Govemment of India
Ministry of Health & Family Welfare Department of Health & Family Welfare
“ut”gJ.ies Regulation) Act,20l0.
.*,
560-4, Nirman Bhawan. New Del
*i,f,i”‘+: days from the date of issue ofthis notice’
i2,
n
r,
.
ili’iuv
H””1’r’ *d
u
m
oAiuillu;rf.t,iii;;fiS, “;;:iio0ll or by email to hilo.ceact20l0@nic.in 9r lTil1,y”lfl:;l’gi,):;
Joint Secretary
a
Medical Services Section
NOTICE
Nirman Bhawan’ New Delhi Dated 171h JulY’ 2019
Subiect: Placing the Draft notification on Clinical Establishments (Central “”**” H;;;?.n””t) rhito ‘A’;enament nutes’ 2019 prescribing ‘minimum-
of. clinical establishments of
for comments/suggestion-
standards fo’ Oif”‘”oi
;ffi;iil ano AYUSH’ in p’frlic domain
regarding
“ut”gories
Mot{FW plans to notil, the rules to prescribe for “minimum standards
of cliniJal .stuutirtrments of Atlopathy-and AYUSH ‘,
oi,tt”-Ctini”ut Establishm;nts (Registration and The comments/suggestions on the draft maY be forward.ed t: ?1tll’
DRAFT
fIo be published in the Gazette ol lndia’ Extraordinary Part ll’ Section 3′ Sub- section (i)l
Government of lndia
Ministry of Health and Family Wellare (Department of Health and Family Welfare)
{t
New Delhi, the l? JulY, 2019.
Notification
G.S.R.-(E). -The following draft of certain rules lurther to amend the
ClinicalEstablishments(CentralGovernment)Rules,20l2,whichthecentral Government proposes to make in exercise of the powers conferred by section 52 of
theclinicalEstablishments(RegistrationandRegulation)Act,2o1o(23oI2010)iS hereby published for information of all persons likely to be affected thereby and
notice is hereby given that the said draft rules will be taken into consideration on or after the expiry of a period of forty five days from the date on which copies of the Gazette of lndia containing these draft rules are made available to the public;
Obiections and suggestions’ if any’ may be addressed to Dr’ Anil Kumar’
Addl.DDG,Dte.GHS,MinistryofHealthandfamilyWelfare’RoomNo560-A Nirman Bhawan, New Delhi- 110011 or sent on email to help ceact2o’1o@nic’in;
Objections and suggestions which may be received from any person within the period specitied above will be considered by the Central Government’
(1) These rules may be called the Clinical Establishments (Central
1.
Government) Third Amendment Rules’ 2019′
(2) They shall come into lorce on the date of their pubtication in the olficial Gazette.
In the said rules, after rule 8′ the following rules shall be inserted’ namely:
SBMinimumstandardsofHindiandEnglishversionsofapprovedminimum 3?;oiliii’ii, iljr,”-‘iini catesories of nttopathic clinicar Estabrishments
Minimum Standards (General) of Clinical establishments as listed under:
1. clinic or Polyclinic: only Consultation, With Dispensary, With Diagnostic Support and With Observation facility
2. Mobile Clinic: Only Consultation’ With Procedures and Dental Mobile
3. Hospitals: Level 1 to 3 4. Health Check-uP Centre
5. Dental Lab
6. PhysiotheraPY
7. Dietetics
8. lntegrated Counselling Centre
MinimumstandardsofSpecilicspecialityisuperspecialityclinicaldepartments/ establishments
1 Anaesthesiology
2. a. Paediatrics (Hospital) b Paediatrics (Clinic)
3. Burn Care Facility (HosPital)
4. a. Plastic Surgery (Hospital) b’ Plastic Surgery (Clinic) 5. a. Cardiology (Hospital) b Cardiology Services (Clinic)
6. DentalSet up a’ Stand Alone b Hospital SetUp
7. a. Dermatology (Hospital) b Dermatology (Clinic) c’ STD Clinic
8. a. Gastroenterology (Hospital) b’ Gastroenterology (Clinic) 9. a. General Surgery (Hospital) b’ General Surgery(Clinic)
’10. a. Neurology (Hospital) b Neurology (clinic)
11. a. Neurosurgery (Hospital) b Neurosurgery (Clinic)
l2.a.GynaeandObstetricslndoorservices(Hospital)b’Gynaeand Jo”*r,””ic,,n'”) ” lVF centre /ctinic (lcMR Norm)
2.
13. a. Orthopaedic (Hospital) b Orthopaedic Services (Clinic)
14,a.otorhinolaryngology(Hospital)b,otorhinolaryngology(clinic)c,Deaf and Dumb Clinic
15. a. Psychiatry SeNices (Hospital) b Psychiatry Services (Clinic) c’
Deaddiction Centre
16. a. Ophthalmology (Hospital) b’ Ophthalmology (Clinic) c Optometrist
Services
17. a. Urology (Hospital) b Urology Services (Clinic)
’18. Dialysis Centre – merged with Nephrology 19. a. CTVS (Hospital) b CTVS (clinic)
20. Radiotherapy
21. Medical Diagnostic Laboratories
22. a. lmaging Centers – X-Ray clinic / Cathlab / DSA / OPG and Dental / DE)(A Scan
b. lmaging centers – Sonography (color Doppler) clinic c. lmaging Centers – CT Scan Center / PET CT Scan
d. lmaging Centers – MRI
23. a. Rheumatology b Rheumatology Clinic /Polyclinic
24. a. Pulmonology b Pulmonology clinic
25. a. Medical Oncology /Clinical Haematology b Medical Oncology /Clinical HaematologY Clinic /PolYclinic
26. a. Gynae Oncology b Gynae Oncology clinid Polyclinic 27. a. Surgical Oncology b Surgical Oncology Clinic /Polyclinic
28. a. Neonatology Clinic b’ Neonatology
29. a. Paediatric Surgery b Paediatric Surgery Clinic Polyclinic
30. Palliative Care
31. Gl Surgery a. Hospital b’ Clinic
32. Endocrinology a Hospital b’ Clinic
33. PMR clinic
34. Nephrology a. Hospital b’ Clinic
35. Medicine and geriatrics a Hospital b Clinic’
‘
Note:
B,llxH:,flil11i:fi ^J!,:I $l’J’illlil’;ff t”‘l#’Xffi:i’ :ill?gi Establishments
I F. No. A.12034/18/201g-MH-IVMS]
Dr. Mandeep K Bhandari’ Joint Secretary The principal rules were published in the Gazette oI lndia’ Extraordinary’ Part
3, sub-section (i) vide notification number May,2112and last vide notiflcation number G S R 468(E)’
2014.
ll, Section
dated the 18th May’
G S’R 387(E)’ dated the 23rd
Clinical Establishments Act Standards for Clinic or Poly Clinic (Only Consultation)
CEA /Clinic- 001
Clinical Establishments Act Standard for
Clinic or Polyclinic (Only Consultation)
Standard No. CEA orClinic- 001
1
Clinical Establishments Act Standards for Clinic or Poly Clinic (Only Consultation)
CEA /Clinic- 001
Table of Contents
Sr. No.
Particulars
Page No.
1.
Definition
4
2.
Scope
4
3.
Infrastructure
5
4.
Furniture & Fixture
6
5.
Human Resource
6
6.
EquipmentorInstrumentsorDrugs
6
7.
Support Service
7
8.
LegalorStatutory Requirements
7
9.
Record Maintenance and Reporting
7
10.
Process
7
11.
Appendix -1
9
12.
Appendix -2
10
13.
Appendix -3
11
14.
Appendix -4
12
15.
Appendix -5
13
16.
Appendix -6
14
2
Clinical Establishments Act Standards for Clinic or Poly Clinic (Only Consultation)
CEA /Clinic- 001
Clinic or Polyclinic (Only Consultation)
1. Definition
1.1 A clinic may be defined as a Clinical establishment providing examination, consultation, prescription to outpatients including dispensing of medicines by a single general practitioner or a specialist doctor or a super-specialist doctor.
1.2 A polyclinic may be defined as a Clinical establishment providing examination, consultation, prescription to outpatients including dispensing of medicines by more than one doctor or general practitioners or specialist doctors or super- specialist doctors.
1.3 A few minor procedures like dressing and administering Injectionections etc may be provided in the clinic or polyclinic however not requiring observation or short stay.
2. Scope (as applicable)
2.1 These set of common minimum standards framed are applicable to a single practitioner or more than one doctor clinic manned by a General physician or specialist doctor or super specialist or a group of doctors who are themselves providing patient care services like dispensing of medicines, Injectionection and dressing.
2.2 To provide examination, consultation, prescription to outpatients by a single doctor or general physician or specialist doctors or super-specialist doctor or group of doctors who are themselves providing patient care services like dispensing of medicines, Injectionection and dressing.
2.3 Advice for health education and health promotion;
2.4 Any or more than one of the following are included:
a) General Physician
b) Cardiology
c) Cardiothoracic surgery
d) Dermatology
e) ENT
f) Endocrinology
g) Gastroenterology
3
Clinical Establishments Act Standards for Clinic or Poly Clinic (Only Consultation)
CEA /Clinic- 001
h) Internal Medicine
i) General Surgery
j) Gastro Intestinal Surgery
k) Gynecology & Obstetrics
l) Medical Oncology
m) Surgical Oncology
n) Nephrology
o) Neurosurgery
p) Neurology
q) Ophthalmology
r) Orthopedics
s) Pediatrics
t) Pediatric Surgery
u) Psychiatry
v) Rheumatology
w) Thoracic surgery
x) Tuberculosis and Respiratory Diseases
y) Urology
3. Infrastructure
3.1 The physical facility shall be developed and maintained to provide safe and secure environment for patients, their families, staff and visitors. It shall be situated in a place having clean surroundings and shall comply with local byelaws in force, if any, from time to time.
3.2 The minimum space requirement for carrying out the basic functions of the facility shall be as per Appendix 1.
3.3 The clinic facility shall be well illuminated, ventilated and clean with adequate water supply.
3.4 The clinic shall have a prominent board or signage displaying the name of the clinic in local language at the gate or on the building of the clinic.
3.5 The following other signage shall be well displayed in the language understood by the local public in the area:
a) Name of the doctor(s) with registration number.
b) Fee structure of the various doctors or specialists.
c) Timings of the clinics (For example: from 8am -2pm)
d) Services provided within the Facility.
4
Clinical Establishments Act Standards for Clinic or Poly Clinic (Only Consultation)
CEA /Clinic- 001
4. Furniture & Fixtures
4.1 Furniture and fixtures shall be available in accordance with the activities and workload of the Clinic or polyclinic.
4.2 The furniture and fixtures shall be functional all the time. For indicative list of items refer Appendix 2 (this list is indicative and not exhaustive).
5. Human Resource
5.1 The general practitioner or specialist doctor or super-specialist doctors as per the scope of the clinic or polyclinic shall be registered with State or Central Medical Council of India.
5.2 The services provided by the medical professionals shall be in consonance with their qualification, training and registration.
5.3 In a clinic or polyclinic, minimum one support staff must be available to meet the care treatment and service needs of the patient. However number may depend upon the workload and scope of the service being provided by the clinical establishment.
6. Equipmentorinstrumentsordrugs
6.1 The clinic or polyclinic shall have essential equipment as per Appendix3, and emergency equipment as per Appendix 4.
6.2 Other equipment as per the scope of service being practiced shall be available.
6.3 Adequate space for storage of equipment and medicines shall be provided and if available medicines shall be stored as per manufacturer’s guidelines. The equipment shall be of adequate capacity to meet work load requirement.
6.4 All equipment shall be in good working condition at all times. Periodic inspection, cleaning, maintenance of equipment shall be done.
5
Clinical Establishments Act Standards for Clinic or Poly Clinic (Only Consultation)
CEA /Clinic- 001
6.5
7.
7.1
8.
The clinic or polyclinic shall have basic minimal essential drugs as per Appendix 5; however other drugs as per the scope of service being practiced may also be available.
Support Service
In a clinic or polyclinic minimum one support staff must be available to meet the care treatment and service needs of the patient. However number may depend upon the workload and scope of the service being provided by the clinical establishment.
Legal or Statutory Requirements
SN
Name of the Act or License
Licensing body
1
Registration of medical doctor with CentralorState Medical Council
MCI or State Medical Council as applicable
2
Biomedical Waste Management Rules, 2016
State Pollution Control Board
3
Registration of the Clinic
State Council
9.
9.1
9.2
Record Maintenance and reporting
Every Clinical Establishment shall maintain medical records of patients treated by it and health information and statistics in respect of national programmes and furnish the same to the district authorities in form of quarterly reports.
All clinical establishments shall be responsible for submission of information and statistics in time of emergency or disaster or epidemic situation or as required from time to time by National Council, Clinical eEtablishments Act 2010.
10. Process
10.1 Registration
10.1.1 Every patient visiting the clinic shall be registered.
10.1.2Patient shall be guided and informed regarding Patients’ Rights and
Responsibilities Appendix 6
6
Clinical Establishments Act Standards for Clinic or Poly Clinic (Only Consultation)
CEA /Clinic- 001
10.2 Assessment
10.2.1Every patient shall undergo assessment, during the course of assessment, the patient findings, medications and investigations should be documented with working diagnosis, legibly in the assessment or OPD prescription with the signature of the consultant or Specialist or Super specialist with date and time.
10.3 Infection Control
10.3.1 The clinic shall take all precautions to control infections like practising hand hygiene etc.
10.3.2 Availability of clean water for hand washing or liberal use of sanitizer shall be maintained throughout the working hours of the clinic.
10.3.3 Sanitation and hygiene of the toilets if available shall be maintained.
10.3.4 Mopping of all patient care areas with disinfectant shall be done at least once a day.
10.4 Safety Considerations
10.4.1 The clinic shall ensure to take care of patient safety aspects like patient fall, etc.
10.4.2 The clinic shall be kept pest and termite free.
10.5.1 Biomedical waste shall be managed in accordance with the Bio Medical Waste management Rules, 2016.
10.5.2 Clinic waste generated shall be segregated at source.
10.5.3 Needles and sharp waste shall be stored in tamper proof, leak proof and puncture proof container.
10.6 First aid
10.6.1 Provision shall be made for providing First Aid.
10.6.2 Contact details of ambulance hospital etc shall be available in case of emergency.
10.5
Biomedical waste Management
7
Clinical Establishments Act Standards for Clinic or Poly Clinic (Only Consultation)
CEA /Clinic- 001
APPENDIX 1
Infrastructure Requirement (Desirable)
Minimum area required for clinic shall be as follows:
SN
LOCATION
AREA REQUIRED
REMARKS
1
Common area (Reception and waiting)
35 sq ft carpet area
2
Consultation room (ancillary area)
70 sq ft including storage
Area specified under consultation room is only for single clinic and shall be multiplied accordingly by the number of consultation chambers.
Note: Reception, waiting, consultation room etc shall be adequate as per the requirement and workload of the clinic.
Ancillary areaorspace: Storage of records, reagents, consumables, stationery etc and eating area for staff.
APPENDIX 2
Furniture or fixtures
S.N.
Articles
1.
Table
2.
Chairs
3.
Examination Table or couch
4.
Screens
5.
Foot Step
6.
Stools
7.
Storage Cabinet for records etc.
8.
BMW storage area
8
Clinical Establishments Act Standards for Clinic or Poly Clinic (Only Consultation)
CEA /Clinic- 001
I. Essential Equipment
APPENDIX 3
Equipment or Instrument
S. No.
Name of the equipment
Minimum Specifications
No. of equipment
1
Stethoscope
1
2
Thermometer
(Non Mercury)
1
3
Torch (flash lights)
1
4
Sphygmomanometer(Blood Pressure Apparatus)
(Non Mercury)
1
5
Weighing machine(Optional)
Adult
1
APPENDIX 4
I. Emergency Equipment
S. No.
Name of the equipment
Minimum Specifications
No. of equipment
1
Resuscitation Equipment Ambu Bag or Air Way
– Adult
– Pediatric
1 1
2
Oxygen Concentrator or Cylinder (Portable)
1
3
Fire Extinguisher
–
1
9
Clinical Establishments Act Standards for Clinic or Poly Clinic (Only Consultation)
CEA /Clinic- 001
APPENDIX 5
I. Emergency Drugs
S. No.
Name of the Drug
Minimum Quantity
1
Injection Adrenaline
2 Ampoules
2
Injection Hydrocortisone
1 vial
3
Injection Atropine
1 Ampoule
5
Injection Pheniramine maleate
1 Ampoule
6
Injection Promethazine
1 Ampoule
7
Injection Deriyphylline
1 Ampoule
8
Injection. Frusemide
1 Ampoule
9
Injection. Metoclopramide
1 Ampoule
10
Injection Dexamethasone
1 Ampoule
11
Injection Diazepam
1 Ampoule
12
Injection Dicyclomine Hydrochloride
1 Ampoule
13
Injection 5% dextrose infusion
1 Vac
14
Injection Normal saline
1 Vac
10
Clinical Establishments Act Standards for Clinic or Poly Clinic (Only Consultation)
CEA /Clinic- 001
APPENDIX 6
Patients’ Rights and Responsibilities: Patients’ Rights
A patient and his or her representative has the following rights with respect to the clinical establishment-
1. To adequate relevant information about the nature, cause of illness, proposed investigations and care, expected results of treatment, possible complications and expected costs;
2. Rate of services provided by the clinical establishment would be displayed prominently.
3. To access a copy of case papers, patient records, investigations reports and detailed bill.
4. To informed consent prior to specific tests or treatment (e.g. surgery, chemotherapy)
5. To seek second opinion from an appropriate clinician of patients’ choice, with records and information being provided by treating hospital
6. To confidentiality, human dignity and privacy during treatment.
7. To have ensured presence of a female person, during physical examination of
a female patient by a male practitioner.
8. To non-discrimination about treatment and behaviour on the basis of HIV
status.
9. To choose alternative treatment if options are available.
10. Rate of services provided by the clinical establishment would be displayed
prominently.
Patients’ Responsibilities
Provide all health related information
Cooperate with Doctors during examination and treatment
Follow all instructions
Pay hospitals agreed fees on time
Respect dignity of doctors and other hospital staff
Never resort to violence
11
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
Clinical Establishments
Act Standard for
Clinic or Polyclinic
with Dispensary Standard No.CEA/Clinic- 002
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
Table of Contents
Sr. No.
Particulars
Page No.
1
Definition
4
2
Scope (as applicable)
4
3
Infrastructure
5
4
Furniture and Fixtures
6
5
Human Resource
6
6
Equipment or Instruments or Drugs
6
7
Support Service
7
8
Legal or Statutory Requirements
7
9
Record Maintenance and Reporting
7
10
Process
8
11
Appendix -1
10
12
Appendix -2
11
13
Appendix -3
12
14
Appendix -4
13
15
Appendix -5
14
16
Appendix -6
15
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
Clinicor Polyclinic with Dispensary
11. Definition
11.1 A clinic may be defined as a clinical establishment providing examination, consultation, prescription to outpatients including dispensing of medicines by a single or general practitioner or group of general practitioners or specialist doctor or super-specialist doctor.
