NACO Approach Paper for Accreditation Scheme in Blood Transfusion

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Accreditation Scheme for Blood Transfusion Services in India

[Approach Paper for Accreditation Scheme in Blood Transfusion

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In recent times, there has been increasing interest not only in the

formulation of, and achieving standards in health care, but also in

the development of a process for use and compliance of such quality

standards. Better quality of health care could be pursued in various

ways, through regulation, certification, quality assurance

programmes, peer review, consumer education, developing accreditation

systems, among others. The Blood Transfusion Services in the country

are also in a stage where emphasis is being increasingly paid to

quality of services rather than attaining quantitative benchmarks.

(1984) defines Accreditation as the awarding of " Professional

and national recognition to facilities that provide high quality of

care. It is implicit that the particular health facility has

voluntarily sought to be measured against high professional standards

and is in substantial compliance with them " . Accreditation is a

process wherein standards are set and compliance with them is

measured.

The setting up standards is always done through a consultative

process in which consensus among those who will use the standards is

sought, particularly regarding the appropriate level of the standards

and how compliance with the standards will be judged. Standards are

subjected to periodic and ongoing review to ensure their continued

appropriateness.

The National AIDS Control Organisation, Ministry of Health and Family

Welfare plans to introduce the Accreditation Scheme for various

components of the Blood Transfusion Services in the country.

Standards and processes will be drawn up for large and small blood

banks, Blood Component Separation Units and possibly for Blood

Storage Centres that have been recently set up.

In India , accreditation is not new and accreditating bodies have

been established to monitor functioning of financial institutions and

hotels. There have been efforts to institute accreditation schemes

for computer education institutions, NGOs and others from the service

sector. There are some studies which brought out the need in the

health sector for accreditation. This felt need by the stakeholders

for accreditation system in the health care area is due to a number

of factors like increasing competition, due to provisions of Consumer

Protection Act and the general demand for quality among discerning

consumers or clients.

An NGO based in Mumbai undertook a study in 1997-98 on this issue and

found that hospital owners, professional bodies and government

officials all see potential advantages in accreditation. It is likely

that with the mushrooming of blood banks in urban areas of the

country, the blood bank owners would also be interested in

accreditation. In effect, we may be addressing a felt need in the

field of Blood Transfusion Services, besides taking a step in

fulfilling our mandate to provide better quality of service in

transfusion services.

After a Supreme Court judgement in January, 1996, compulsory

licensing for all blood banks have been made mandatory from 17th May,

1997 . All blood banks presently operating in the country are

supposed to be licensed and hence supposed to meet certain minimum

criteria in space, equipment and trained manpower. The proposed

Accreditation Scheme aims at ensuring and recognising higher

standards of quality, than that is ensured by licensing, in all

aspects of blood transfusion services.

It is proposed that this would be entirely a voluntary activity which

participating blood banks may take up and once accreditated, it would

serve the interests of both the blood banks and consumers in

general.The Committee will have to consider the type of organisation,

the process that needs to be followed, the type of personnel to be

involved and the funding requirements for an efficient Accreditation

Programme. The very definition of the term implies that accreditation

should be entirely voluntary, and hence, the confidence of potential

participating blood banks in the system is of utmost importance. We

need to develop a consensus in terms of locating the

system/organisation that will carry out accreditation, whether in

the public or private sector or if existing organisations need to be

developed for this purpose.

It also needs to be decided as to whether there should be a regional

or state level set up for accreditation or a national body would be

sufficient.Experience world wide has shown that three major factors

contribute to the success of accreditation systems. The first is,

involvement of stakeholders in the accreditation bodies which

provides them opportunity to participate in the accreditation

processes.

Secondly, the accreditation scheme played a major role in informing

and educating consumers, thereby giving them an impetus. Thirdly,

accreditation process gets strengthened when there is connection to

state and third party payments like in medical and health insurance

schemes. Developing standards for accreditation is another concern

that the committee needs to look into.

One existing accreditation scheme is the National Board for Test and

Calibration Laboratory (NABL) of the DST. They have done some

preliminary work in developing standards or guidelines for

accreditation of blood banks. These standards are not very different

from licensing requirements as laid down in the Drugs & Cosmetics

Rules for Blood Banks. By using these standards, it is unlikely that

any better quality standards than that is laid down for licensing

will be achieved. Issues like who develops the standards, what will

be the gradations for accreditation etc. need to be discussed. The

committee needs to chalk out a path way from this stage of statement

of intent to actually operationalising a scheme of accreditation for

blood banking services in the country. Some details of composition

and location of the accreditating Body/Bodies, methods of developing

or adopting standards, identifying funding for this scheme etc need

to be documented. A feasible time frame for implementation of this

activity also needs to be drawn up.·

Approach Paper for Accreditation Scheme in Blood Transfusion

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http://naco.nic.in/vsnaco/announcements/bloodtrans.htm