Recent Practices in Accreditation and Hospital Pharmacies

Day 2 at Healthcare Senate 2016 began with a panel discussion on ‘Recent practices in accreditation and hospital pharmacies’. The panelists of this session were Dr Suresh Saravdekar, Director, The Rural Centre, Krishnamurti Foundation India, Varanasi- UP; Dr Harish Nadkarni, Consultant for NABH, CEO & MD, Quality Care and Dr Arun Palaniswami, Director- Quality Systems, Kovai Medical Center and Hospital. Dr Saravdekar, the moderator, began the session by emphasing on the importance of accreditation  for quality healthcare services in India. He urged Dr Nadkarni to share his insights on accreditation and various quality assurance bodies that provide these certifications to Indian hospitals. Replying to this, Dr Nadkarni spoke of bodies such as NABH, JCI and Australian Board of Accreditation. He went on to speak about how most of these accreditation boards lay emphasis on medical management within hospitals. “Right from medical procurement to dispension of medicines, accreditation ensures that the entire process is well managed,” opined Dr Nadkarni. Continuing the discussion, Dr Saravdekar asked Dr Palaniswami to provide a comparison of accreditation parameters between the US and India. Replying to the same, Dr Palaniswami went to say, “Clinical pharmacists is a heavily integrated model within the US hospitals. The pharmacy team within a US hospital intervenes at clinical levels to ensure quality medical procurement and dispension of medicines. These clinical pharmacists regularly interact with doctors, nurses and other clinical staff. This, in turn, bring down medical errors by a substantial level. A clinical pharmacy is well respected within a hospital in the US.”

Dr Palaniswami further highlighted the biggest challenge in setting up the clinical pharmacist model in India. He said, “Day-to-day interactions between doctors and clinical pharmacist and other hospital staff is a huge challenge in India.”

Dr Saravdekar, agreeing  with this viewpoint, urged the panel to provide solutions for the challenges that hinder adherence to good hospital pharmacy practices in India. He also explained the ideal process of medical procurement within a hospital. “Every hospital should have a medical procurement committee. This should be a therapeutic committee comprising various clinicians, the Medical Director and pharmacists. This committee is also in charge of preparing a formulary policy that decides the parameters of medical procurement. However, in India the biggest challenge is to set up a good formulary policy that chooses the right medicines at the right price,” explained Dr Saravdekar.

Key takeaways

• Widen the role of a clinical pharmacist within hospitals
• Every hospital should constitute a stringent formulatory policy for medical procurement
• Prescription auditing is paramount

When asked to share his experience on the same, Dr Palaniswami replied that the US hospitals has a strict formulary policy, however in India, doctors decide the medicines they would prefer to prescribe to their patients. Dr Saravdekar further questioned Dr Palaniswami on defining the criteria to judge that a low-cost medicine is of good quality? He added that  Indian hospitals or rather doctors in India believe that high cost of medicines is proportional to good quality.

Replying to this, Dr Palaniswami said that in the US hospitals, they have a surveillance team that checks the background of all the manufacturing units of  companies that approach them to sell their medicines.

The discussion moved forward with comparisons drawn between the US and Indian procurement policies. They also discussed the role of NABH and JCI in formulating these policies in India. The panel discussed other issues such as errors made by nurses and other pharmacy staff while dispensing medicines. The panel finally concluded that prescription auditing is paramount and  every hospital needs to conduct timely audits on medicine prescriptions and its dispensation within hospitals.