11.2 A polyclinic may be defined as a clinical establishment providing examination, consultation, prescription to outpatients including dispensing of medicines by more than one doctor or general practitioner or group of general practitioners or specialist doctor or super-specialist doctor.
11.3 A few minor procedures like dressing, administering Injections, family planning etc may be provided in the clinic or polyclinic however not requiring observation or short stay.
11.4 Dispensing of medicines shall be done by qualified professionals to out- patients.
12.Scope (as applicable)
12.1 These set of common minimum standards framed are applicable to a single practitioner or more than one doctor clinic manned by a general physician or specialist doctor or super specialist or a group of doctors who are themselves providing patient care services like dispensing of medicines, Injections and dressings.
12.2 To provide examination, consultation, prescription to outpatients by a single doctor or general physician or specialist doctor or super-specialist doctor or group of doctors who are themselves providing patient care services like dispensing of medicines, Injections and dressings.
12.3 To deliver primary service in health education and health promotion;
12.4 To deliver health care services of rehabilitative nature.
12.5 Any or more than one of the following are included:
a) General Physician
b) Cardiology
c) Cardiothoracic surgery
d) Dermatology
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
e) ENT
f) Endocrinology
g) Gastroenterology
h) Internal Medicine
i) General Surgery
j) Gastro Intestinal Surgery
k) Gynecology & Obstetrics
l) Medical Oncology
m) Surgical Oncology
n) Nephrology
o) Neurosurgery
p) Neurology
q) Ophthalmology
r) Orthopedics
s) Pediatrics
t) Pediatric surgery
u) Psychiatry
v) Rheumatology
w) Thoracic surgery
x) Tuberculosis and Respiratory Diseases
y) Urology
13. Infrastructure
13.1 The physical facility shall be developed and maintained to provide safe and secure environment for patients, their families, staff and visitors. It shall be situated in a place having clean surroundings and shall comply with local byelaws in force, if any, from time to time.
13.2 The minimum space requirement for carrying out the basic functions of the facility shall be as per Appendix 1.
13.3 The area shall be well illuminated, ventilated and clean with adequate water supply.
13.4 The clinic shall have a prominent board or signage displaying the name of the clinic in local language at the gate or on the building of the clinic.
13.5 The following other signages shall be well displayed in the language understood by the local public in the area:
a) Name of the doctor(s) with registration number(s).
b) Fee structure of the various doctors or specialists
c) Timings of the clinics (For e.g. from 8am -2pm)
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
d) Services provided within the facility
14.Furniture & Fixtures
14.1 Furniture and fixtures shall be available in accordance with the activities and workload of the Clinic or polyclinic.
14.2 The furniture and fixtures shall be functional all the time. For indicative list of items refer to Appendix 2 (This list is indicative and not exhaustive).
15.Human Resource Requirements
15.1 A single general practitioner or group of general practitioners or specialist doctors or super-specialist doctors as per the scope of the clinic or polyclinic shall be registered with State or Central Medical Council of India.
15.2 The services provided by the medical professionals shall be in consonance with their qualification, training and registration.
15.3 If dispensing is done by paramedic like pharmacist, he shall be qualified, trained and registered with the Pharmacy Council.
16.Equipment or instruments or drugs
16.1 The clinic or polyclinic shall have essential equipments as per Appendix 3 and emergency equipment as per Appendix 4.
16.2 Other equipments as per the scope of service being practised shall also be available.
16.3 Adequate space for storage of equipments and medicines shall be provided and if available medicines shall be stored as per manufacturer’s guidelines. The equipment shall be of adequate capacity to meet work load requirement.
16.4 All equipment shall be in good working condition at all times. Periodic inspection, cleaning, maintenance of equipment shall be done.
16.5 The clinic or polyclinic shall have basic minimal essential drugs as per Appendix 5; however other drugs as per the scope of service being practised may also be available.
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
17.Support Service
7.1 In a Clinic or polyclinic, minimum one support staff must be available to meet the care, treatment and service needs of the patient. However number may depend upon the workload and scope of the service being provided by the clinical establishment.
18.LegalorStatutory Requirements
S. No
Name of the Actor License
Department or Area
Licensing body
1
Registration of medical doctor with Central or State Medical Council
Administration
MCI or State Medical Council
2
Biomedical Waste Management Rules, 2016
Administration
State pollution control Board
3
Local registration of the Clinic
Administration
State Council
4.
Pharmacy License
Administration
Indian Pharmacy Council
19.Record Maintenance and reporting
19.1 Every Clinical Establishment shall maintain medical records of patients treated by it and health information and statistics in respect of national programmes and furnish the same to the district authorities in form of quarterly reports.
19.2 All clinical establishments shall be responsible for submission of information and statistics in time of emergency or disaster or epidemic situation or as required from time to time by National Council, Clinical Establishments Act 2010.
19.3 Medicine Records and Registers
20.Basic processes 10.1 Registration
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
Every patient visiting the clinic shall be registered.
10.1.1Patient shall be guided and informed regarding Patients’ rights and
responsibilities Appendix 6 10.2 Assessment
10.2.1 Every patient shall undergo assessment, during the course of assessment, the patient findings, medications and investigations should be documented with working diagnosis, legibly in the assessment or OPD prescription with the signature of the consultant or Specialist or Super Specialist with date and time.
10.2.2 Medicines shall be dispensed by qualified doctor or pharmacist as allowed by law.
10.2.3 No medicines shall be dispensed from pharmacy store without a written prescription order of doctor, except in emergency cases. Medication dispensing shall be done with care to prevent any medication error. Following shall be checked before dispensing of medication. These checks shall be done at store level.
10.2.3.1 10.2.3.2 10.2.3.3 10.2.3.4 10.2.3.5
Medicine prescribed.
Dose of prescribed medicine.
Expiry date.
Particulate matter in liquid dosage forms and parenteral drugs. Labels (if reconstituted drugs).
10.2.4 Labeling shall be done for every prepared or reconstituted medication, which shall include name, date of preparation, strength and frequency of administration of drug.
10.3 Infection Control
10.3.1 The clinic shall take all precautions to control infections like practising hand hygiene etc.
10.3.2 The clinic shall have availability of clean water for hand washing or should be maintained throughout the working hours of the clinic.
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
10.3.3 Sanitation and hygiene of the toilets if available shall be maintained.
10.3.4 Mopping of all patient care areas with disinfectant shall be done at least once a day
10.4 Safety Considerations
10.4.1 Effort shall be made to take care of patient safety aspects like patient fall, etc.
10.4.2 Effort shall be made to keep clinic pest and termite free.
10.5 Biomedical waste Management
10.5.1 Biomedical waste should be managed in accordance with the BMW management Rules, 2016.
10.5.2 Clinic waste generated should be segregated at source.
10.5.3 Needles and sharp waste should be stored in puncture proof, leak proof and tamper proof containers.
10.6 First aid
10.6 Provision shall be made for providing First Aid.
10.7 Contact details of ambulance hospital etc shall be available.
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
Minimum area required for a clinic:
APPENDIX 1
Infrastructure requirement (Desirable)
SN
LOCATION
AREA REQUIRED
REMARKS
1
Common area (Reception and waiting)
35 sq ft carpet area
2
Consultation room (ancillary area)
70 sq ft carpet area including storage
Area specified under consultation room is only for single clinic and shall be multiplied accordingly by the number of consultation chambers.
3
Store and pharmacy
40 sq ft
Note: Reception, waiting, consultation room etc shall be adequate as per the requirement and workload of the clinic.
Ancillary area or space: Storage of records, reagents, consumables, stationery etc
Furniture or fixtures
APPENDIX 2
S.N.
Articles
1
Table
2
Chairs
3
Examination Table or couch
4
Screens
5
Foot Step
6
Stools
7
Storage Cabinet for records etc.
8
BMW Storage area
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
I. Essential Equipment:
APPENDIX- 3
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
Stethoscope
1
2
Thermometer
(Non Mercury)
1
3
Torch (flash lights)
1
4
Sphygmomanometer (B.P. Apparatus)
(Non Mercury)
1
5
Weighing machine (Optional)
Adult
1
APPENDIX- 4
I. Emergency Equipment:
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
Resuscitation Equipment Ambu Bag or Air Way
– Adult
– Pediatric
1 1
2
Oxygen Concentrator or Cylinder (Portable)
1
3
Fire Extinguisher
–
1
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
APPENDIX- 5
I. Emergency Drugs
S. No.
Name of the Drug
Minimum Quantity
1
Injection Adrenaline
2 Ampoules
2
Injection Hydrocortisone
1 vial
3
Injection Atropine
1 Ampoule
5
Injection Pheniramine maleate
1 Ampoule
6
Injection Promethazine
1 Ampoule
7
Injection Deriyphylline
1 Ampoule
8
Injection Frusemide
1 Ampoule
9
Injection Metoclopramide
1 Ampoule
10
Injection Dexamethasone
1 Ampoule
11
Injection. Diazepam
1 Ampoule
12
Injection Dicyclomine Hydrochloride
1 Ampoule
13
Injection. 5% dextrose infusion
1 Vac
14
Injection. Normal saline
1 Vac
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
APPENDIX 6 Patients’ rights and responsibilities:
Patients’ Rights
A patient and his or her representative has the following rights with respect to the clinical establishment-
11. To adequate relevant information about the nature, cause of illness, proposed investigations and care, expected results of treatment, possible complications and expected costs;
12. Rate of services provided by the clinical establishment would be displayed prominently.
13. To access a copy of case papers, patient records, investigations reports and detailed bill.
14. To informed consent prior to specific tests or treatment (e.g. surgery, chemotherapy.)
15. To seek second opinion from an appropriate clinician of patients’ choice, with records and information being provided by treating hospital
16. To confidentiality, human dignity and privacy during treatment.
17. To have ensured presence of a female person, during physical examination of
a female patient by a male practitioner.
18. To non-discrimination about treatment and behaviour on the basis of HIV
status.
19. To choose alternative treatment if options are available
20. Rate of services provided by the clinical establishment would be displayed
prominently.
Patients’ Responsibilities
Provide all health related information
Cooperate with doctors during examination, treatment etc
Follow all instructions
Pay hospitals agreed fees on time
Respect dignity of doctors and other hospital staff
Never resort to violence
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
Clinical Establishments Act Standard for Clinic or Polyclinic or Dispensary with Diagnostic Support Services
Standard No.CEA or Clinic-003
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
Table of Contents
Particulars
Page No.
1
Definition
4
2
Scope (as applicable)
4
3
Infrastructure
5
4
Furniture & Fixture
6
5
Human Resource
6
6
Equipment or Instruments or Drugs
6
7
Support Service
6
8
Legal or Statutory Requirements
7
9
Record Maintenance and Reporting
7
10
Process
8
11
Appendix -1
10
12
Appendix -2
11
13
Appendix -3
12
14
Appendix -4
13
15
Appendix -5
14
16
Appendix -6
18
17
Appendix -7
19
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
Clinicor Polyclinic with Diagnostic Support Services
11 Definition
11.1 A clinic with support services may be defined as a healthcare facility providing examination, consultation, prescription to outpatients by a single general practitioner or or a group of general practitioners or specialist doctor or super- specialist doctor. In addition, also have the support services like pharmacy, Injections, family planning facility, dressing room, and sample collection facility, basic laboratory, X- ray, USG with or without color Doppler, ECG or any other.
12 Scope (as applicable)
12.1 These set of common minimum standards framed are applicable to a single practitioner or more than one doctor clinic manned by a General physician or specialist doctor or super specialist or a group of doctors who are providing patient care services like dispensing of medicines, Injection and dressing, with observation or short stay facility. In addition, also have the support services like pharmacy, Injections, family planning facility, dressing room, sample collection facility, basic laboratory, X- ray, USG with or without colour Doppler, ECG or any other.
12.2 To provide examination, consultation, prescription to outpatients by a single doctor or general physician or specialist doctors or super-specialist doctor or group of doctors who are providing patient care services like dispensing of medicines, Injection and dressing with observation or short stay facility.
12.3 To deliver primary service in health education and health promotion;
12.4 To deliver health care services of rehabilitative nature.
12.5 Any or more than one of the following are included:
a) General Physician
b) Cardiology
c) Cardiothoracic surgery
d) Dermatology
e) ENT
f) Endocrinology
g) Gastroenterology
It differs from Health checkup center which provides health preventive and promotive services.
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
h) Internal Medicine
i) General Surgery
j) Gastro Intestinal Surgery
k) Gynecology & Obstetrics
l) Medical Oncology
m) Surgical Oncology
n) Nephrology
o) Neurosurgery
p) Neurology
q) Ophthalmology
r) Orthopedics
s) Pediatrics
t) Pediatric surgery
u) Psychiatry
v) Rheumatology
w) Thoracic surgery
x) Tuberculosis and Respiratory Diseases
y) Urology
13 Infrastructure
13.1 The physical facility shall be developed and maintained to provide safe and secure environment for patients, their families, staff and visitors. It shall be situated in a place having clean surroundings and shall comply with municipal byelaws in force from time to time.
13.2 The minimum space requirement for carrying out the basic functions of the facility shall be as per Appendix 1.
13.3 The area shall be well illuminated, ventilated and clean with adequate water supply.
13.4 The clinic shall have a prominent board or signage displaying the name of the clinic in local language at the gate or on the building of the clinic.
13.5 The following other signage shall be well displayed in the language understood by the local public in the area:
a) Name of the doctors with registration number.
b) Fee structure of the various doctors or specialists
c) Timings of the clinics (For e.g. – from 8am -2pm)
d) Services provided within the Facility
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
14 Furniture & Fixtures
14.1 Furniture and fixtures shall be available in accordance with the activities and workload of the Clinic or Polyclinic.
14.2 The furniture and fixtures shall be functional all the time. For indicative list of items, refer to Appendix 2. (This list is indicative and not exhaustive).
15 Human Resource
15.1 The general practitioner or specialist doctor or super-specialist doctors as per the scope of the clinic or polyclinic shall be registered with State or Central Medical Council of India.
15.2 The services provided by the medical professionals shall be in consonance with their qualification, training and registration.
15.3 In a polyclinic, minimum one support staff must be available to meet the care treatment and service needs of the patient. However, number may depend upon the workload and scope of the service being provided by the clinical establishment.
16 Equipmentor instrumentsor drugs
16.1 The clinic or polyclinic shall have essential equipment as per Appendix 3, emergency equipment Appendix 4 and other equipment as per the scope of service being practiced as per Appendix 5.
16.2 Adequate space for storage of medicines equipment etc shall be provided. The equipment shall be of adequate capacity to meet work load requirement.
16.3 All equipment shall be in good working condition at all times. Periodic inspection, cleaning, maintenance of equipment shall be done.
16.4 The clinic or polyclinic shall have desired beds for observation or short stay facility.
16.5 The clinic or polyclinic shall have basic minimal essential drugs as per Appendix 6; however other drugs as per the scope of service being practiced may also be available.
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
17 Support Service
7.1 In a Clinic or polyclinic, minimum one support staff must be available to meet the care treatment and service needs of the patient. However number may depend upon the workload and scope of the service being provided by the clinical establishment.
18 LegalorStatutory Requirements
S. No
Name of the Act or License
Department or Area
Licensing body
1
Registration of medical doctor with Central or State Medical Council
Administration
MCI or State Medical Council
2
Biomedical Management & Rules, 2016
Administration
State Pollution Control Board
3
Local registration of the Clinic
Administration
State Council
4.
Pharmacy License
Administration
Indian Pharmacy Council (If applicable)
5.
USG
Administration
PC-PNDT
5
Approval for X-ray if available
Administration
AERB
19
Record Maintenance and reporting
19.1 Every Clinical Establishment shall maintain medical records of patients treated by it and health information and statistics in respect of national programmes and furnish the same to the district authorities in form of quarterly reports.
19.2 All clinical establishments shall be responsible for submission of information and statistics in time of emergency or disaster or epidemic situation or as required from time to time by National Council Clinical establishments Act 2010.
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
10. Process
10.1Registration
10.1.1 Every patient visiting the clinic shall be registered.
Patient shall be guided and informed regarding Patients’ Rights and Responsibilities Appendix 7
10.2Assessment
10.2.1 Each patient shall undergo an initial assessment, which would include
measurement of the vitals, height & weight.
10.2.2 The same shall be documented in an assessment or O.P.D. card.
10.2.3 During the course of assessment, the patient findings, medications and investigations shall also be documented legibly in the card with the signature of the consultant or Specialist or super specialist, date and time.
10.2.4 No medicines shall be dispensed from pharmacy store (if facility available) without a written prescription order of doctor, except in emergency cases. Medication dispensing shall be done with care to prevent any medication error. Following shall be checked before dispensing of medication. These checks shall be done at store level:
10.2.4.1 10.2.4.2 10.2.4.3 10.2.4.4 10.2.4.5
Medicine prescribed.
Dose of prescribed medicine.
Expiry date.
Particulate matter in liquid dosage forms and parenteral drugs Labels (if reconstituted drugs).
10.2.5 Labeling shall be done for every prepared or reconstituted medication, which shall include name, date of preparation, strength and frequency of administration of drug.
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
10.2.6 The availability of support staff including nursing is essential to ensure safe observation or short stay facility.
10.3Infection Control
10.3.1 The clinic shall take all precautions to control infections like religiously
practicing hand washing.
10.3.2 Availability of running tap water for hand washing or liberal use of sanitizer shall be maintained throughout the working hours of the clinic.
10.3.3 The clinic environment shall be kept clean.
10.3.4 Sanitation and hygiene of the toilets shall be maintained.
10.3.5 Mopping of all areas with disinfectant shall be done at least once a day.
10.4.1 There shall be no seepage in walls or any blockade of drains. There shall be provision of air circulation. Effort shall be made to keep clinic pest and termite free. Availability of mosquito net on windows shall be ensured by the clinician.
10.5Biomedical waste Management
10.5.1 Clinic waste generated shall be segregated at source.
10.5.2 Biomedical waste shall be managed in accordance with the BioMedical Waste management Rules, 2016.
10.5.3 Needles shall be destroyed with the help of a needle destroyer before putting them in tamper proof, leak proof and puncture proof container.
10.6.1 Appropriate facility for First Aid shall be available.
10.4
Safety Considerations
10.6
First aid & basic life support
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
Minimum area required for a clinic:
APPENDIX 1
Infrastructure requirement (Desirable)
SN
LOCATION
AREA REQUIRED
REMARKS
1
Common area (Reception and waiting)
35 sq ft carpet area
2
Consultation room (ancillary area)
70 sq ft
Area specified under consultation room is only for single clinic and shall be multiplied accordingly by the number of consultation chambers.
3
Store and pharmacy
40 sq ft
4
Observation and short stay (if applicable)
65 sq ft or bed
5
For X-Ray or USG, if applicable
As per laws applicable
Note: Reception, waiting, consultation room etc shall be adequate as per the requirement and workload of the clinic.
Ancillary area or space: Storage of records, reagents, consumables, stationery etc eating area for staff
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
APPENDIX 2
Furniture or fixtures
S.No.
Articles
1
Table
2
Chairs
3
Examination Table or couch
4
Screens
5
Foot Step
6
Stools
7
Storage Cabinet for medicine, records etc.
