NATIONAL QUALITY ASSURANCE STANDARDS (NQAS) Guidelines

Compiled by Alok Bains

National Quality Assurance Standards are developed to improve public health facilities up to global best practices. NQAS are applicable for government District Hospitals, CHCs, PHCs and Urban PHCs. These standards help healthcare providers to assess their own quality. This helps to improve their services to the public. National Quality Assurance Standards (NQAS) are ISQua accredited. They are at par with global benchmarks of health services providers.

Scope of NQAS guidelines:

These are minimum acceptable Quality Standards and support facilities. They help to enhance the competence & performance of healthcare teams. These standards identify the deficiency in working for improvement. Health service providers take necessary actions to improve their quality.

Objectives of NQAS guidelines

Health service providers aim to ensure:

1. Safe, efficient, effective and people-centred healthcare services.

2. High-quality preventive, promotive, curative, rehabilitative and palliative healthcare services.

3. Promotion of hospitals among communities. Engagement of community and individuals in capacity building of hospitals.

4. Availability of basic management & ambulatory care to the community.

5. Serve as an important link to ensure a continuous care

Summary of National Quality Assurance Standards (NQAS) guidelines:

These standards are arranged in eight areas of concern. These areas of concern are Service Provision, Patient Rights, Inputs, Support Services, Clinical Care, Infection Control, Quality Management and Outcome. Each area of concern has different standards to be observed by the hospitals.

1. Area of Concern “A” - Service Provision: It measures the availability of functional services in hospitals. There are two standards in this area of concern. These are

   • Standard A1: Facilities for health care services such as Pregnancy & childbirth, Neonatal & Infant Health, Child & Adolescent Health, Elderly & Palliative Health, Family Planning, Control of communicable diseases, Control of non-communicable diseases, Acute simple & minor illnesses, Common eye and ENT illness, oral health, trauma, burn and emergency medical care, Screening & Management of Mental Health Illness and health promotion activities.

   • Standard A2: Facility for drugs and diagnostic services: These are the availability of Medical Laboratories and Pharmacies.

2. Area of Concern B - Patient Rights: There are five standards in this area of concern These are facilities for

   • Standard B1: Information to caretakers and attendants,

   • Standard B2: accessible services for care seekers and visitors,

   • Standard B3: Gender, religious and culturally sensitive sensitized services,

   • Standard B4: Maintenance of privacy, confidentiality and dignity of the patient, and

   • Standard B5:  Free of cost medical services,

3. Area of Concern C - Inputs: There are five standards in this area of concern. These are

   • Standard C1: Adequate infrastructures for safe delivery of services,

   • Standard C2: Availability of qualified and trained staff,

   • Standard C3: Effective utilization, evaluation, and growth of staff performance,

   • Standard C4: Availability of drugs and consumables,

   • Standard C5: Availability of functional equipment and instruments.

4. Area of Concern D - Support Services: There are six standards in this area of concern. These are established systems to

   1. Standard D1: Maintain infrastructure, Sanitation and hygiene

   2. Standard D2: Store, dispense and manage drugs/inventories,

   3. Standard D3: Record and manage clinical data using digital technology,

   4. Standard D4: Establish hospital transparency and accountability,

   5. Standard D5: Promote activities for Health promotion and disease prevention,

   6. Standard D6: Compliance with statutory and regulatory requirements

5. Area of Concern E - Clinical Care: There are eighteen standards in this area of concern. These are established procedures for

   • Standard E1: Registration, consultation and clinical assessment,

   • Standard E2: Continuity of care and referral,

   • Standard E3: Diagnostic services,

   • Standard E4: Safe drug administration,

   • Standard E5: Rational use of drugs,

   • Standard E6: Nursing care,

   • Standard E7: Emergency care,

   • Standard E8: Management of ophthalmic, ENT, and oral diseases,

   • Standard E9: Mental health illness management,

   • Standard E10: communicable diseases management,

   • Standard E11: Non-communicable diseases management

   • Standard E12: Elderly and Palliative health care,

   • Standard E13: New-born, infant and child health care,

   • Standard E14: Family planning,

   • Standard E15: Sexual health services,

   • Standard E16: Antenatal care,

   • Standard E17: Intra-natal care,

   • Standard E18: Post-natal care.

6. Area of Concern F - Infection Control: There are five standards in this area of concern. These are established programs for the management of

   • Standard F1: Infection prevention and control,

   • Standard F2: Hand hygiene practice,

   • Standard F3: Standard practices and equipment for personal protection,

   • Standard F4: Disinfection and sterilization of equipment and instruments.

   • Standard F5: Segregation, collection, treatment and disposal of Bio-Medical and Hazardous Waste,

7. Area of Concern G-Quality Management: There are five standards in this area of concern. These are Standard

   • Standard G1: Organizational Framework for quality improvement,

   • Standard G2: Established Patient and Employee satisfaction,

   • Standard G3: Standard Operating Procedures,

   • Standard G4: Periodic review of clinical, support and quality management processes,

   • Standard G5: Mission, Values, Quality policy, Objectives, and approved plan to achieve them.

8. Area of Concern H-Outcome: There are four standards in this area of concern. These are measures OF

   1. Standard H1: Productivity Indicators,

   2. Standard H2: Efficiency Indicators,

   3. Standard H3: Clinical Care Indicators,

   4. Standard H4: service Quality Indicators

Compiled by Alok Bains