] Northouse, P. G. Leadership: Theory and Practice (Sixth Edition). Thousand Oaks, CA: Sage Publications 2013
[36] Dileep Mavalankar, KV Ramani, Jane Shaw. Management of RH Services in India and the Need for Health System Reform. W.P.No. 2003-09-04 September 2003; Indian Institute of Management Ahmedabad-380 015 India
[37] Ramani & Mavalankar Dileep. Health System in India: Opportunities and Challenges for Improvements. Indian Institute of Management, Ahmadabad, India; WP No. 2005-07-03
[38] Mathioudakis A, Rousalova I, Gagnat AA, Saad N, Hardavella G. How to keep good clinical records. Breathe (Sheff). 2016;12(4):369–373.
[39] Sarika Chaturvedi, Bharat Randive, Joanna Ravend, Vishal Diwan, Ayesha De Costa. Assessment of the quality of clinical documentation in India’s JSY cash transfer program for facility births in Madhya Pradesh. International Journal of Gynaecology and Obstetrics. Volume 132, Issue 2, February 2016, Pages 179-183
[40] Thomas J. Medical records and issues in negligence. Indian J Urol. 2009;25(3):384–388
[41] Manoj Mohanan, Katherine Hay, Nachiket Mor. Quality of Health Care in India: Challenges, Priorities and the Road Ahead. Health Affairs, Vol. 35, No. 10: Insurance, the ACA, Care in India & More; https://doi.org/10.1377/hlthaff.2016.0676
[42] Rahat, N. “Healthcare accreditation in India-Key factors & challenges”, paper presented to the Proceedings of International Conference 2017, TMIMT, Moradabad
[43] De Vos, M., Graafmans, W., Kooistra, M., Meijboom, B., Van Der Voort, P. and Westert, G. (2009), “Using quality indicators to improve hospital care: a review of the literature”, International Journal for Quality in Health Care, Vol. 21 No. 2, pp. 119-129
[44] Reena Duggal, Shukla Balvinder & Sunil Kumar Khatri. Opportunities and Challenges of Using Big Data Analytics in Indian Healthcare System. October 2016; Indian Journal of Public Health Research and Development 7(4):238
[45] Shruti Tripathi, Rachna Sharma and Shyama Nagarajan. Health Information Systems in India: Challenges and way forward. Munich Personal RePEc Archive Paper No. 87067, posted 3 June 2018
[46] Zhang, J., Patel, V.L., & Johnson, T.R. Medical error: Is the solution medical or cognitive? Journal of the American Medical Informatics Association. 2008; 6 (Supp1), 75-77. doi:10.1197/jamia.M1232
[47] Al Kuwaiti. A. Application of Six Sigma Methodology to Reduce Medication Errors in the Outpatient Pharmacy Unit: A Case Study from the King Fahd University Hospital, Saudi Arabia. International Journal for Quality Research. 2016; 10(2), 267-278
[48] Tabish. Hospital & Health Services Administration: Principles & Practice Edition: First (Reprint) Chapter: Hospital Management: Challenges and Strategies 2005. Publisher: Oxford University Press
[49] WHO Bulletin of the World Health Organization. 2004; Volume 82, Number 2, February 2004, 82-159
[50] McDermott DR. A comparative analysis of the community contributions and profits of Virginia's hospitals. Health Care Manage Rev. 2007 Apr-Jun;32(2):179-87
[51] Joint commission international (JCI) (2017), “Joint commission international accreditation standards for hospitals including standards for academic medical center hospitals 6th edition”, available at: www.jointcommissioninternational.org/jci-accreditation-standardsfor-hospitals-6th-edition/ (accessed 12 July 2019)