8
Bed(s) for observation
9
BMW storage area
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
APPENDIX- 3
I. Essential Equipment:
S. No.
Name of the equipment
Minimum Specifications
No. Of equipment
1
Stethoscope
1
2
Thermometer
(Non Mercury)
1
3
Torch (flash lights)
1
4
Tongue depressor
1
6
Measuring Tape
1
7
Sphygmomanometer (B.P. Apparatus)
(Non Mercury)
1
8
Height measuring Scale
1
9
Needle Destroyer
1
10
Weighing machine(Optional)
Adult
1
11
Bed(s)
1 or more
12
IV stand
1
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
APPENDIX- 4
I. Emergency Equipment:
S. No.
Name of the equipment
Minimum Specifications
No. of equipment
1
Resuscitation Equipment Ambu Bag or Air Way
– Adult
– Pediatric
1 1
2
Oxygen Cylinder (Portable)
1
3
Fire Extinguisher
ABC Type
1
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
APPENDIX – 5
Specialty wise Equipment List 1. Cardiology
2. Cardiothoracic Surgery
3. ENT
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
ECG Machine
1
2
Pulse Oximeter
1
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
ECG Machine
1
2
Pulse Oximeter
1
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
Examination instruments set(speculums, mirrors, Bull’s lamp)
1
2
Diagnostic Otoscope
1
3
Head Light
1
4
Oesophagoscope Adult
(Desirable)
1
5
Oesophagoscope Child
(Desirable)
1
6
Laryngoscope
(Desirable)
1
7
Tuning Fork
1
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
4. Endocrinology
5. Gastroenterology
6. General Medicine
7. Gynaecology & Obstetrics
8. Neurosurgery
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
Glucometer
1
S. No.
Name of the equipment
Minimum
Specifications
Number of
equipment
1
Proctoscope
1
2
Surgical Gloves
1
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
ECG Machine
1
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
Sim’s vaginal speculum
1
2
Infantometer
1
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
EMG Machine
1
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
9. Neurology
10. Ophthalmology
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
EMG Machine
S. No.
Name of the equipment
Minimum
Number of
Ophthalmoscope
Specifications
equipment
1
1
2
Slit Lamp
1
3
Retinoscope
Perimeter
1
4
1
5
Distant Vision Charts
1
6
Near Vision charts
Trial Frame Adult or Children
1
7
1
8
Trial Lens Set
1
11. Orthopaedics
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
Ortho Fracture Table
1
2
Skeleton traction set
1
3
Cramer wire splints
1
4
Thomas Splint
1
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
12. Paediatrics
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
Nebulizer baby
1
2
Weighing machine infant
1
13. Tuberculosis and Respiratory Disease
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
Spirometer
2
Nebulizer
3
Face mask
4
Peak Air flow meter
14. Urology
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
Uroflowmeter
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
APPENDIX- 6
I. Essential Drugs
S. No.
Name of the Drug
Minimum Quantity
1
Injection Adrenaline
2 Ampoules
2
Injection Hydrocortisone
1 vial
3
Injection Atropine
1 Ampoule
5
Injection Pheniramine maleate
1 Ampoule
6
Injection Promethazine
1 Ampoule
7
Injection Deriphylline
1 Ampoule
8
Injection Frusemide
1 Ampoule
9
Injection Metoclopramide
1 Ampoule
10
Injection Dexamethasone
1 Ampoule
11
Injection. Diazepam
1 Ampoule
12
Injection Dicyclomine Hydrochloride
1 Ampoule
13
Injection 5% dextrose infusion
1 Vac
14
Injection. Normal saline
1 Vac
Note: Other drugs as per the scope of service being practiced may also be available.
Clinical Establishments Act Standards for Clinic or Polyclinic with Dispensary /Clinic-002
APPENDIX 7
Patients’ Rights and Responsibilities: Patients’ Rights
A patient and his or her representative has the following rights with respect to the clinical establishment-
21. To adequate relevant information about the nature, cause of illness, proposed investigations and care, expected results of treatment, possible complications and expected costs;
22. Rate of services provided by the clinical establishment would be displayed prominently.
23. To access a copy of case papers, patient records, investigations reports and detailed bill.
24. To informed consent prior to specific tests or treatment (e.g. surgery, chemotherapy)
25. To seek second opinion from an appropriate clinician of patients’ choice, with records and information being provided by treating hospital
26. To confidentiality, human dignity and privacy during treatment.
27. To have ensured presence of a female person, during physical examination of
a female patient by a male practitioner.
28. To non-discrimination about treatment and behaviour on the basis of HIV
status
29. To choose alternative treatment if options are available
30. Rate of services provided by the clinical establishment would be displayed
prominently.
Patients’ Responsibilities
Provide all health related information
Cooperate with Doctors during examination, treatment
Follow all instructions
Pay hospitals agreed fees on time
Respect dignity of doctors and other hospital staff
Never resort to violence
Clinical Establishments Act Standards for Clinic or Polyclinic with Observation or Short Stay CEA/Clinic-004
Clinical Establishments Act Standard for Clinic or Polyclinic with Observation or Short Stay
Standard No.CEA/ Clinic- 004
Clinical Establishments Act Standards for Clinic or Polyclinic with Observation or Short Stay CEA/Clinic-004
Table of Contents
Particulars
Page No.
1
Definition
4
2
Scope (as applicable)
4
3
Infrastructure
5
4
Furniture & Fixture
6
5
Human Resource
6
6
Equipment or Instruments or Drugs
6
7
Support Service
7
8
Legal or Statutory Requirements
7
9
Record Maintenance and Reporting
7
10
Process
8
11
Appendix -1
10
12
Appendix -2
11
13
Appendix -3
12
14
Appendix -4
13
15
Appendix -5
14
16
Appendix -6
18
17
Appendix -7
19
Clinical Establishments Act Standards for Clinic or Polyclinic with Observation or Short Stay CEA/Clinic-004
Clinicor Polyclinic with Observation or Short Stay
20 Definition
20.1 A clinic with observation or short stay may be defined as a healthcare facility providing examination, consultation, prescription to outpatients by a single general practitioner or group of general practitioners or specialist doctor or super-specialist doctor and carrying out few minor procedures like dressing and administering Injections with observation or short stay facility.
20.2 A polyclinic with observation or short stay may be defined as a healthcare facility providing consultation to outpatients by more than one doctor or general practitioner or specialist doctor or super-specialist doctor and carrying out few minor procedures like dressing and administering Injections with observation or short stay facility.
20.3 Observation or short stay facility would be available.
21 Scope (as applicable)
21.1 These set of common minimum standards framed are applicable to a single practitioner or more than one doctor clinic manned by a General physician or specialist doctor or super specialist or a group of doctors who are providing patient care services like dispensing of medicines, Injection and dressing, family planning with observation or short stay facility.
21.2 To provide examination, consultation, prescription to outpatients by a single doctor or general physician or specialist doctors or super-specialist doctor or group of doctors who are providing patient care services like dispensing of medicines, Injection and dressing with observation or short stay facility.
21.3 To deliver primary service in health education and health promotion;
21.4 To deliver health care services of rehabilitative nature.
21.5 Any or more than one of the following are included:
a) General Physician
b) Cardiology
c) Cardiothoracic surgery
d) Dermatology
e) ENT
Clinical Establishments Act Standards for Clinic or Polyclinic with Observation or Short Stay CEA/Clinic-004
f) Endocrinology
g) Gastroenterology
h) Internal Medicine
i) General Surgery
j) Gastro Intestinal Surgery
k) Gynaecology & Obstetrics
l) Medical Oncology
m) Surgical Oncology
n) Nephrology
o) Neurosurgery
p) Neurology
q) Ophthalmology
r) Orthopedics
s) Pediatrics
t) Pediatric surgery
u) Psychiatry
v) Rheumatology
w) Thoracic surgery
x) Tuberculosis and Respiratory s
y) Urology
22 Infrastructure
22.1 The physical facility shall be developed and maintained to provide safe and secure environment for patients, their families, staff and visitors. It shall be situated in a place having clean surroundings and shall comply with municipal byelaws in force from time to time.
22.2 The minimum space requirement for carrying out the basic functions of the facility shall be as per Appendix 1.
22.3 The area shall be well illuminated, ventilated and clean with adequate water supply.
22.4 The clinic shall have a prominent board or signage displaying the name of the clinic in local language at the gate or on the building of the clinic.
22.5 The following other signage shall be well displayed in the language understood by the local public in the area:
a) Name of the doctors with registration number.
Clinical Establishments Act Standards for Clinic or Polyclinic with Observation or Short Stay CEA/Clinic-004
b) Fee structure of the various doctors or specialists
c) Timings of the clinics (For e.g. from 8am -2pm)
d) Services provided within the Facility
23 Furniture & Fixtures
23.1 Furniture and fixtures shall be available in accordance with the activities and workload of the Clinic or Polyclinic.
23.2 The furniture and fixtures shall be functional all the time. For indicative list of items refer Appendix 2. This list is indicative and not exhaustive.
24 Human Resource
24.1 The general practitioner or specialist doctor or super-specialist doctors as per the scope of the clinic or polyclinic shall be registered with State or Central Medical Council of India.
24.2 The services provided by the medical professionals shall be in consonance with their qualification, training, registration.
24.3 In a polyclinic, minimum one support staff must be available to meet the care treatment and service needs of the patient. , number may depend upon the workload and scope of the service being provided by the clinical establishment.
25 Equipment o rinstruments or drugs
25.1 The clinic or polyclinic shall have essential equipments as per Appendix3, emergency equipment Appendix 4 and other equipments as per the scope of service being practiced as per Appendix 5.
25.2 Adequate space for storage of medicines equipments etc shall be provided. The equipment shall be of adequate capacity to meet work load requirement.
25.3 All equipment shall be in good working condition at all times. Periodic inspection, cleaning, maintenance of equipment shall be done.
25.4 The clinic or polyclinic shall have desired beds for observation or short stay facility.
Clinical Establishments Act Standards for Clinic or Polyclinic with Observation or Short Stay CEA/Clinic-004
25.5
26
7.1
27
The clinic or polyclinic shall have basic minimal essential drugs as per Appendix 6; however other drugs as per the scope of service being practiced may also be available.
Support Service
In a Clinic or polyclinic, minimum one support staff must be available to meet the care treatment and service needs of the patient. However, number may depend upon the workload and scope of the service being provided by the clinical establishment.
LegalorStatutory Requirements
S. No
Name of the Act or License
Department or Area
Licensing body
1
Registration of medical doctor with Central or State Medical Council
Administration
MCI or State Medical Council
2
Biomedical Management Rules, 2016
Administration
State Pollution Control Board
3
Local registration of the Clinic
Administration
State Council
4.
Pharmacy License
Administration
Indian Pharmacy Council
28
28.1
28.2
Record Maintenance and reporting
Every Clinical Establishment shall maintain medical records of patients treated by it and health information and statistics in respect of national programmes and furnish the same to the district authorities in form of quarterly reports.
All clinical establishments shall be responsible for submission of information and statistics in time of emergency or disaster or epidemic situation or as required from time to time by National Council Clinical Establishments Act 2010.
Clinical Establishments Act Standards for Clinic or Polyclinic with Observation or Short Stay CEA/Clinic-004
10. Process
10.1Registration
10.1.1 Every patient visiting the clinic shall be registered.
10.1.2Patient shall be guided and informed regarding Patients’ rights &
responsibilities. Appendix 7 10.2Assessment
10.2.1 Each patient shall undergo an initial assessment, which would include measurement of the vitals, height & weight.
10.2.2 The same shall be documented in an assessment or O.P.D. card.
10.2.3 During the course of assessment, the patient findings, medications and investigations shall also be documented legibly in the card with the signature of the consultant or specialist or super specialist, date and time.
10.2.4 No medicines shall be dispensed from pharmacy store (if facility available) without a written prescription order of doctor, except in emergency cases. Medication dispensing shall be done with care to prevent any medication error. Following shall be checked before dispensing of medication. These checks shall be done at store level:
10.2.4.1 10.2.4.2 10.2.4.3 10.2.4.4 10.2.4.5
Medicine prescribed.
Dose of prescribed medicine
Expiry date.
Particulate matter in liquid dosage forms and parenteral drugs. Labels (if reconstituted drugs).
10.2.5 Labeling shall be done for every prepared or reconstituted medication, which shall include name, date of preparation, strength and frequency of administration of drug.
Clinical Establishments Act Standards for Clinic or Polyclinic with Observation or Short Stay CEA/Clinic-004
10.2.6 The availability of support staff including nursing is essential to ensure safe observation or short stay facility.
10.3Infection Control
10.3.1 The clinic shall take all precautions to control infections like religiously
practicing hand washing.
10.3.2 Availability of running tap water for hand washing or liberal use of sanitizer shall be maintained throughout the working hours of the clinic.
10.3.3 The clinic environment shall be kept clean.
10.3.4 Sanitation and hygiene of the toilets shall be maintained.
10.3.5 Mopping of all areas with disinfectant shall be done at least once a day.
10.4. Safety Considerations
10.4.1 Floor shall have even surface and be non slippery in nature. There shall be no seepage in walls or any blockade of drains. There shall be provision of air circulation. Effort shall be made to keep clinic pest and termite free. Availability of mosquito net on windows shall be ensured by the clinician.
10.5Biomedical waste Management
10.5.1 Clinic waste generated shall be segregated at source.
10.5.2 Biomedical waste shall be managed in accordance with the BMW management Rules, 2016.
10.5.3 Needles shall be destroyed with the help of a needle destroyer before putting them in tamper proof, leak proof and puncture proof container.
10.6First aid & basic life support
10.6.1Appropriate facility for First Aid shall be available.
Clinical Establishments Act Standards for Clinic or Polyclinic with Observation or Short Stay CEA/Clinic-004
Minimum area required for clinic shall be as follows:
APPENDIX –1
Infrastructure Requirement (Desirable)
SN
LOCATION
AREA REQUIRED
1
Common area (Reception and waiting)
35 sq ft carpet area
2
Consultation room (ancillary area)
70 sq ft carpet area including storage
Area specified under consultation room is only for single clinic and shall be multiplied accordingly by the number of consultation chambers.
3
Store and pharmacy
40 sq ft
4
Observation and short stay (if applicable)
65 sq ft or bed
Note: Reception, waiting, consultation room etc shall be adequate as per the requirement and workload of the clinic.
Ancillary areaorspace: Storage of records, reagents, consumables, stationery etc
Clinical Establishments Act Standards for Clinic or Polyclinic with Observation or Short Stay CEA/Clinic-004
APPENDIX 2
Furniture or fixtures
S. No
Articles
1
Table
2
Chairs
3
Examination Table or couch
4
Screens
5
Foot Step
6
Stools
7
Storage Cabinet for medicine, records etc.
8
Bed(s) for observation or short stay
9
BioMedical Waste storage area
Clinical Establishments Act Standards for Clinic or Polyclinic with Observation or Short Stay CEA/Clinic-004
I. Essential Equipment.
APPENDIX 3
Equipment or Instruments
S. No.
Name of the equipment
Minimum Specifications
No. Of equipment
1
Stethoscope
1
2
Thermometer
(Non Mercury)
1
3
Torch (flash lights)
1
4
Tongue depressor
1
6
Measuring Tape
1
7
Sphygmomanometer(B.P. Apparatus)
(Non Mercury)
1
8
Height measuring Scale
1
9
Needle Destroyer
1
10
Weighing machine(Optional)
Adult
1
11
Bed(s)
1 or more
12
IV stand
1
Clinical Establishments Act Standards for Clinic or Polyclinic with Observation or Short Stay CEA/Clinic-004
APPENDIX 4
II. Emergency Equipment:
S. No.
Name of the equipment
Minimum Specifications
No. of equipment
1
1 1
2
Resuscitation Equipment Ambu Bag or Air Way
Oxygen Cylinder (Portable)
– Adult
– Pediatric
1
3
Fire Extinguisher
ABC Type
1
Clinical Establishments Act Standards for Clinic or Polyclinic with Observation or Short Stay CEA/Clinic-004
APPENDIX – 5
Specialty Wise Equipment List: I. Cardiology
II. Cardiothoracic Surgery
III. ENT
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
ECG Machine
1
2
Pulse Oximeter
1
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
ECG Machine
1
2
Pulse Oximeter
1
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
Examination instruments set (speculums, mirrors, Bull’s lamp)
1
2
Diagnostic Otoscope
1
3
Head Light
1
4
Oesophagoscope Adult
(Desirable)
1
5
Oesophagoscope Child
(Desirable)
1
6
Laryngoscope
1
7
Tuning Fork
1
Clinical Establishments Act Standards for Clinic or Polyclinic with Observation or Short Stay CEA/Clinic-004
IV. Endocrinology
V. Gastroenterology
VI. General Medicine
VII. Gynecology& Obstetrics
VIII. Neurosurgery
IX. Neurology
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
Glucometer
1
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
Proctoscope
1
2
Surgical Gloves
1
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
ECG Machine
1
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
Sim’s vaginal speculum
1
2
Infantometer
1
S. No.
Name of the equipment
Minimum Specifications
No. of equipment
1
EMG Machine
1
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
EMG Machine
Clinical Establishments Act Standards for Clinic or Polyclinic with Observation or Short Stay CEA/Clinic-004
X. Ophthalmology
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
Ophthalmoscope
1
2
Slit Lamp
1
3
Retinoscope
1
4
Perimeter
1
5
Distant Vision Charts
1
6
Near Vision charts
1
7
Trial Frame AdultorChildren
1
8
Trial Lens Set
1
XI. Orthopedics
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
Ortho Fracture Table
1
2
Skeleton traction set
1
3
Cramer wire splints
1
4
Thomas Splint
1
XII. Pediatrics
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
Nebulizer baby
1
2
Weighing machine infant
1
Clinical Establishments Act Standards for Clinic or Polyclinic with Observation or Short Stay CEA/Clinic-004
XIII. Tuberculosis and Respiratory Disease
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
Spirometer
2
Nebulizer
3
Face mask
4
Peak Air flow meter
XIV. Urology
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
Uroflow meter
Clinical Establishments Act Standards for Clinic or Polyclinic with Observation or Short Stay CEA/Clinic-004
APPENDIX- 6
I. Essential Drugs
S. No.
Name of the Drug
Minimum Quantity
1
Injection Adrenaline
2 Ampoules
2
Injection Hydrocortisone
1 vial
3
Injection Atropine
1 Ampoule
5
Injection Pheniramine maleate
1 Ampoule
6
Injection Promethazine
1 Ampoule
7
Injection Deriphylline
1 Ampoule
8
Injection Frusemide
1 Ampoule
9
Injection Metoclopramide
1 Ampoule
10
Injection Dexamethasone
1 Ampoule
11
Injection.Diazepam
1 Ampoule
12
Injection. Dicyclomine Hydrochloride
1 Ampoule
13
Injection 5% dextrose infusion
1 Vac
14
Injection Normal saline
1 Vac
Note: Other drugs as per the scope of service being practiced may also be available.
