Family Friendly Hospital Initiative

1. Family Friendly Hospital Initiative Dr.P.Padmanaban NHSRC

2. FFHI “A family friendly hospital is a public health facility where the service providers offer quality medical care by following evidence based protocols and check lists for all the beneficiaries with special focus on women and children to ensure patient safety. The hospital environment to be made conducive for the service providers to practice the skills and the beneficiaries to stay comfortably in the institution”

3. Why Family Friendly hospital certification ? • Increased utilization and over crowding of public facilities • Medical and paramedical functionaries often do not follow evidence based protocols , esp.in the labour room and operation theatre • Compromise on quality result in the higher mortality and morbidity • Under utilisation of RKS funds • FFHI aims to effectively use of available HR and RKS funds to maximize the output

5. ISO/NABH Vs FFHI • ISO and NABH certification need more resources and time consuming • FFH is the first step for ISO/NABH certification and cut down the delay for ISO/NABH • FFH hospitals can be certified for basic quality standards within 3 months. More institutions can participate in the programme • Unlike ISO/NABH certification , all the service providers actively participate in the gap analysis, prepare action plan and implement by themselves for FFH certification • Capacity building for FFHI certification will be provided NHSRC

6. Steps in the FFH certification • Sensitization workshop by NHSRC • Quality assurance cell and FFH support groups at the state level • State level meeting and encourage voluntary participation by Dist. Hospitals/ CHCs/ FRUs • Service providers meeting at the facility level • Gap analysis, action plan and implementation of action plan with handholding by state support groups

7. Steps in FFH certification (cont’d) • Formation of certification teams with senior obstetrician , programme officer, NGO partner at the state level • Quality assurance cell to monitor the certification programme • Facilities ready for certification inform the quality assurance cell • Certification team visit the facility and carryout assessment

8. Steps in FFH certification (cont’d) • Certificate distributed to the facility in a public function • Certificate is exhibited outside and inside the hospital • Quality parameters are also displayed with the signatures and photographs of the staff • Reassessed once in 3 years • One surprise inspection every year • Additional points in the district ranking based on the number of facilities certified

9. Benefits of FFH certification • Improved patient satisfaction and service providers satisfaction • Reduction of morbidity, mortality and hospital acquired infection • Improvement in the quality of care • More financial autonomy and incentives may be given to the FFH certified institutions • Recognition of service providers with certificates • Exchange visits by other hospital staff enhances the motivation

10. Options of FFHI • Two categories of certificate Silver/ Gold or 3 star / 5 star certification • 3 star certification ensures the basic quality of care and patient safety • 5 star certification ensures all service guarantees eg. 24 C section, blood transfusion • Silver FFH can move to Gold FFH • Gold FFH may be given additional funds, functional autonomy, incentives etc. • The assessment tools can be adapted to suit the state needs.

11. Support needed from the state • Form the state quality assurance cell and support groups for FFHI • Training the staff in the evidence based protocols and check lists • Create enabling environment for the service providers • Encourage and support the willing hospitals to participate in the FFHI • Monitor the certified institutions • Use the FFH certification for district ranking • Recognize the certified institutions and service providers • Identify the institutions which could be certified quickly • Arrange exchange visits to the certified institutions

12. FFHI CHECKLIST

13. Progress in Setting up SHSRCs

14. States with functional SHSRCs • Chhattisgarh: functional- registered society headed by executive director: also incorporates ASHA resource center: reporting to secretary. • Kerala: Functional : consultant team housed in SIHFW and funded through it: headed directly by Mission Director • Karnataka: Functional : consultant team located in SIHFW- under an executive director – reporting to Commissioner. • Maharashtra: Functional: Registered society with offices in Pune: headed by executive director, reporting • Gujarat: functional: Outsourced to EPOS: team of consultants under a team leader. • Uttarakhand: Functional: consultant team reporting to MD.

15. States setting up – Recruitment in progress: would be functional by February end: • Rajasthan • Punjab • Delhi Bihar: NHSRC team providing support- state to take over/ create institutional structure and further recruitment Jharkhand : agreement with NGO and NHSRC signed but not operationalised. J &K: TORs finalised but recruitment not started up. Orissa: TORs finalised- but institutional structure not decided .

16. Other Agencies providing TA • Madhya Pradesh: TAST – DFID • West Bengal: SPSRC – SHRC- TAST- DFID linked- role is limited. • Uttar Pradesh- SIFPSA: but plans to set up SHRC

17. No plans currently • Tamil Nadu • Himachal Pradesh:

18. THANK YOU