Clinical Establishments Act Standards for Clinic or Polyclinic with Observation or Short Stay CEA/Clinic-004
APPENDIX 7 Patients’ rights and responsibilities:
Patients’ rights
A patient and his or her representative has the following rights with respect to the clinical establishment-
31. To adequate relevant information about the nature, cause of illness, proposed investigations and care, expected results of treatment, possible complications and expected costs;
32. Rate of services provided by the clinical establishment would be displayed prominently.
33. To access a copy of case papers, patient records, investigations reports and detailed bill.
34. To informed consent prior to specific tests or treatment (e.g. surgery, chemotherapy)
35. To seek second opinion from an appropriate clinician of patients’ choice, with records and information being provided by treating hospital
36. To confidentiality, human dignity and privacy during treatment.
37. To have ensured presence of a female person, during physical examination of
a female patient by a male practitioner.
38. To non-discrimination about treatment and behaviour on the basis of HIV
status
39. To choose alternative treatment if options are available
40. Rate of services provided by the clinical establishment would be displayed
prominently.
Patients’ responsibilities:
Provide all health related information
Cooperate with doctors during examination, treatment.
Follow all instructions
Pay hospital’s agreed fees on time
Respect dignity of doctors and other hospital staff
Never resort to violence
Clinical Establishments Act Standards for Health Checkup Centres-CEA
Clinical Establishments Act Standard
for
Health Check up Centres
Standard No.CEA or Health Check up Centre
Clinical Establishments Act Standards for Health Checkup Centres-CEA
Table of Contents
Particulars
Page No.
1
Definition
4
2
Scope (as applicable)
4
3
Infrastructure
5
4
Furniture & Fixtures
8
5
Human Resource
8
6
Equipment or Instruments or Drugs
9
7
Appendix 1
10
8
Appendix 2
12
9
Appendix 3
14
10
Appendix 4
15
11
Appendix 5
17
12
Appendix 6
19
Clinical Establishments Act Standards for Health Checkup Centres-CEA
Health Checkup Centre
29 Definition
The standards for Health Checkup Centre are framed based on the basic functions of the unit or centre or provider.
Type of Services
Scope of Services
Health Checkup
Health Checkup is interventions that do not require overnight stay at the centre for medical reasons; leaving the treatment after any stage should not cause any harm to the individual.
30 Scope (as applicable)
2. This includes the services being provided by the facility to which the standards will be applicable.
2.1. List of services: The scope of services that may be provided at an centre may include services in any or all of the following specialties, but not necessarily limited to:
Specific Services under each category to be decided by the centre
Health Checks e.g., Health Check up
1.
Laboratory services
2.
Imaging services
3.
Fitness check
4.
Consultation – Optional
2.2. List of Support Services:
2.2.1 Laboratory services to be available either in-house or outside the centre.
2.2.2 Imaging services to be available either in-house or outside the centre.
Sr. no.
Support Service
Applicability
1.
Accounting
Optional
2.
Billing
If Applicable
3.
Essential commodities like water supply, electric supply etc.
Applicable
4.
Finance
Optional
5.
Financial accounting and auditing
As required by Law
6.
Housekeeping and Sanitation
Applicable
7.
Inventory Management
Optional
Clinical Establishments Act Standards for Health Checkup Centres-CEA
8.
Laundry services
Optional
9.
Medical records
Applicable
10.
Office Management (Provision should be made for computerized medical records with anti-virus facilities whereas alternate records should also be maintained)
Applicable
11.
Personnel Department
Optional
12.
Pharmacy or Dispensary
Optional
13.
Purchase
Applicable
14.
Reception
Applicable
15.
Security services
Optional
16.
Stores
Optional
17.
Waste management Housekeeping or sanitation
Applicable
18.
Equipment Management
Applicable
31 Infrastructure Requirements
31.1 Basic signage- A signage within or outside the facility shall be made available containing the following information.
31.1.1 A signage within or outside the facility should be made available containing the following information.
31.1.2 All signage meant for customer and visitors shall be bilingual 31.2 Following informative signage shall be displayed:
31.2.1 Name of the care provider with registration number
31.2.2 Name of organization.
31.2.3 Display of Registration under clinical establishments act
31.2.4 Fee structure
31.2.5 Availability of tariff list.
31.2.6 Timings of the facility
31.2.7 Availability of timings with names and respective specializations
31.2.8 Services provided
31.2.9 Directional signage for customers for utilities and conveniences like toilets, drinking water, telephone booths, shops.
31.2.10 Display of Health checks centre scope of services
Clinical Establishments Act Standards for Health Checkup Centres-CEA
31.2.11 Floor Plan With Location Of Departments
31.2.12 Plan of Facility, if stand-alone building.
31.3
Following safety signage shall be displayed:
31.3.1 Safety Hazard and Caution signs
31.3.2 Display of all radiation hazard signage in radiation areas (if applicable).
31.3.3 Display of Biomedical waste segregation at all location where BioMedical
Waste bins are kept
31.3.4 Display of danger signage at all electric panels and other dangerous areas
31.3.5 Display of General instructions like ‘No Smoking’, ‘Keep Silence’, ‘Use dustbin’, etc. at various customer and visitor areas in the hospital
31.3.6 Display of important phone contact numbers of hospital authorities
31.3.7 Displays required by regulations like PCPNDT Act, Lifts, Fire, etc.
31.3.8 Display of patients rights and responsibilities
31.3.9 Display of safety instructions in areas where any kind of safety hazard may be expected. This includes areas like transformers, Cylinder storage, LPG storage etc
31.3.10 Hazards- electrical, fall, pipe locations, prohibited areas
31.3.11 Signage for parking. (Signage for ambulance parking shall be separately
mentioned)
31.3.12 Appropriate Fire exit signages
31.3.13 Display of how to use fire extinguisher at all point where fire extinguisher
is installed
31.3.14 Emergency exit signage (preferably in auto illumination material, like radium)
Clinical Establishments Act Standards for Health Checkup Centres-CEA
3.4. Functional space planning of the facility like reception area, waiting area should be as per the scope of services.
i. ii. iii. iv. v. vi.
i. ii.
iii.
i. ii. iii.
i. i.
i. ii. iii. iv. v.
vi. vii.
3.4.1 Consultation & examination room
Consultation room should be adequate to accommodate: Table for Consultancy
Consultation chair,
Two stools or chairs,
Examination bed, if necessary, will be of the size 6 ft X 2.5 ft., Privacy screen around examination area while having free mobility
3.4.2 Laundry (optional)
Laundry services can be in-house or outsourced.
If it is provided in house, it should have necessary facilities for drying, pressing and storage of soiled and cleaned linens.
If outsourced, quality of outsourced work is monitored by the organization.
3.4.3 House-Keeping:
Housekeeping services should be made available for effective cleanliness. Housekeeping services can be outsourced.
A designated area within functional areas for safe storage of housekeeping materials has to be in centre.
3.4.4 Security Services:
There is a designated location for security staff on duty. 3.4.5 Clinical laboratory specifications:
Laboratory services to be available either in-house or outside the Hospital for quick diagnosis of blood, urine, etc.,
3.4.6 Radiology section
Imaging services to be available either in-house or outside the Hospital.
The department should be located at a place which is accessible to customers. The size of the room should depend on the type of instrument installed.
It should confirm to Atomic Energy Regulatory Board requirements.
The room should have a sub-waiting area with toilet facility and a change room facility, if required.
Film developing and processing (dark room) shall be provided in the department for loading, unloading, developing and processing of X-ray films.
Separate Reporting Room for doctors should be provided.
Clinical Establishments Act Standards for Health Checkup Centres-CEA
i. ii. iii.
i. ii.
i. ii. iii.
i. ii. iii.
i.
32
3.4.7 Customer or Medical record-room:
Customer or Medical record-storage should be of adequate size as per the load of the documents of the centre.
Tamperproof material and locking facility Cabinets or cupboards or Boxes should be used.
Fire extinguishers of correct type should be made available nearby all locations.
3.4.8 Store rooms:
Store room should be lockable & of adequate size with exhaust fan.
Area should be clean, well ventilated, well lit, without any dampness or fungal growth on walls.
3.4.9 Duty rooms for doctors
To accommodate 1 bed of 6 feet X 3 feet and a side table. Separate beds if sharing for same gender.
Separate rooms for separate genders will be provided.
3.4.10 Duty rooms for technicians:
To accommodate 1 bed of 6 feet X 3 feet and a side table. Separate beds if sharing for same gender.
Separate rooms for separate genders will be provided.
3.4.11 Dirty utility room:
Separate area of minimum 15 sq feet.
Furniture &Fixtures
32.1 Furniture and fixtures shall be available in accordance with the services and workload of the centre. For indicative list refer to Appendix 1.
32.2 The furniture and fixtures shall be functional all the time.
33 Human Resource
33.1 A suitably qualified and individual heads the organization and manages in ethical manner. For detail refer to Appendix 2.
33.2 The technical staff employed should have the relevant education or registration, training and experience to provide service to customer care without supervision.
33.3 The additional staff member shall be adequately trained on specific job duties or responsibilities related to customer safety and well being.
Clinical Establishments Act Standards for Health Checkup Centres-CEA
33.4 Personnel record containing personal and professional information shall be maintained for each staff.
33.5 Periodic skill enhancement or upgradation or refresher trainings shall be provided for all categories of the staff relevant to their job profile.
34 Equipment or Instruments
34.1 The centre shall have equipment or instruments as per the scope of services provided. For indicative list refer to Appendix 3
34.2 Adequate space for placement and usage of equipment and Instruments shall be provided.
34.3 The equipment should be of adequate capacity to meet work load requirement.
34.4 All equipment should be in good working condition at all times. Periodic inspection, cleaning, maintenance of equipment should be done.
35 Drugs and Consumables
35.1 Drugs and consumables as per the scope of services provided. For indicative list refer to Appendix 4.
35.2 Storage of drugs, cosmetic and consumables shall be stored as per manufacturer’s guidelines.
35.3 The drugs are handled by appropriate personnel in accordance of the regional, local and national regulations.
For Legal requirement refer to Appendix 5 For record maintenance refer to Appendix 6
Clinical Establishments Act Standards for Health Checkup Centres-CEA
APPENDIX 1 Furniture or fixture
I. Furniture or Fixture Requirements: as per the scope of services
Sr. No.
Name of the Equipment
Health checks Centre
1.
Adequate lockable storage space
As per requirement
2.
Air conditioning
As per requirement
3.
An examination table of 6 ft. X 2.5 ft. With privacy screen
As per requirement
4.
Blood pressure apparatus
1 per Centre
5.
Ceiling Fans
As per requirement
6.
Clock 1 per Centre
1 per Centre
7.
Computers (if required)
1 per Centre
8.
Consultant’s chair
As needed
9.
Consultant’s or Office table
1 per Centre
10.
Duty table for staff
1 per Centre
11.
Emergency resuscitation kit
1 per Centre
12.
Essential diagnostic tools required for examination of customer as per the scope of services offered by the Centre.
As per requirement
13.
Fire extinguisher
ABC 1 per ward or floor based on layout
14.
Foot stools
1 per consultation room
15.
Heavy duty Torch light
1 per Centre
16.
Hot Water Bags
As per requirement
17.
Hot Water geyser
As per requirement
18.
Light source which gives light colour and temperature similar to solar light,
Light intensity of at least 500 lux at the point of examination.
As per requirement
19.
Office chairs
1 per Centre
20.
Customer locker
1 per Centre
21.
Refrigerator if temperature sensitive medication are stored (if required)
1 per Centre
22.
Steel or Wooden cup board
As per requirement
23.
Steel rack
As per requirement
24.
Stethoscope
1 per Centre
Clinical Establishments Act Standards for Health Checkup Centres-CEA
25.
Stools
As per requirement
26.
Stools revolving
2 per Centre
27.
Hammock Stretcher or Stretcher or Customer trolley – 1 per Centre
1 per Centre
28.
Telephone or Fax equipment
As per requirement
29.
Thermometer
1 per Centre
30.
Waiting chairs or benches for customer’s relatives
50% of the customer strength
31.
Weighing machine
1 per Centre
32.
Wheel chair
1 per Centre
33.
X-ray viewer
1 per Centre
II. Other Furniture or Fixture Requirements
Sr. No.
Name of the Equipment
Health checks Centre
1.
Air conditioners Central AC
As per requirement
2.
Computer with modem with UPS, printer with internet connection
As needed
3.
Coolers
As needed
4.
Drinking Water purifier
As needed
5.
Emergency lamp
2 Per Area or Ward
6.
Exhaust Fan
As needed
7.
Fire extinguishers
As needed
8.
Geyser
1 per ward
9.
Refrigerator
1 per ward
10.
Tables & Chairs
As needed
11.
Telephone or cell phone
1 per ward
12.
Tube lights
As needed
13.
Vacuum cleaner
As needed
14.
Computer with Modem with UPS, Printer with Internet Connection
As needed
15.
Photocopy Machine
As needed
16.
Intercom (10 lines)
As needed
17.
Fax Machine
As needed
Clinical Establishments Act Standards for Health Checkup Centres-CEA
APPENDIX 2
Human Resource Requirement
1. This includes the Designation, minimum qualification & number of people required in the facilityas per the scope of services.
1.1Medical practitioners
1. Category: MBBS Doctors.
2. Minimum Qualifications: Degree or Post Graduate Degree from recognized
university. Registration: (if applicable): with state or central council related to
the profession.
3. Trained or skilled: Trained
1.2 Nurses:
ANM or GNM or BSc or MSc nurses,
One per shift per for 50% of the total number of consulting room
1.3 Paramedics
1. Category: Paramedics
2. Minimum Qualifications: (diploma or degree from recognized university.)
3. Registration with the concerned council(if applicable): state or central council
4. Trained or skilled: Trained
Sr. no.
Health Checks
1.
As per Allopathy standards in relevant specialties as the profile of checkup provided at the centre
Sr. no
Paramedics
Minimum qualification
Health Checks
1.
ECG Technician
(if ECG services are provided in-house)
1 year experience of taking ECG
As per requirement
2.
Laboratory Attendant (if lab is in-house)
Ability to read national or local language
As per requirement
3.
Laboratory Technician (if Laboratory is in- house)
Qualified Laboratory Technician
As per requirement
4.
Medical Records Officer or Technician
Minimum qualification- 12th Standard passed.
As per requirement
5.
Radiographer
(if Imaging is in-house)
Qualified Radiographer
As per requirement
6.
Ward Ayah
Eight standard completed
As per
Clinical Establishments Act Standards for Health Checkup Centres-CEA
requirement
7.
Ward boy
Eight standard completed
As per requirement
1.4. Administrative staff: The number would vary as per scope of the centre or requirement and may be outsourced.
Administrative staff
Sr. no
Administrative staff
Health Checks
1.
Office Administrator
As per requirement
2.
Accountant
As per requirement
3.
Multipurpose worker
As per requirement
Clinical Establishments Act Standards for Health Checkup Centres-CEA
APPENDIX 3 Equipment or Instrument
Following emergency equipment shall be available as follows:
Sr. No.
Emergency Equipment
Health Checks Centre
1.
Emergency equipment box for first aid & BLSS
Minimum 1
2.
Crash-Cart trolley:1
Minimum 1
3.
Portable defibrillator:1
Optional
4.
Disposable syringes
As needed
5.
Ambu Bag:1
Minimum 1
6.
Laryngoscope with cells & adult and pediatric blades
Minimum 1
7.
Sealed battery cell
Minimum 1
8.
Endotracheal tubes
As needed
9.
Pulse Oxymeter
Minimum 1
10.
Suction Apparatus
Minimum 1
11.
ECG Machine
Minimum 1
12.
BP Apparatus & Stethoscope
Minimum 1
13.
Oxygen cylinders with flow meter or tubing or catheter or face mask or nasal prongs
Minimum 1
Other necessary and sterilizing equipment as per the scope of services shall also be available.
Clinical Establishments Act Standards for Health Checkup Centres-CEA
APPENDIX 4
Drugs, Medical devices and Consumables
I. Emergency drugs:
Category: Emergency Drugs
Sr. no. Name of the Drug Minimum Quantity
Strength
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
As per I.P.
Injection Adrenaline Minimum 10 Ampoules or Vials
1.
2. Injection Atropine Minimum 10 Ampoules or Vials
3.
Injection Calcium Minimum 10 Ampoules or Vials Carbonate
Injection Dopamine Minimum 10 Ampoules or Vials Injection Dobutamine Minimum 10 Ampoules or Vials Injection Nitroglycerine Minimum 10 Ampoules or Vials
4.
5.
6.
7. Injection Sodium Minimum 10 Ampoules or Vials
8. 9.
Bicarbonate
Injection Hydrocortisone Minimum 10 Ampoules or Vials Inhaler Beclomethasone Minimum 10 Ampoules or Vials (250 microordose)
10. Inhaler Salbutamol (200 Minimum 10 Ampoules or Vials micrograms)
11. 12.
13. 14.
Injection Frusemide Minimum 10 Ampoules or Vials Injection Diazepam or Minimum 10 Ampoules or Vials Midazolam
Injection. Deriphylline Minimum 10 Ampoules or Vials Injection. Phenytoin Minimum 10 Ampoules or Vials sodium
15. Injection Pheniramine Minimum 10 Ampoules or Vials maleate (Avil)
16. Injection 17. Injection
Ondansetrone Minimum 10 Ampoules or Vials KCl Minimum 10 Ampoules or Vials Lignocaine 2% Minimum 10 Ampoules or Vials Amiodarone Minimum 10 Ampoules or Vials Magnesium Minimum 10 Ampoules or Vials
Mannitol Minimum 10 Ampoules or Vials Morphine or Minimum 10 Ampoules or Vials Pethidine
24. Injection. Fentanyl Minimum 10 Ampoules or Vials 25. Water for Injection Minimum 10 Ampoules or Vials 26. Injection Sodium Valproate Minimum 10 Ampoules or Vials
18.
19.
20. Injection
Injection Injection
sulphate
23.
Injection
21.
22. Injection
Injection
Injection. Noradrenaline Minimum 10 Ampoules or Vials bitartrate
27.
28.
29. Mannitol Injection Minimum 10 Ampoule or Vials 30. Metoprolol Injection Minimum 10 Ampoules or Vials
Injection Voveran Minimum 10 Ampoules or Vials Injection Paracetamol Minimum 10 Ampoules or Vials
Nor2 saline Injection Minimum 10 Ampoules or Vials Oxytocin Injection Minimum 10 Ampoules or Vials
31.
32. Oxygen Inhalation
33.
Clinical Establishments Act Standards for Health Checkup Centres-CEA
II. Linen
Sr. no
Linen
Quantity
1.
Bed sheets
As per requirement
2.
Bedspreads
As per requirement
3.
Blankets
one per bed
4.
Curtain cloth for windows and doors
As per requirement
5.
Overcoat for consultant
one per consultant
6.
Mats (Nylon)
As per requirement
7.
Mattress (foam) adults
As per requirement
8.
Pediatric Mattress
one per bed
9.
towels
As per requirement
10.
Pillow covers
As per requirement
11.
Pillows
As per requirement
12.
Table cloth
adequate quantity
13.
Uniform or Apron
As per requirement
III. Stationery as per the scope of services
Sr. no.
Items
1.
Consent Forms
2.
Consultant Reference Form
3.
Continuation sheets
4.
Diet Sheets
5.
Initial Assessment Form
6.
Pathological Books
7.
Registers
8.
Registration Card
9.
Sentinel Event Form
10.
Supplementary Sheets
11.
X-ray Forms
Clinical Establishments Act Standards for Health Checkup Centres-CEA
APPENDIX 5
Legal or Statutory Requirements
This includes the minimum statutory compliance applicable as per the central or state government along with licensing body, wherever applicable.
Sr. no.
Name of the Act
Department or Area
Licensing body
1.
Registration under Shops and Establishment Act
Organization
Jurisdictional Authorities like Panchayator Nagarpalika or Mahanagarpalika or Municipality or Municipal Corporation
2.
Registration under Clinical Establishments Act
Organization
Jurisdictional Authorities like Panchayat or Nagarpalika or Mahanagarpalika or Municipality or Municipal Corporation
3.
Agreement for Common Biomedical Waste Collection, Transportation, Treatment, Storage and Disposal Facility
Organization
Local Pollution Control Board
4.
Registration under Air (prevention and control of pollution) Act, 1981.
Organization
Local Pollution Control Board
5.
Building Permit (From the Municipality).
To be obtained from
Jurisdictional Revenue Authorities like Panchayat or Nagarpalika or Mahanagarpalika or Municipality or Municipal Corporation
6.
Certificate uors 80-G of IT Act
Organization
If applicable.
7.
ESI registration in case of >20 employees
Organization
Employee State Insurance Company
8.
Excise permit to store Spirit.
Organization
Excise department
9.
Generator Exhaust air Quality Report
Generator
Authorized Air Testing Laboratory
10.
License to sale or distribute drugs Form 20, 21, 21C
Pharmacy
FDA
11.
License for lift
Lift
Mobile Electric Vehicles
Clinical Establishments Act Standards for Health Checkup Centres-CEA
Department
12.
License to play music for public use
Organization
Indian
13.
Occupation Certificate
To be obtained from
Jurisdictional Revenue Authorities like Panchayat or Nagarpalika or Mahanagarpalika or Municipality or Municipal Corporation
14.
PC PNDT Act, 1996.
Sonography
Health Department of Regulatory Body assigned with the responsibility
15.
SMPV License for Storage of Liquid Oxygen, Form III (License to compressed gas in pressure vessel or vessels)
Medical Gases in Pressu rized Vessels
Licensing Authority
16.
TAN Number
Organization
Income Tax Department
17.
PAN Number
Organization
Income Tax Department
18.
Vehicle Registration certificates for Ambulance
Ambulance and Vehicles owned by the organization
Road Traffic Authority
19.
Water Prevention and control of pollution Act
Organization
Pollution Control Board
Clinical Establishments Act Standards for Health Checkup Centres-CEA
APPENDIX 6
Record Maintenance and reporting
1. Standard on record maintenance
Sr. no
Records
1.
Records
2.
Customer reports records
3.
Reports of investigations
4.
Consents
2. Standard on content of record.
Sr. no.
Name of Forms
1.
Registration number of treating doctor
2.
Name and contact number
3.
Relevant assessment
4. 5.
Advise or Treatment record
Imaging Report Format for each imaging modality
6.
Laboratory Report Forms for each category of investigation
7.
outcome
Clinical Establishments Act Standards for Mobile Clinic (only Consultation) and dispensary
CEA or Mobile Clinic 001
Clinical Establishments Act
Standard for
Mobile Clinic (only Consultation) and dispensary
Standard No.CEA orMobile Clinic- 001
Clinical Establishments Act Standards for Mobile Clinic (only Consultation) and dispensary
CEA or Mobile Clinic 001
Table of Contents
Particulars
Page No.
1
Definition
4
2
Scope
4
3
Infrastructure
4
4
Human Resource
5
5
Equipment or instruments or drugs
6
6
Record Maintenance and reporting
6
7
Process
7
8
Appendix – 1
8
9
Appendix – 2
9
Clinical Establishments Act Standards for Mobile Clinic (only Consultation) and dispensary
CEA or Mobile Clinic 001
Mobile Clinic with Consultation and Dispensary
36 Definition
The Mobile clinic may be defined as a facility on a vehicle or specially fabricated on a vehicle providing examination, consultation, prescription to outpatients including dispensing of medicines by a general practitioner or specialist or super-specialist doctor to those in remote or specified areas who have access to little or no medical facilities.
37 Scope
37.1 The operation of mobile clinics is to render general health care services to those in remote or specified areas who have access to little or no medical facilities.
37.2 The mobile clinics will visit the identified service point to provide health services to the identified community or area.
37.3 To deliver primary service in health education and health promotion.
37.4 The services offered may also include one or more than one specialty of allopathy medicine, AYUSH, Dental, wellness, etc. and allied services like Physiotherapy, in the mobile clinic.
37.5 Health records for all patients will be maintained to monitor the program and to facilitate follow-up treatments.
38 Infrastructure
38.1 Vehicle
38.1.1 The vehicle shall be kept clean to provide safe and hygienic care to the patients commensurate to the scope of the services provided.
38.1.2 The vehicle shall be registered as per local laws and regulations.
38.1.3 The vehicle shall prominently display the name and services provided which is easily visible to the community.
38.1.4 The vehicle shall have provision for hand hygiene.
38.1.5 The vehicle shall have appropriate communication facilities.
Clinical Establishments Act Standards for Mobile Clinic (only Consultation) and dispensary
CEA or Mobile Clinic 001
38.1.6 The vehicle shall be well illuminated and ventilated.
38.1.7 Furniture and fixtures shall be available in accordance with the activities and
workload and shall be kept functional.
39.1 The general practitioner or specialist or super-specialist shall be registered with respective state or central council of India as per the scope of the mobile clinic.
39.2 The services provided by the medical professionals shall be in consonance with their qualification, training, registration.
39.3 Periodic skill enhancement or up gradation or refresher trainings shall be provided for all categories of the staff relevant to their job profile.
39.4Personnel record containing personal and professional information shall be maintained for each staff.
39.5 Please refer below mentioned table for Manpower details. This list is indicative and not exhaustive.
39.6 Manpower
39
Human Resource
S. No
Category
Num ber
Minimum Qualifications from recognized university
Registration with the concerned council
(if applicable)
1
Doctor
1
MBBS
State or Central Medical council
2
Pharmacist
1
Diploma in Pharmacy.
Pharmacy Council of India
Desirable
3
Staff nurse
1
Qualified staff nurse with general nursing.
Indian Nursing Council
4
Counselor for HIVorAIDS counseling (Desirable)
1
Qualified staff nurse
Indian Nursing Council
Training required for counseling and lab techniques.
5
Driver
1
With requisite registration and licenses.
Clinical Establishments Act Standards for Mobile Clinic (only Consultation) and dispensary
CEA or Mobile Clinic 001
40 Equipment or instruments requirement
40.1 The mobile clinic shall have essential equipments as per APPENDIX I.
40.2 Other equipments as per the scope of service being practiced shall be available.
40.3 Adequate space for storage of equipments and medicines shall be provided.
40.4 If available, all medicines shall be stored as per manufacturer’s guidelines.
40.5 The equipment should be of adequate capacity to meet work load requirement.
40.6All equipment should be in good working condition at all times. Periodic inspection, cleaning, maintenance of equipment should be done.
40.7 The mobile clinic shall have basic minimal essential drugs as per APPENDIX II; however other drugs as per the scope of service being practiced may also be available.
41 Record Maintenance and reporting
41.1 Records shall be maintained in physical or digital format.
41.2 Confidentiality, security and integrity of records shall be maintained.
41.3 Every Clinical Establishment shall maintain medical records of patients treated by it and health information and statistics in respect of national programmes and furnish the same to the district authorities in form of quarterly reports.
41.4 Copies of all records and statistics shall be kept with the clinical establishment in accordance with CE Act under Section 12(1) (iii) of CEA 2010, or any other relevant Act in force at the time.
41.5 All clinical establishments shall be responsible for submission of information and statistics in time of emergency or disaster or epidemic situation or as required from time to time by National Council Clinical Establishments Act 2010.
42 Basic processes
42.1 Registration: Every patient visiting the mobile clinic shall be registered.
Clinical Establishments Act Standards for Mobile Clinic (only Consultation) and dispensary
CEA or Mobile Clinic 001
42.2Assessment: Every patient shall undergo assessment, during the course of assessment, the patient findings, medications and investigations should be documented with working diagnosis, legibly in the assessment or OPD prescription with the signature of the consultant or Specialist or super Specialist with date and time.
Clinical Establishments Act Standards for Mobile Clinic (only Consultation) and dispensary
Essential Equipments
Appendix 1
CEA or Mobile Clinic 001
S. No.
Name of the equipment
Minimum Specifications
Number of equipment
1
Stethoscope
1
2
Thermometer
(Non Mercury)
1
3
Torch (flash lights)
1
4
Sphygmomanometer(B.P. Apparatus)
(Non Mercury)
1
5
Weighing machine(Optional)
Adult
1
Clinical Establishments Act Standards for Mobile Clinic (only Consultation) and dispensary
Emergency Drugs
Appendix- II
CEA or Mobile Clinic 001
S. No.
Name of the Drug
Minimum Quantity
1
Injection Adrenaline
2 Ampoules
2
Injection Hydrocortisone
1 vial
3
Injection Atropine
1 Ampoule
5
Injection Pheniramine maleate
1 Ampoule
6
Injection Promethazine
1 Ampoule
7
Injection. Deriyphylline
1 Ampoule
8
Injection Frusemide
1 Ampoule
9
Injection Metoclopramide
1 Ampoule
10
Injection Dexamethasone
1 Ampoule
11
Injection Diazepam
1 Ampoule
12
Injection Dicyclomine Hydrochloride
1 Ampoule
13
Injection 5% dextrose infusion
1 Vac
14
Injection Normal saline
1 Vac
Clinical Establishments Act Standards for Mobile Clinic with Procedures in Local or Regional Anesthesia CEA or Mobile Clinic 002
Clinical Establishments Act Standard for
Mobile Clinic with procedures in Local or Regional Anaesthesia
Standard No.CEA orMobile Clinic- 002
Clinical Establishments Act Standards for Mobile Clinic with Procedures in Local or Regional Anesthesia CEA or Mobile Clinic 002
Table of Contents
Particulars
Page No.
1
Definition
4
2
Scope
4
3
Infrastructure
5
4
Human Resource
5
5
Equipment or instruments or drugs
5
6
Furniture & Fixtures
6
7
Record Maintenance and reporting
7
8
Process
7
9
Appendix – 1
8
10
Appendix – 2
9
11
Glossary
12
Clinical Establishments Act Standards for Mobile Clinic with Procedures in Local or Regional Anesthesia CEA or Mobile Clinic 002
MOBILE CLINIC – With Procedures
43 Definition
The Mobile clinic may be defined as a facility on a vehicle or specially fabricated on a vehicle providing examination, consultation, prescription to outpatients including dispensing of medicines ,basic laboratory services, vaccination facilities and procedures by a general practitioner or specialist or super-specialist doctor to those in remote or specified areas who have access to little or no medical facilities.
A Mobile clinic is a facility providing general or basic examination, consultation, prescription to outpatients by a General Practitioner(s) or Specialist or Super-specialist Doctor(s) in a mobile vehicle.
44 Scope
44.1 Preventive: Immunization, Antenatal and Postnatal Care.
44.2 Diagnostic: Minimum investigation facilities like Haemoglobin Test, Urine Examination for albumen, sugar and microscopic examination. Diseases like Leprosy, Tuberculosis, and locally endemic diseases to be detected and referred, ECG & Ultrasonography facilities also to be offered in the Mobile unit.
44.3 Curative: Treatment for minor ailments and geriatric cases etc. Appropriate referral of cases for medical specialists etc.
44.4 The Operation of Mobile Clinics is to render Primary Health Care services to those in remote or specified areas who have access to little or no medical facilities.
44.5 The mobile clinics will visit the identified service point to provide health services to the identified community or area.
44.6 To deliver primary service in health education and health promotion.
44.7 To deliver health care services of rehabilitative nature.
44.8 The services offered may also include one or more than one specialty of allopathy medicine, AYUSH, dental, wellness, etc. and allied services like physiotherapy, in the mobile clinic.
44.9 Health records for all patients will be maintained to monitor the program and to facilitate follow-up treatments.
Clinical Establishments Act Standards for Mobile Clinic with Procedures in Local or Regional Anesthesia CEA or Mobile Clinic 002
44.10 Few minor procedures like dressing and administering Injections etc may be provided in the clinic however not requiring observation or short stay.
45 Infrastructure
45.1 The physical facility shall be developed and maintained to provide safe and secure environment for patients, their families, staff and visitors. It shall be situated in a place having clean surroundings and shall comply with local byelaws in force, if any from time to time.
45.2 The clinic should have a prominent board or signage displaying the name of the clinic in local language at the gate or on the building of the clinic.
45.3 The following other signages shall be well displayed in the language understood by the local public in the area:
a) Name of the doctors with registration number.
b) Services provided within the Facility
46.1 The general practitioner or specialist doctor or super-specialist doctors as per the scope of the clinic or polyclinic shall be registered with State or Central Medical Council of India
46.2 The services provided by the medical professionals shall be in consonance with their qualification, training, registration.
a) Doctor: Allopathic Doctor with minimum MBBS qualification.
b) Pharmacist: With at least Diploma in Pharmacy(Desirable)
c) Staff Nurse: Qualified staff nurse with general nursing.
d) Group D:MaleorFemale
e) Counselor for HIV or AIDS counseling: A nurse who will be given training for counselling and laboratory techniques.(Desirable)
f) Driver: With requisite licenses, registration
46.3 Vehicle Requirements:
46.3.1 The vehicle should accommodate visiting team with all needed equipment and materials.
46
Human Resource
Clinical Establishments Act Standards for Mobile Clinic with Procedures in Local or Regional Anesthesia CEA or Mobile Clinic 002
a) Oxygen Cylinder.
b) Drug Storage rack.
46.4 Equipment’s Storage Rack.
46.5 Space for Laboratory Equipments.
46.6 IV infusion facilities.
46.7 A licensed driver with uniform, he should be a non-alcoholic and should be available as & when required.
46.8 Vehicle should be kept clean and tidy and should have a name board on the vehicle.
46.9 Vehicle should be regularly serviced and maintained so as to avoid any break down.
46.10 In case of break down, an alternative vehicle should be arranged for without compromising the services of Mobile Health Clinic.
46.11 Vehicle should be insured and coordinated. Under no circumstances, uninsured vehicle shall be used.
46.12 The clinic or polyclinic shall have essential equipment as per APPENDIX I, and emergency equipment as per APPENDIX 2.
46.13 Other equipment as per the scope of service being practiced shall be available.
46.14 Adequate space for storage of equipment and medicines shall be provided and if available, medicines shall be stored as per manufacturer’s guidelines. The equipment should be of adequate capacity to meet work load requirement.
46.15 All equipment should be in good working condition at all times. Periodic inspection, cleaning, maintenance of equipment should be done.
Clinical Establishments Act Standards for Mobile Clinic with Procedures in Local or Regional Anesthesia CEA or Mobile Clinic 002
47 Furniture & Fixtures
47.1 The Mobile Health Clinic should have furniture like
a) Examination table
b) Chairs
c) Stools
d) Table
e) Furniture required for storage of drugs, equipments, chemicals etc.
f) Dressing table and Stool.
g) Waste collecting bins, as per Biomedical waste management Rules specifications.
48 Record Maintenance and reporting
48.1 Every Clinical Establishment shall maintain medical records of patients treated by it and health information and statistics in respect of national programmes and furnish the same to the district authorities in form of quarterly reports.
48.2 Copies of all records and statistics shall be kept with the clinical establishment in accordance with CE Act (under Section 12(1) (iii) of CEA 2010) or any other relevant Act in force at the time.
48.3 All clinical establishments shall be responsible for submission of information and statistics in time of emergency or disaster or epidemic situation or as required from time to time by National Council CEA 2010.
49 Basic processes
49.1 Registration: Every patient visiting the clinic shall be registered.
49.2Assessment: Every patient shall undergo assessment, during the course of assessment, the patient findings, medications and investigations should be documented with working diagnosis, legibly in the assessment or OPD prescription with the signature of the consultant or Specialist or super specialist with date and time.
49.3 First Aid: Provision shall be made for providing First Aid. Contact details of ambulance hospital etc shall be available.
Clinical Establishments Act Standards for Mobile Clinic with Procedures in Local or Regional Anesthesia CEA or Mobile Clinic 002
Appendix 1
Essential Equipments
S. No. 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16 17
18 19
20
21 22
23
Name of the equipment
Stethoscope
Thermometer(Non Mercury)
Torch (flash lights)
Sphygmomanometer(B.P. Apparatus) (Non Mercury)
Weighing machine(Optional)
Autoclave
Stretcher Folding
Oxygen Cylinder with Accessories
Sterilizers
Examination Table
Stool
Artery forceps
Needle Holder
Needles
Cutting Scissor
Dressing Scissor
Dressing Bin
BP Handle
BP Blades
Glues syringes with needles
Disposable syringes kidney tray
Ambu bags
Suction apparatus with accessories
Clinical Establishments Act Standards for Mobile Clinic with Procedures in Local or Regional Anesthesia CEA or Mobile Clinic 002
Drugs
S.No Name Of Drugs
Appendix- 2
1 All Essential Emergency drugs
2 Antibiotics
3 Analgesics
4 Anti Helminthics
6 Anti Hypertensives
7 Anti diabetics
8 Anti diarrheals
9 Sedatives
10 Anti snake venom
11 Vitamins and other supportive drugs
12 Eye drops
13 Ointments
14 Dressing materials
15 Anti coagulants
16 IV fluids
17 ORS
5
Anti fungal drugs
Clinical Establishments Act Standards for Mobile Clinic with Procedures in Local or Regional Anesthesia CEA or Mobile Clinic 002
Clinical Establishments Act
Standard for
Mobile Dental Van Standard No.CEA or Dental Mobile Van
Clinical Establishments Act Standards for Mobile Clinic with Procedures in Local or Regional Anesthesia CEA or Mobile Clinic 002
DEFINITION
Mobile dental van
SCOPE OF SERVICES PROVIDED
Units may be towed or self-propelled, ranging from smaller, one-chair to two-chair units that can be used for examination, preventive and treatment services.
MOBILE UNITS: Mobile units with more than one chair would generally be recommended for full treatment services
PHYSICAL INFRASTRUCTURE
LOCATION
It is important to consider the size and practicality of the unit needed in relation to the locations it will be required to service. Appropriate access to a suitable site and services (concrete pad, electricity, clean and waste water, data and phone) must be available at each location.
SPACE REQUIREMENT
2. There must be a specific space for cleaning and sterilisation of dental instruments designated as STERILIZATION AREA to accommodate front loading autoclave and lab area to carry out minor prosthetic adjustment with washbasin and running tap water.
3. Dedicated area for storing patient’s records or Electronic Health Record (EHR)maintenance
1. In a self-propelled vehicle, a two-chair program requires a treatment area of a minimum of 18 square feet, plus a cab area of at least 7 square feet–generally a total of around 30 square feet.
OUTSIDE SIGNAGES
1. Name of the dental or medical college or hospital or charitable institute or NGO(to
which the van belongs)
INSIDE SIGNAGES
1. Name of dentist in charge 2. Name of stationed doctors 3. OPD hours
4. Services provided
5. Charges of the services offered
6. Emergency contact number
7. Safety signages: to make the patient aware so as to inform treating doctor of any pre
existing medical conditions
Clinical Establishments Act Standards for Mobile Clinic with Procedures in Local or Regional Anesthesia CEA or Mobile Clinic 002
INFRASTRUCTURE CONSIDERATIONS
• •
•
• • •
medical gases –oxygen(cylinder)-in case treatment services are being provided floors and walls – these must be non-porous, without carpets, smooth and easily cleaned
lighting – natural or high-intensity colour-corrected artificial lighting
FIXTURES
Dental chair: minimum 2 dental chairs.
specialist fittings (example: overhead light, x- ray unit, dental unit) hand-washing facilities (elbow-touch taps or infra-red)
dental cabinetry and overhead cabinets
bins for general waste, clinical waste and sharps
PERSONAL HYGIENE AND PROTECTION
Hand-washing facilities in every dental surgery are essential, and must not be combined with sinks used for other purposes, such as decontamination and instrument cleaning. Emphasis should be given to the use of hands-free facilities, where possible (eg, elbow or knee operated taps or infra-red-activated operating lights and hand-basin taps).
Procedures must be implemented for the safe handling and appropriate disposal of contaminated materials and waste. Hands-free access to bins for paper and clinical waste is recommended
ACOUSTICS
Compressor should preferably not be kept in the working area
LIGHTING
colour-corrected light or natural
SPECIFIC CONSIDERATIONS OF MOBILE DENTAL VAN
•Chassis: a durable, watertight, reinforced floor is recommended. Insulation should provide the best possible protection from outside temperatures.
• Levelling jacks: there should be one on each corner to provide stability when the unit is stationary.
• Access: there should be at least one door for one –two dental chairs
• Steps: these should be fold-away, lockable when in position, and incorporate a handrail.
• Windows: tinted security windows are best, with insect screens and blinds.
• Services: these will include a compressor, evacuator motor, water inlet, and pump for the base of the dental chair(s).
• Mounting brackets: these are required for lights, the x-ray unit and dental unit.
• Water supply: use a dual system so that town water can be used when available, plus storage tanks top or beneath the vehicle floor (but protected from road damage).
• Water filter: use a filter suitable for use in dental units, and locate this with the water pump.
• Waste disposal: there should be an inbuilt waste water collection unit beneath the floor for collection of the generated waste water. If disposed outside, solid and water waste must comply with territorial local authority and regional council requirements where the unit will be operated.
Clinical Establishments Act Standards for Mobile Clinic with Procedures in Local or Regional Anesthesia CEA or Mobile Clinic 002
• •
Internal finishes: cabinetry and bench tops must be easily cleaned. Sinks or basins: there should be a minimum of one clean and one dirty.
Equipment: must be properly secured to be protected from road shock and vibration, and wall-mounted x-rays and lights must be secure in-transit. Water and air lines must not leak, on-board power generators cannot make too much noise andoror vibration, and equipment must be properly placed to ensure there is adequate space for dentists and technicians to operate.
HUMAN RESOURCES DOCTORS
1. Dental surgeons(Bachelor in Dental Surgery or Master in Dental Surgery) on full time basis- 1-2 in number
TECHNICAL STAFF
1. Dental operating room assistant
one for a every 2 dental chairs installed qualification: tenth pass
having 5 years working experience under a registered dental surgeon
NON TECHNICAL STAFF
GRADE IV staff employed full time.
Duty roster
Hospital or concerned authority for technical or non-technical staff
Periodic health check up, vaccination of staff
Once in a year health check up of all the staff.
Mandatory hepatitis B vaccination of the staff.
EQUIPMENT (FUNCTIONAL)
1. Stethoscope
2. Thermometer- non mercury based
3. BP apparatus- non mercury based
4. Glucometer
5. Weighing machine
6. Emergency kit and medicine
Oxygen cylinder Adrenaline Diphenhydramine Hydrocortisone Nitroglycerine Salbutamol
Morphine
Diazepamor midazolam Aspirin tablets Ambulatory bag
7. DEFIFIBRILLATOR- either mechanical or automatic
8. Consumables- should be available in adequate
number.
QUANTITY 1
1
1
1 1
2 ampoules 2 ampoules 2 ampoules 2 ampoules 2 ampoules 2 ampoules 2 ampoules
1 1
Clinical Establishments Act Standards for Mobile Clinic with Procedures in Local or Regional Anesthesia CEA or Mobile Clinic 002
Facemask
Gloves: both sterile and non-sterile
Cotton rolls
Gauze
2cc and 5cc syringes with needles
Sutures- vicryl
Silk
Lignocaine 2 percent with 1:200000
Adrenaline and without adrenaline
Zinc oxide powder and eugenol liquid
Glass ionomer (powder and liquid)
Silver based GIC(powder and liquid)
Gum paint
9. DENTAL EQUIPMENT
Dental operating unit
Dental chair
SUCTION UNIT AUTOCLAVE IOPA MACHINE
Either hydraulic or electric; with a back rest in movable trendelenberg or reverse trendelenberg position
Either attached to dental chair or separate; Should have a separate amalgam separation filter
office-based front loading autoclave;
Processing system and design – automation or manual; daylight loader or RVG
IOPA machine should be approved by AERB.
1 Lead apron and thyroid collar or lead shield
Maintenance of logbook mandatory which mentions the identity of the person radiographed, part exposed, date along with operator or doctor’s name and signatures
Clinical Establishments Act Standards for Mobile Clinic with Procedures in Local or Regional Anesthesia CEA or Mobile Clinic 002
SUPPORT SERVICES
ETHICS
To do no harm (Non- maleficience) Veracity(truthfulness) confidentiality
BMW MANAGEMENT
Segregation of waste should be done in black, yellow and blue bags . It is mandatory to segregate the waste at the site of waste generation.
BLACK BAGS: Kitchen waste
Carry bags
Paper and packaging Disposable glasses or plates Leftover foods
Bouquets
Thermocol
YELLOW BAGS Human tissues
Histopathology specimens
Body parts and organs
Soiled waste swabs, dressing, mops, bandages or items contaminated with blood Microbiology or bio-technology waste
BLUE BAGS
Disinfected catheters
Any other tubings
IV bottles
IV tubes
Disinfected plastic drains
Rubber or latex gloves(mutilated and disinfected) Other plastic material
RED BAGS
Every dental chair installed will have its separate yellow bag. For 2 chairs there will be one black, one red and one blue bag.
There will be one needle destroyer in the mobile van.
Contract for disposal of BMW should be given to a company approved by government of India or Ministry of Environment or CPC.
There should be a written contract for BMW management along with the economy involved.
Logbook should be maintained mentioning weight of the waste (infected) and date on which waste (new or old) was lifted.
Clinical Establishments Act Standards for Mobile Clinic with Procedures in Local or Regional Anesthesia CEA or Mobile Clinic 002
RECORD MAINTENANCE AND REPORTING
Daily record keeping for incoming patients mentioning patient name, age, sex, date, services rendered along with treatment charges.
MLC
NA
CONFIDENTIALITY
“All that may come to my knowledge in the exercise of my profession or in daily commerce with men, which ought not be spread, I will keep secret and will never reveal”-Hippocratic oath
STANDARDS ON BASIC PROCESSESES
INFECTION CONTROL
1.Instruments sterilization and cleaning must not be executed inside the surgery room.
2.There must be good supply of clean water, through a quality piping that support good water hygiene.
3.All general purpose cleaning equipment and agents should be stored in a separate part of the premises
4.There must be a specific space for cleaning and sterilisation of dental instruments and should not be used other than above.
5.Use trash bin lined with commercial color coded plastic bag for the medical waste inside the surgery room.
6.Needle destroyer must be used for disposable needles
7.Keep cleaning equipment always in a very clean condition before use; type of floor sanitizing and cleaning agents must be approved for clinical use.
8.Hands-free access to bins for paper and clinical waste is recommended
9.Emphasis should be given to the use of hands-free facilities, where possible (eg, elbow or knee operated taps or infra-red-activated operating lights and hand-basin taps).
10.Use of liquid soap (no soap bar)is mandatory
11.There should be no cotton or wool fabric curtains in dental clinics.
12.In door pets and natural plant inside the surgery room should be not permitted 13.Non-wooden storage cabinet shall be used for storing cleaning equipment and agents
14.An infection control protocol should be established to include an exposure control plan based on OSHA’S blood borne pathogen standard. This is a written plan to minimize or eliminate occupational exposure.
15.Personal Protective Equipment(PPE)such as laboratory coats, gowns ,facemask, gloves etc should be utilized.
FACILITIES FOR HAND WASHING
Hand-washing facilities in every dental surgery are essential, and must not be combined with sinks used for other purposes, such as decontamination and instrument cleaning. Emphasis should be given to the use of hands-free facilities, where possible (eg, elbow or knee operated
Clinical Establishments Act Standards for Mobile Clinic with Procedures in Local or Regional Anesthesia CEA or Mobile Clinic 002
taps or infra-red-activated operating lights and hand-basin taps). Use of liquid soap (no soap bar) is mandatory.
FACILITIES FOR STERILIZATION
Disinfectants- 2 percent glutaraldehyde, sodium hypochlorite, chlorhexidine etc
Autoclave office-based; maintenance (self-contained with drier); availability of parts; door design; loading system; cylinder size; cycle-reporting system; validation and calibration system
POLICY ON OUTSOURCED SERVICES Lab work can be outsourced
BioMedical Waste management, cleaning staff and pest control are some of the other services which can be outsourced
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEA/Hospital – 001
Clinical Establishments Act
Standard for
HOSPITAL (LEVEL 1A &1B) Standard No. CEA /Hospital – 001
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEA/Hospital – 001
Table of Contents
Sr. No.
Particulars
Page No.
1.
Categorization of Hospitals
4
2.
Definition
6
3.
Scope
7
4.
Infrastructure
7
5.
Equipment
8
6.
Human Resource
9
7.
Support Services
9
8.
Legal or Statutory Requirements
9
9.
Record Maintenance and Reporting
10
10.
Basic Processes
10
11.
Appendix 1
12
12.
Appendix 2
14
13.
Appendix 3
15
14.
Appendix 4
22
15.
Appendix 5
24
16.
Appendix 6
25
17.
Appendix 7
27
18.
Appendix 8
28
19.
Appendix 9
29
20.
Appendix 10
30
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEA/Hospital – 001
Categorization of Hospitals
The minimum standards for Allopathic hospitals under Clinical Establishments Act, 2010 have been developed on the basis of level of care provided as defined below:
Hospital Level 1 (A)-
General Medical services with indoor admission facility provided by recognized allopathic medical graduate(s) and may also include general dentistry services provided by recognized BDS graduates.
Example: PHC, Government and Private Hospitals and Nursing Homes run by MBBS Doctors etc.
Hospital Level 1(B) –
This level of hospital shall include all the general medical services provided at level 1(A) above and specialist medical services provided by Doctors from one or more basic specialties namely General Medicine, General Surgery, Paediatrics, Obstetrics & Gynaecology and Dentistry, providing indoor and OPD services.
Level 1(A) and Level 1(B) Hospitals shall also include support systems required for the respective services like Pharmacy, Laboratory, etc.
Example: General Hospital, Single or Multiple basic medical specialties provided at Community Health Centre, Sub Divisional Hospital, and Private Hospital of similar scope, Nursing Home, Civil or District Hospital in few places etc.
Hospital Level 2 (Non-Teaching)
This level may include all the services provided at level 1(A) and 1(B) and services through other medical specialties given as under, in addition to basic medical specialty given under 1(B) like:
a. Orthopaedics
b. ENT
c. Ophthalmology
d. Dentistry
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
e. f. g. h. i. j.
Imaging facility, Operation Theatre etc.
Example: District Hospital, Corporate Hospitals, Referral Hospital, Regional or State Hospital, Nursing Home and Private Hospital of similar scope etc.
Hospital Level 3 (Non-Teaching) Super-specialty services –
This level may include all the services provided at level 1(A), 1(B) and 2 and services of one or more of the super specialty with distinct departments and or also Dentistry if available. It will have other support systems required for services like pharmacy, Laboratory, and Imaging facility, Operation Theatre etc.
Example: Corporate Hospitals, Referral Hospital, Regional or State Hospital, Nursing Home and Private Hospital of similar scope etc.
Hospital Level 4 (Teaching) –
This level will include all the services provided at level 2 and may also have Level 3 facilities. It will however have the distinction of being teaching or training institution and it may or may not have super specialties. Tertiary healthcare services at this level can be provided through specialists and may be super specialists (if available). It will have other support systems required for these services. It shall also include the requirement of Medical Council of India or other registering body for teaching hospitals and will be governed by their rules. However registration of teaching Hospitals will also be required under Clinical Establishments Act for purpose other than those covered under Medical Council of India such as, records maintenance and reporting of information and statistics, and compliance to range of rates for Medical and Surgical procedures, etc.
Emergency with or without ICU Anaesthesia
Psychiatry
Dermatology Pulmonary Medicine
Physical medicine and Rehabilitation, etc.
And support systems required for the above services like Pharmacy, Laboratory,
CEA/Hospital – 001
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEA/Hospital – 001
Clinical Establishment Act Standards for Hospital (LEVEL 1A 1B)
1. Definition
A hospital is a clinical establishment providing patient treatment by qualified and trained staff and equipment through Allopathy – Modern system of medicine; where the patients are ‘admitted’ and stay overnight or more and they are referred as ‘inpatients’; while some patients may go to a hospital just for diagnosis, treatment, or therapy and then leave, they are referred as ‘outpatients’ without staying overnight.
Hospitals have facility to admit and care for inpatients whilst the other clinical establishments are described as clinics or polyclinics or day care centres. There are other exceptions too like Hospice etc.
The general hospital, may have multiple departments taking care of many kinds of disease and Injury, and normally has an emergency department to deal with immediate and urgent care.
Specialized hospitals may include trauma centres, rehabilitation hospitals, children’s hospitals, Mental hospitals or, and hospitals for dealing with specific medical needs such as psychiatric problems (psychiatric hospital) or Sanatorium, certain disease categories such as neurology, cardiology, oncology, or orthopaedic, IVF and so forth.
Some hospitals are affiliated with universities for medical research and the training of medical personnel such as physicians and nurses, often called teaching hospitals. Guidelines laid down by MCI or other legal bodies shall be applicable to such hospitals. The minimum standards will not apply to them.
A hospital can be situated in rural or urban setting. It can be run by Public Sector (Central government or State government or Local government or Public Sector undertaking or Registered Society etc) or by Private Sector (Individual Proprietorship or Registered Partnership or Registered Company or Co-operative Society or Trust or Charitable etc).
Hospital Level 1 (A)-
General Medical services with indoor admission facility provided by recognised allopathic medical graduate(s) and may also include general dentistry services provided by recognized BDS graduates.
Example: PHC, Government and Private Hospitals and Nursing Homes run by MBBS Doctors etc.
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
all of the
2.1. 2.2. 2.3. 2.4. 2.5. 2.6.
following specialities:
General Medicine
Obstetrics & Gynaecology (Non-surgical)
Paediatrics
Community Health and Family Medicine
General Dentistry
Basic Support services
Registration or help desk and billing
Diagnostic Services:(Can be own or outsourced or Tie up)
Collection centre or Laboratory X-ray
UltraSonoGraphy
Waste Management Services (General and Biomedical)
3. Infrastructure
a) b)
c)
CEA/Hospital – 001
Hospital Level 1(B) –
This level of hospital shall include all the general medical services provided at level 1(A) above and specialist medical services provided by Doctors from one or more basic specialties namely General Medicine, General Surgery, Paediatrics, Obstetrics & Gynaecology and Dentistry, providing indoor and OPD services.
Level 1(A) and Level 1(B) Hospitals shall also include support systems required for the respective services like Pharmacy, Laboratory, etc.
Example: General Hospital, Single or Multiple basic medical Specialties provided at Community Health Centre, Sub Divisional Hospital, and Private Hospital of similar scope, Nursing Home, Civil or District Hospital in few places etc.
2. Scope
The scope of services that may be provided at a hospital(level 1A &1B) practising Allopathy – Modern system of Medicine may include patient-care services in any or
3.1
Signage
3.1.1
The Hospital shall display appropriate signage which shall be in at least two
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEA/Hospital – 001
languages
The building shall have a board displaying the name of the hospital at a prominent location.
Directional signage shall be placed within the facility to guide the patient(s).
3.1.2
3.1.3
Following informative signage shall be displayed:
3.1.4 3.1.5 3.1.6
3.1.7 3.1.8 3.1.9
Following safety signage shall be displayed: 3.1.11
3.1.12 3.1.13 3.2. 3.2.1
3.2.2
3.2.3 3.2.4
3.2.5 3.2.6
4. Medical Equipment and Instruments:
Name of the care provider with registration number.
Registration details of the hospital as applicable.
Availability of fee structure of the various services provided (refer to Clinical Establishments Act 2010 rules & regulation).
Timings of the facility and services provided.
Mandatory information such as under PNDT Act etc.
Important contact numbers such as Blood Banks, Fire Department, Police and Ambulance Services available in the nearby area.
Safety Hazard and Caution signs, for e.g. hazards from electrical shock, inflammable articles, radiation etc shall be displayed at appropriate places, and as applicable under law.
Appropriate Fire exit signage.
Signage for “No Smoking” at prominent places.
Other requirements
Access to the hospital shall be comfortable for the patient and or attendants or visitors.
Access shall be provided within the requirements of “Persons with Disabilities Act” and shall be easy for all those whose mobility may be restricted due to whatever cause.
The hospital shall be developed and maintained to provide safe, clean and hygienic environment for patients, their attendants, staff and visitors
The hospital shall have 24hr provision of potable water for drinking & hand hygiene. It shall also have 24 hr supply of electricity, either through direct supply or from other sources.
The hospital shall have clean public toilet(s).
Furniture and fixtures shall be available in accordance with the activities and workload of the hospital. They shall be functional and properly maintained.
The minimum space requirements shall be as per Appendix 1
Indicative list of furniture and fixtures is as per Appendix 2
4.1
The hospital shall have adequate medical equipment and instruments, commensurate to the scope of service and number of beds.
4.2
There shall be established system for maintenance of critical equipment.
4.3
Equipment shall be kept in good working condition through a process of periodic inspection, cleaning and maintenance. Annual maintenance.
For indicative list of medical equipment and instruments, Please refer to
Appendix 3.
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEA/Hospital – 001
5. Drugs, Medical devices and Consumables:
5.1
The hospital shall have adequate drugs, medical devices and consumables commensurate to its scope of services and number of beds.
5.2
Emergency drugs and consumables shall be available at all times.
5.3
Drug storage shall be in a clean, well lit, and safe environment and shall be in consonance with applicable laws and regulations.
5.4
The facility shall have defined procedures for storage, inventory management and dispensing of drugs in pharmacy and patient care areas.
For indicative list of drugs, medical devices and consumables please refer to
Appendix4.
6. Human Resource Requirement
6.1
The hospital shall have qualified and or trained medical and nursing staff as per the scope of service provided and the medical or nursing care.
6.2
The support or paramedical staff shall be qualified and or trained as per the scope of services provided, and as per requirement
6.3
For every staff (including contractual staff), there shall be personal record containing the appointment order, documentary evidence of qualification and or training (and professional registration where applicable).
For human resource requirements please refer to Appendix5.
7. Support Services:
7.1
The Hospital shall have a Registration or Help-desk & Billing counter.
7.2
The diagnostic services, whether in house or outsourced, shall be
commensurate with the scope of service of the hospital.
7.3
Segregation, collection, transportation, storage and disposal of general waste shall be done as per applicable local laws
7.4
Segregation, collection, transportation, storage and disposal of biomedical waste shall be done as per Bio medical waste handling rules.
7.5
The Hospital shall arrange transportation of patients for transfer or referral or investigations etc. in safe manner.
8. Legal or Statutory Requirements
9. Record Maintenance and reporting:
8.1
Compliance with local regulations and law.
Indicative list of legal requirement is as per Appendix 6.
9.1.
The minimum medical records to be maintained and nature of information to be provided by the Hospitals shall be as prescribed by the Clinical Establishment Act
9.2.
Medical Records shall be maintained in physical or digital format.
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEA/Hospital – 001
9.3.
The hospital shall ensure confidentiality, security and integrity of records.
9.4.
The medical records of IPD patients shall be maintained in consonance with National or local law, MCI guidelines, and court orders.
9.5.
The Hospital shall maintain health information and statistics in respect of national programmes, notifiable diseases and emergencies or disasters or epidemics and furnish the same to the district authorities in the prescribed formats and frequency.
For content of medical record refer to Appendix7
10.Basic Processes
10.1.
The hospital shall register all patients who visit the hospital except if the required service is not available in the facility, in which case the patient is guided to the appropriate nearest facility.
10.2.
Patient shall be guided and informed regarding Patients’ rights & responsibilities, cost estimates, third party services (e.g. Insurance) etc. Appendix 8.
10.3.
The billing shall be as per the Hospital tariff list, which shall be available to patients in a suitable format.
10.4.
Each patient shall undergo an initial assessment by qualified and or trained personnel.
10.5.
Further management of patient shall be done by a registered medical practitioner on the basis of findings of initial assessment; for example, OPD treatment, admission, transfer or referral, investigation etc.
10.6.
The hospital shall ensure adequate and proper spacing in the patient care area so as to prevent transmission of infections.
10.7.
Regular cleaning of all areas with disinfectant shall be done .
10.8.
Housekeeping or sanitary services shall ensure appropriate hygiene and sanitation in the establishment.
10.9.
At the time of admission of patient, general consent for admission shall be taken.
10.10.
In case of non-availability of beds or where clinical need warrants, the patient shall be referred to another facility along with the required clinical information or notes.
10.11.
Reassessments of the admitted patients shall be done at least once in a day and or according to the clinical needs and these shall be documented.
10.12.
Any examination, treatment or management of female patient shall be done in the presence of an employed female attendant or female nursing staff, if conducted by male personnel inside the hospital and vice versa
10.13.
The patient and family shall be treated with dignity, courtesy and politeness.
10.14.
The Hospital shall provide care of patient as per Standard Treatment Guidelines that may be notified by the Central or State Government (Desirable)
10.15.
The Clinical Establishment shall undertake to provide within the staff and facilities available, such medical examination and treatment as may be required to stabilize the emergency medical condition of any individual who comes or is brought to such clinical establishment.
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEA/Hospital – 001
10.16.
Prescription shall include name of the patient, date, name of medication, dosage, route, frequency, duration, name, signature and registration number of the medical practitioner in legible writing.
10.17.
Drug allergies shall be ascertained before prescribing and administration; if any allergy is discovered, the same shall be communicated to the patient and recorded in the case sheet as well.
10.18.
Patient identity, medication, dose, route, timing, expiry date shall be verified prior to administration of medication.
10.19.
Patients shall be monitored after medication administration and adverse drug reaction or events if any shall be recorded and reported.
10.20.
The hospital shall follow standard precautions like practicing hand hygiene, use of personal protection equipment etc. so as to reduce the risk of healthcare associated infections.
10.21.
Security and safety of patients, staff, visitors and relatives shall be ensured by provision of appropriate safety installations and adoption of appropriate safety measures.
10.22.
The patient and or family members are explained about the disease condition, proposed care, including the risks, alternatives and benefits. They shall be informed on the expected cost of the treatment. They shall also be informed about the progress and any change of condition.
10.23.
Informed consent shall be obtained from the patient or next of kin or legal guardian as and when required as per the prevailing Guidelines or Rules and regulations in the language patient can understand (for e.g. before Invasive procedures, Blood transfusion, HIV testing, etc.).Appendix 9
10.24.
10.25.
A Discharge summary shall be given to all patients discharged from the
hospital.
Discharge or Death summary shall also be given to patient and or attendant in case of transfer or Leaving Against Medical Advice or Discharge Against Medical Advice or death
10.26.
The discharge summary shall include the points as mentioned in the Appendix in an understandable language and format. For content of discharge summary refer to Appendix 10.
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEA/Hospital – 001
APPENDIX 1
Minimum space requirements in a hospital level 1 shall be as follows:
Area (Desirable)
Wards
1.
Ward bed and surrounding space
6sqmor bed; in addition circulation space of 30% as indicated in total area shall be provided for Nursing station, Ward store, Sanitary etc
Minor Operation Theatre or Procedure room
2.
OT for minor procedures (where applicable)
10.5sqm
Labour room
3.
Labour Table and surrounding space
10.5 sqm for labour table
4.
Other areas- nursing station, doctors’ duty room, store, Clean and dirty utility, Circulating area, Toilets
10.5 sqm for clean utility and store and 7 sqm for dirty utility and 3.5 sqm for toilet
5.
Bio-medical Waste
5 sqm
Other functional areas( laboratory, diagnostics, front office or reception, waiting area, administrative area etc.) should be appropriately sized as per the scope of service and patient load of the hospital
Other requirements:
Wards:
1. The ward shall also have designated areas for nursing station, doctors’ duty room, store, clean and dirty utility, janitor room, toilets and this shall be provided from circulation area.
2. For a general ward of 12 beds, a minimum of 1working counter and 1 hand wash basin shall be provided.
3. Distance between beds shall be 1.0 metres.
4. Space at the head end of bed shall be 0.25 metres.
5. Door width shall be 1.2 metres and corridor width 2.5 metres
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
Labour room:
1. The obstetrical unit shall provide privacy, prevent unrelated traffic through the unit and provide reasonable protection of mothers from infection and from cross-infection.
2. Measures shall be in place to ensure safety and security of neonates.
3. Resuscitation facilities for neonates shall be provided within the obstetrical unit and convenient to the delivery room.
4. The labour room shall contain facilities for medication, hand washing, charting, and storage for supplies and equipment.
5. The labour room shall be equipped with oxygen and suction
Emergency room(if available)
1. Emergency bed and surrounding space shall have minimum 10.5 sq m or bed area.
CEA/Hospital – 001
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEA/Hospital – 001
APPENDIX 2
FURNITURE AND FIXTURES
S.N 2.
3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23.
ARTICLES
Examination Table Writing tables Chairs
Almirah
Waiting Benches
Medical or Surgical Beds
Labour Table- if applicable
Wheel Chair or Stretcher
Medicine Trolley, Instrument Trolley Screens or curtains
Foot Step
Bed Side Table
Baby Cot- if applicable
Stool
Medicine Chest
Examination Lamp
View box
Fans
Tube Light or lighting fixtures
Wash Basin
IV Stand
Colour coded bins for BMW
*This is an indicative list and the items shall be provided as per the size of the hospital and scope of service.
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEA/Hospital – 001
APPENDIX 3
EQUIPMENT
a. EMERGENCY EQUIPMENT
S. No.
Name of Emergency Equipment
1
Resuscitation equipment including Laryngoscope, endotracheal tubes, suction equipment, xylocaine spray, oropharyngeal and nasopharyngeal airways, Ambu Bag- Adult &Paediatric (neonatal if indicated)
2
Oxygen cylinders with flow meteror tubing or catheteror face mask or nasal prongs
3
Suction Apparatus
4
Defibrillator with accessories (Desirable)
5
Equipment for dressingorbandagingorsuturing
6
Basic diagnostic equipment- Non mercury Blood Pressure Apparatus, Stethoscope, weighing machine, thermometer (Non mercury)
7
ECG Machine
8
Pulse Oximeter (Desirable)
9
Nebulizer with accessories
b. Other equipment and consumables, which shall also be available in good working condition as per the scope of services and bed strength (some of the emergency equipment are already mentioned above).
Department
Equipment
Level 1A
Level 1B
Level 2
Level 3
NON MEDICAL
Administration
Office equipment
Yes
Yes
Yes
Yes
Office furniture
Yes
Yes
Yes
Yes
Electricity
Emergency lights
Yes
Yes
Yes
Yes
Water Supply
Hand-washing sinksortapsorbowls on stands in all areas
Yes
Yes
Yes
Yes
Storage tank
Yes
Yes
Yes
Yes
Water purification
Yes
Yes
Yes
Yes
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
Sharps containers in all treatment areas
Food refrigeration
Plates, cups & cutlery
Yes
Yes
Yes
CEA/Hospital – 001
chemicals or filter
Water source for drinking water
Yes
Yes
Yes
Waste Disposal
Yes Yes
Yes Yes
Yes
Yes Yes
Yes
Yes
Yes
Yes Yes
Yes
Yes Yes Yes
Yes Yes
Yes Yes
Yes
Yes
Buckets for contaminated waste in all treatment areas
Yes
Yes
Yes
Drainage system
Rubbish bins in all
Yes
Yes
Yes
Yes
Yes
Yes
Yes
rooms
Sanitation facilities for patients
Yes
Yes
Separate Bio-medical waste disposal
Yes
Yes
Yes
Yes
Safety Vehicle(OwnorOutsourced)
Medical Stores Kitchen(OwnorOutsourced)
Laundry(OwnorOutsourced)
Housekeeping(OwnorOutsourced)
Fire extinguisher
Yes
Yes
Yes
Vehicle
4 wheeler
Desirable
Desirable
Yes
Ambulance
Yes
Yes
Yes
Lockable storage
Yes
Yes
Yes
Refrigeration
Yes
Yes
Yes
Cooking pots and utensils
Yes
Yes
Yes
Cooking stove
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Storage
Yes
Yes
Yes
Washing and drying area facilities
Yes
Yes
Yes
Detergentorsoap
Washing and rinsing equipmentorbowls
Housekeeping Brooms, brushes and mops
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Buckets
Yes
Yes
Yes
Soap and
Yes
Yes
Yes
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
Yes
Yes
CEA/Hospital – 001
disinfectant
MEDICAL
Outpatient Rooms
Non Mercury Blood Pressure Apparatus and stethoscope
Container for sharps disposal
Yes
Yes
Desk and chairs
Yes
Yes
Examination gloves
Yes
Yes
Examination table
Yes
Yes
Hand washing facilities
Yes
Yes
Light source
Yes
Yes
Minor surgical instruments
No
Yes
Ophthalmoscope
No
No
Otoscope
No
No
Patellar hammer
Receptacle for soiled pads, dressings, etc.
Yes
Yes
Yes
Yes
Separate biohazard disposal
Yes
Yes
Sterile equipment storage
Yes
Yes
Sutures
Yes
Yes
Thermometer(Non mercury)
Yes
Yes
Torch with extra batteries
Weighing scale
Yes
Yes
Yes
Yes
Women and Child health examination room
Yes Yes
Yes Yes
Yes Yes
Yes Yes
Yes Yes
Yes Yes
Yes Yes
Yes Yes
Yes (as Yes applicable)
Yes (as Yes applicable)
Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
Yes
Yes Yes Yes Yes
Yes Yes Yes
Yes Yes
Non Mercury Blood Pressure Apparatus and stethoscope
Yes
Yes
Yes
Contraceptive supplies
Yes
Yes
Yes
Birth register
Examination gloves
Examination table with stirrups
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Fetal stethoscope
No
Yes
Yes
Yes
Doppler
No
No
No
Hand washing facility
Yes
Yes
Yes
Yes
Height measure
Yes
Yes
Yes
IUD insertion set
Yes
Yes
Yes
Yes
Pregnant woman Register
Yes
Yes
Yes
Speculum and vaginal examination kit
Yes
Yes
Yes
Yes
Syringes and needles
Tape measure
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Tococardiograph
No
Yes
Yes
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEA/Hospital – 001
Labour room
Baby scales Yes Yes Non Mercury Blood Yes Yes
Pressure Apparatus and
stethoscope
Clean delivery kits and Yes Yes
cord ties
Curtains if more Yes Yes Yes Yes than one bed
Delivery bed and bed Yes Yes
linen
Fetal stethoscope Yes Yes Yes Yes
Yes Yes Yes Yes
Yes Yes
Yes Yes
Hand washing facility Yes Yes
Instrument trolley Yes Yes Yes Yes
Yes Yes
IV treatment sets Yes Yes
Latex gloves and Yes Yes Yes Yes protective clothing
Linens for newborns Yes Yes
Mucus extractor Yes Yes Yes Yes
Yes Yes
Yes Yes
Oral airways, various Yes Yes
sizes
Oxygen cylinder Yes Yes Yes Yes orconcentrator
Partograph charts Yes Yes
Self inflating bag and Yes Yes
mask – adult and
neonatal size
Suction machine Yes Yes
Suturing sets Yes Yes Yes Yes
Thermometer(Non Yes Yes mercury)
Tray with routine & Yes Yes emergency drugs,
syringes and needles
Urinary catheters and Yes Yes
collection bags
Vacuum extractor set Yes Yes Yes Yes
Yes Yes
Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes
Work surface near bed Yes Yes for newborn
resuscitation
Yes Yes Yes Yes
Inpatient Wards
Basic examination Yes Yes equipment
(stethoscope, Non
mercury BP Apparatus
(etc)
Yes Yes
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEA/Hospital – 001
Beds, washable mattresses and linen
Yes
Yes
Yes
Curtains
Yes
Yes
Yes
Dressing sets
Yes
Yes
Yes
Dressing trolleyorMedicine trolley
Yes
Yes
Yes
Gloves
Yes
Yes
Yes
IV stands
Yes
Yes
Yes
Medicine storage cabinet
Yes
Yes
Yes
Oxygen cylinder and concentrator
Yes
Yes
Yes
Patient trolley on wheels
Yes
Yes
Yes
PPE kits
Yes
Yes
Yes
Suction machine
Yes
Yes
Yes
Urinals and bedpans
Yes
Yes
Yes
OperationTheatre : If available
Yes
Yes Yes Yes
Yes Yes Yes
Yes Yes
Yes Yes Yes
Yes Yes
Yes Yes Yes
Yes Yes
Yes Yes
Yes (as applicable )
Yes
Yes
Adequate storage
Ambu resuscitation set with adult and child masks
Yes
Yes
Yes
Yes
Yes
Yes
Defibrillator
Yes
Electro cautery
No
Yes
Yes
Fixed operating lights
Laryngoscope set
No
No
No
Fixed suction machine
No
No
Hand washing facilities
Yes
Yes
Yes
Instrument tray
Yes
Yes
Yes
Yes
Instrument trolley
Yes
Yes
Yes
No
Yes
Yes
Mayo Stand
Mobile operating light
Oral airways, various sizes
Oxygen cylinder and concentrator
Patient trolley on wheels
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Ophthalmic Operating Microscope
No
No
Yes (as applicabl e)
No
Yes
Yes
Yes
Yes
Yes
Yes
Portable suction machine
Yes
Safety Box
Yes
Yes
No
Yes
Yes
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEA/Hospital – 001
Sphygmomanometer Yes Yes
(Non Mercury) and
stethoscope
Stool adjustable height No Yes Yes Yes
Yes Yes
Operating table No Yes IV Therapy Equipment No
Anesthesia Equipment No Yes Anesthetic
trolleyormachine
O2 Monitor No
Endoscopic equipment No No
and necessary
accessories
Bronchoscope No No
Colonoscope No No Desirable Yes
Yes Yes Yes Yes
CO2 Monitor
No
Yes
Yes
Yes Yes No Yes
Desirable Yes
Endoscope No No
Fiber Optic No No Desirable Yes Laryngoscope
Central Supply
Amputation set No No No Yes
Desirable Yes
Caesareanorhysterecto No No my set
Dilatation and No No curettage set
Yes Yes Yes Yes No Yes
Endoscopic instrument No No
cleaning machines
and solutions
Hernia set No No Yes Yes
Laparotomy set No No
Linens Yes Yes Yes Yes
Yes Yes
Locked storage Yes Yes
Operating drapes No Yes Yes Yes
Yes Yes
Ophthalmic instrument No No
Protective caps, aprons, Yes Yes Yes Yes shoes and gowns etc.
Pelvicorfistula repair No No
set
Yes Yes No Yes Yes Yes
No Yes
Sterile gloves
Yes
Yes
Yes
Yes
Sterilization equipment Yes Yes for instrument and
linens
Thoracocentesis set No No
Surgical supplies (e.g., sutures, dressings, etc.)
Yes
Yes
Yes
Yes
Thoracostomy set with
No
No
No
Yes
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEA/Hospital – 001
appropriate tubes and water sealbottles
Thoracotomy set
No
No
No
Yes
ThyroidorParathyroid set
No
No
No
Yes
Tracheostomy set
No
No
Yes
Yes
Tubal ligationset
No
No
Yes
Yes
Vascular repair set
No
No
Yes
Yes
Other equipment as per the specialized services available shall also be there
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEA/Hospital – 001
a. List of Emergency Drugs and consumables (Essential in all hospitals)
Sl. No.
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21.
22. 23.
APPENDIX 4
DRUGS, MEDICAL DEVICES AND CONSUMABLES
Name of the Drug
INJECTIONECTIONS
Injection. Diazepam 10 Mg Injection. Frusemide 20 Mg Injection. Ondansetron 8 Mgor4ml Injection. Ranitidine
Injection Nor Adrenaline 4 Mg Injection. Phenytoin 50 Mg Injection Diclofenac 75 Mg Injection. Deriphylline
Injection Chlorpheniramine Maleate Injection. Hydrocortisone 100 Mg Injection. Atropine 0.6 Mg
Injection. Adrenaline 1 Mg Injection. Kcl
Sterile Water
Injection. Soda Bicarbonate Injection. Dopamine Injection. Nalaxone 400 Mcg Injection. Lignocaine 50 Ml Tab. Sorbitrate
Tab. Aspirin
Injection. Tetanus Other
Neb. Salbutamol2.5 Ml Neb. Budesonide
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEA/Hospital – 001
24.
Lignocaine Jelly 2%
25.
Activated Charcoal
26.
Calcium (Injection Or Tab)
Fluids
27.
RL 500 Ml
28.
NS 500 Ml
29.
NS 250 Ml
30.
NS 100 Ml
31.
DNS 500 Ml
32.
Dextrose 5% 500 Ml
33.
Dextrose 10% 500 Ml
34.
Pediatric Iv Infusion Solution 500 Ml
b. The other drugs and consumables shall be available as per the scope of services, bed strength and patient turnover.
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
APPENDIX 5
HUMAN RESOURCE
The Human Resource requirement for any hospital depends on the scope of services provided by the hospitals, bed strength and workload of the hospital.
However on the basis of level of care provided the minimum staffing requirements for Hospital level 1 shall be as follows:
CEA/Hospital – 001
1.
Doctor
Qualified doctor shall be available round the clock on site. Level 1A shall have a MBBS qualified doctor.
(Qualified doctor is a MBBS approved as per state government rules & regulations as applicable from time to time).
Level 1B shall have MBBS doctor with required post-graduation qualification.
2.
Nurses
Qualified nurses per unit per shift shall be available as per requirement laid down by“The Indian Nursing Council, 1985”, occupancy rate and distribution of bed.
3.
Pharmacist (If in house pharmacy available)
1 in a hospital
4.
Lab Technician (if in house laboratory service available)
1 in a hospital (minimum DMLT) BSc, MSc ,MLT(Desirable)
5.
X-ray Technician (if in house X-ray facility available)
1 in a hospital (minimum Diploma in X Ray Technician course)
6.
Multi Task staff
Minimum 1
Requirement of other staff (Support and administrative) will depend on the scope of the hospital.
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
APPENDIX 6
LIST OF LEGAL REQUIREMENTS
Below is the list of legal requirements to be complied with by a hospital as applicable by the localorstate health authority (all may not be applicable):
CEA/Hospital – 001
Sn Name of Document
1 Registration under Nursing Home Actor Medical Establishment Act
2 Bio-medical Waste Management Licenses Authorization of HCO by PCB
MOU with Vendor
3 AERB Licenses
4 NOC from Fire Department
5 Ambulance
Commercial Vehicle Permit Commercial Driver License Pollution Control Licenses
6 Building Completion Licenses
7 Lift license for each lift
8 DG Set Approval for Commissioning
9 Diesel Storage Licenses
10 Retail and bulk drug license (pharmacy)
11 Food Safety Licenses
12 Narcotic Drug Licenses
13 Medical Gases Licensesor Explosives Act
14 Clinical Establishments and Registration (if
applicable)
15 Blood Bank Licenses
16 MoU or agreement with outsourced human resource agencies as per labor laws
17 Spirit License
18 Electricity rules
19 Provident fundorESI Act
20
21 PC PNDT Act
23 PAN
25 Arms Act, 1950 (if guards have weapons)
Valid Vali From d
Send for
Remark
(Expiredo r validorN A)
renewal Till by
MTP Act
22
Sales Tax registration
24
No objection certificate under Pollution Control Act (AirorWater)
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
APPENDIX 7
CONTENT OF MEDICAL RECORD
Medical record shall contain, at the least, the following information:
CEA/Hospital – 001
S. No.
Content
1.
Name & Registration number of treating doctor
2.
Name, demographic details & contact number of patient
3.
Relevant Clinical history, Assessment and re-assessment findings, nursing notes and Diagnosis
4.
Investigation reports
5.
Details of medical treatment, invasive procedures, surgery and other care provided
6.
Applicable consents
7.
Discharge summary
8.
Cause-of-death certificate & Death Summary (where applicable)
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEA/Hospital – 001
APPENDIX 8 Patients’ rights and responsibilities:
A patient and hisorher representative has the following rights with respect to the clinical establishment-
41. To adequate relevant information about the nature, cause of illness, proposed investigations and care, expected results of treatment, possible complications and expected costs;
42. Rate of services provided by the clinical establishment would be displayed prominently.
43. To access a copy of case papers, patient records, investigations reports and detailed bill.
44. To informed consent priorto specific testsortreatment (e.g. surgery, chemotherapy)
45. To seek second opinion from an appropriate clinician of patients’ choice, with records and information being provided by treating hospital
46. To confidentiality, human dignity and privacy during treatment.
47. To have ensured presence of a female person, during physical examination of
a female patient by a male practitioner.
48. To non-discrimination about treatment and behaviour on the basis of HIV
status
49. To choose alternative treatment if options are available
50. Rate of services provided by the clinical establishment would be displayed
prominently.
Provide all health related information
Cooperate with Doctors during examination, treatment
Follow all instructions
Pay hospitals agreed fees on time
Respect dignity of doctors and other hospital staff
Never resort to violence
Patients’ Rights
Patients’ Responsibilities
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEA/Hospital – 001
APPENDIX 9
INFORMED CONSENTorCONSENT GUIDELINES
The informed consent shall at the least contain the following information in an understandable language and format (desirably which a lay person can easily understand)
Sl. No.
Content
1.
Name of the patientor guardian (in case of minorormentally disabled).
2.
Registration number of patient
3.
Date of admission
4.
Name & Registration number of treating doctor
5.
Name of procedureoroperationorinvestigationorblood transfusionoranaesthesia and potential complications should be explained
6.
Signature of patientorguardian with date and time
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
APPENDIX 10
DISCHARGE SUMMARY
The discharge summary shall at the least contain the following information in any understandable language and format:
CEA/Hospital – 001
Sl.no.
Content
1.
Name & Registration number of treating doctor
2.
Name, demographic details & contact number of patient, if available
3.
Date of admission and discharge
4.
Relevant clinical history, assessment findings and diagnosis
5.
Investigation results,
6.
Details of medical treatment, invasive procedures, surgery and other care provided
7.
Discharge advice (medications and other instructions).
8.
Instruction about when and how to obtain urgent care.
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEAorHospital – 001
Clinical Establishments Act
Standard for
HOSPITAL (LEVEL 1A &1B) Standard No. CEA orHospital – 001
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEAorHospital – 001
Table of Contents
Sr. No.
Particulars
Page No.
Categorization of Hospitals
4
Definition
6
Scope
7
Infrastructure
7
18.
Equipments
8
19.
Human Resource
9
20.
Support Services
9
21.
LegalorStatutory Requirements
9
22.
Record Maintenance and Reporting
10
23.
Basic Processes
10
24.
Appendix 1
12
25.
Appendix 2
14
26.
Appendix 3
15
27.
Appendix 4
22
28.
Appendix 5
24
29.
Appendix 6
25
30.
Appendix 7
27
18.
Appendix 8
28
19.
Appendix 9
29
20.
Appendix 10
30
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEAorHospital – 001
Categorization of Hospitals
The minimum standards for Allopathic hospitals under Clinical Establishments Act, 2010 are developed on the basis of level of care provided, as defined below:
Hospital Level 1 (A)-
General Medical services with indoor admission facility provided by recognized allopathic medical graduate(s) and may also include general dentistry services provided by recognized BDS graduates.
Example: PHC, Government and Private Hospitals and Nursing Homes run by MBBS Doctors etc.
Hospital Level 1(B) –
This level of hospital shall include all the general medical services provided at level 1(A) above and specialist medical services provided by doctors from one or more basic specialties namely General Medicine, General Surgery, Paediatrics, Obstetrics & Gynaecology and Dentistry, providing indoor and OPD services.
Level 1(A) and Level 1(B) Hospitals shall also include support systems required for the respective services like Pharmacy, Laboratory, etc.
Example: General Hospital, Singleor Multiple basic medical Specialties provided at Community Health Centre, Sub Divisional Hospital, and Private Hospital of similar scope, Nursing Home, Civil or District Hospital in few places etc.
Hospital Level 2 (Non-Teaching)
This level may include all the services provided at level 1(A) and 1(B) and services through other medical specialties given as under ,in addition to basic medical specialty given under 1(B) like:
k. l. m. n.
Orthopaedics ENT
Ophthalmology Dental
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEAorHospital – 001
o. Emergency with or without ICU
p. Anaesthesia
q. Psychiatry
r. Skin
s. Pulmonary Medicine
t. Rehabilitation, etc.
And support systems required for the above services like Pharmacy, Laboratory, Imaging facilities, Operation Theatre etc.
Example: District Hospital, Corporate Hospitals, Referral Hospital, Regionalor State Hospital, Nursing Home and Private Hospital of similar scope etc.
Hospital Level 3 (Non-Teaching) Super-specialty services –
This level may include all the services provided at level 1(A), 1(B) and 2 and services of one or more of the super specialty with distinct departments andoror also Dentistry if available. It will have other support systems required for services like pharmacy, Laboratory, and Imaging facility, Operation Theatre etc.
Example: Corporate Hospitals, Referral Hospital, RegionalorState Hospital, Nursing Home and Private Hospital of similar scope etc.
Hospital Level 4 (Teaching) –
This level will include all the services provided at level 2 and may also have Level 3 facilities. It will however have the distinction of being teaching or training institution and it may or may not have super specialties. Tertiary healthcare services at this level can be provided through specialists and may be super specialists (if available). It will have other support systems required for these services. It shall also include the requirement of MCIorother registering body for teaching hospitals and will be governed by their rules. However registration of teaching Hospitals will also be required under Clinical Establishment Act for purpose other than those covered under MCI such as, records maintenance and reporting of information and statistics, and compliance to range of rates for Medical and Surgical procedures, etc.
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEAorHospital – 001
Clinical Establishment Act Standards for Hospital (LEVEL 1A 1B)
11. Definition
A hospital is a clinical establishment providing patient treatment by qualified and trained staff and equipment through Allopathy – Modern system of medicine; where the patients are ‘admitted’ and stay overnight or more and they are referred as ‘inpatients’; while some patients may go to a hospital just for diagnosis, treatment, or therapy and then leave, they are referred as ‘outpatients’ without staying overnight.
Hospitals have facility to admit and care for inpatients whilst the other clinical establishments are described as clinicsorpolyclinics or day care centres. There are other exceptions too like Hospice etc.
The general hospital, may have multiple departments taking care of many kinds of disease and Injectionury, and normally has an emergency department to deal with immediate and urgent care.
Specialized hospitals may include trauma centres, rehabilitation hospitals, children’s hospitals, Mental hospitals or, and hospitals for dealing with specific medical needs such as psychiatric problems (psychiatric hospital) or Sanatorium, certain disease categories such as neurology, cardiology, oncology, or orthopaedic, IVF and so forth.
Some hospitals are affiliated with universities for medical research and the training of medical personnel such as physicians and nurses, often called teaching hospitals. Guidelines laid down by MCI or other legal bodies shall be applicable to such hospitals. The minimum standards will not apply to them.
A hospital can be situated in rural or urban setting. It can be run by Public Sector (Central governmentorState governmentorLocal governmentorPublic Sector undertakingorRegistered Society etc) or by Private Sector (Individual Proprietorshipor Registered PartnershiporRegistered Company orCo-operative SocietyorTrust orCharitable etc).
Hospital Level 1 (A)-
General Medical services with indoor admission facility provided by recognised allopathic medical graduate(s) and may also include general dentistry services provided by recognized BDS graduates.
Example: PHC, Government and Private Hospitals and Nursing Homes run by MBBS Doctors etc.
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
all of the
2.7. 2.8. 2.9. 2.10. 2.11. 2.12.
d) e)
f)
following specialities:
General Medicine
Obstetrics & Gynaecology (Non-surgical)
Paediatrics
Community Health and Family Medicine
General Dentistry
Basic Support services
Registration or help desk and billing
Diagnostic Services:(Can be ownoroutsourcedorTie up)
Collection centreorLaboratory X-ray
USG
Waste Management Services (General and Biomedical)
13. Infrastructure
CEAorHospital – 001
Hospital Level 1(B) –
This level of hospital shall include all the general medical services provided at level 1(A) above and specialist medical services provided by Doctors from one or more basic specialties namely General Medicine, General Surgery, Paediatrics, Obstetrics &Gynaecology and Dentistry, providing indoor and OPD services.
Level 1(A) and Level 1(B) Hospitals shall also include support systems required for the respective services like Pharmacy, Laboratory, etc.
Example: General Hospital, Singleor Multiple basic medical Specialties provided at Community Health Centre, Sub Divisional Hospital, and Private Hospital of similar scope, Nursing Home, Civil or District Hospital in few places etc.
12. Scope
The scope of services that may be provided at a hospital(level 1A &1B) practising Allopathy – Modern system of Medicine may include patient-care services in any or
3.1
Signage
3.1.1
The Hospital shall display appropriate signage which shall be in at least two languages.
A board stating “24 hours emergency available” is desirable.
3.1.2
The building shall have a board displaying the name of the hospital at a prominent location.
3.1.3
Directional signage shall be placed within the facility to guide the patient(s).
The directional signages should be permitted outside in the nearby vicinity of
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
Important contact numbers such as Blood Banks, Fire Department, Police and Ambulance Services available in the nearby area.
CEAorHospital – 001
the hospitalorNursing Home to facilitate easy access
Following informative signage shall be displayed:
3.1.4 3.1.5 3.1.6
3.1.7 3.1.8 3.1.9
Following safety signage shall be displayed: 3.1.11
3.1.12 3.1.13 3.2. 3.2.1
3.2.2
3.2.3 3.2.4
3.2.5 3.2.6
14. Medical Equipment and Instruments:
Name of the care provider with registration number.
Registration details of the hospital as applicable.
Availability of fee structure of the various services provided (refer to CEA 2010 rules & regulation).
Timings of the facility and services provided.
Mandatory information such as under PNDT Act etc.
Safety Hazard and Caution signs, for e.g. hazards from electrical shock, inflammable articles, radiation etc shall be displayed at appropriate places, and as applicable under law.
Appropriate Fire exit signage.
Signage for “No Smoking” at prominent places.
Other requirements
Access to the hospital shall be comfortable for the patient andoror attendantsorvisitors.
Access shall be provided within the requirements of “Persons with Disabilities Act” and shall be easy for all those whose mobility may be restricted due to whatever cause.
The hospital shall be developed and maintained to provide safe, clean and hygienic environment for patients, their attendants, staff and visitors
The hospital shall have 24hr provision of potable water for drinking & hand hygiene. It shall also have 24 hr supply of electricity, either through direct supply or from other sources.
The hospital shall have clean public toilet(s).
Furniture and fixtures shall be available in accordance with the activities and workload of the hospital. They shall be functional and properly maintained.
The minimum space requirements shall be as per Appendix 1
Indicative list of furniture and fixtures is as per Appendix 2
4.1
The hospital shall have adequate medical equipment and instruments, commensurate to the scope of service and number of beds.
4.2
There shall be established system for maintenance of critical equipment.
4.3
Equipment shall be kept in good working condition through a process of periodic inspection, cleaning and maintenance. Annual maintenance.
For indicative list of medical equipment and instruments, Please refer to
Appendix 3.
15. Drugs, Medical devices and Consumables:
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
17.Support Services:
CEAorHospital – 001
5.1
The hospital shall have adequate drugs, medical devices and consumables commensurate to its scope of services and number of beds.
5.2
Emergency drugs and consumables shall be available at all times.
5.3
Drug storage shall be in a clean, well lit, and safe environment and shall be in consonance with applicable laws and regulations.
5.4
The facility shall have defined procedures for storage, inventory management and dispensing of drugs in pharmacy and patient care areas.
For indicative list of drugs, medical devices and consumables please refer to
Appendix4.
16.Human Resource Requirement
6.1
The hospital shall have qualified andoror trained medical and nursing staff as per the scope of service provided and the medicalornursing care.
6.2
The supportorparamedical staff shall be qualified andoror trained as per the scope of services provided, and as per requirement
6.3
For every staff (including contractual staff), there shall be personal record containing the appointment order, documentary evidence of qualification andoror training (and professional registration where applicable).
For human resource requirements please refer to Appendix5.
7.1
The Hospital shall have a Registrationor Help-desk & Billing counter.
7.2
The diagnostic services, whether in house or outsourced, shall be commensurate with the scope of service of the hospital.
7.3
Segregation, collection, transportation, storage and disposal of general waste shall be done as per applicable local laws
7.4
7.5
Segregation, collection, transportation, storage and disposal of biomedical waste shall be done as per Bio medical waste handling rules.
The Hospital shall arrange transportation of patients for transferorreferralorinvestigations etc. in safe manner. The arrangement can be
.
out sourced or self owned
18.LegalorStatutory Requirements
8.1
Compliance with local regulations and law.
Indicative list of legal requirement is as per Appendix 6.
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEAorHospital – 001
19.Record Maintenance and reporting:
9.6.
The minimum medical records to be maintained and nature of information to be provided by the Hospitals shall be as prescribed by the Clinical Establishment Act
9.7.
Medical Records shall be maintained in physical or digital format.
9.8.
The hospital shall ensure confidentiality, security and integrity of records.
9.9.
The medical records of IPD patients shall be maintained in consonance with National or local law, MCI guidelines, and court orders.
9.10.
The Hospital shall maintain health information and statistics in respect of national programmes, notifiable diseases and emergenciesordisastersor epidemics and furnish the same to the district authorities in the prescribed formats and frequency.
For content of medical record refer to Appendix7
20.Basic Processes
10.27.
The hospital shall register all patients who visit the hospital except if the required service is not available in the facility, in which case the patient is guided to the appropriate nearest facility.
10.28.
Patient shall be guided and informed regarding Patients’ rights & responsibilities, cost estimates, third party services (e.g. Insurance) etc.Appendix 8.
10.29.
The billing shall be as per the Hospital tariff list, which shall be available to patients in a suitable format.
10.30.
Each patient shall undergo an initial assessment by qualified andoror trained personnel.
10.31.
Further management of patient shall be done by a registered medical practitioner on the basis of findings of initial assessment; for example, OPD treatment, admission, transferorreferral, investigation etc.
10.32.
The hospital shall ensure adequate and proper spacing in the patient care area so as to prevent transmission of infections.
10.33.
Regular cleaning of all areas with disinfectant shall be done .
10.34.
Housekeepingorsanitary services shall ensure appropriate hygiene and sanitation in the establishment.
10.35.
At the time of admission of patient, general consent for admission shall be taken.
10.36.
In case of non-availability of beds or where clinical need warrants, the patient shall be referred to another facility along with the required clinical information or notes.
10.37.
Reassessments of the admitted patients shall be done at least once in a day andoror according to the clinical needs and these shall be documented.
10.38.
Any examination, treatment or management of female patient shall be done in the presence of an employed female attendantorfemale nursing staff, if conducted by male personnel inside the hospital and vice versa
10.39.
The patient and family shall be treated with dignity, courtesy and politeness.
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEAorHospital – 001
10.40.
The Hospital shall provide care of patient as per Standard Treatment Guidelines that may be notified by the Central orState Government (Desirable)
10.41.
The Clinical Establishment shall undertake to provide within the staff and facilities available, such medical examination and treatment as may be required to stabilize the emergency medical condition of any individual who comes or is brought to such clinical establishment.
10.42.
Prescription shall include name of the patient, date, name of medication, dosage, route, frequency, duration, name, signature and registration number of the medical practitioner in legible writing.
10.43.
Drug allergies shall be ascertained before prescribing and administration; if any allergy is discovered, the same shall be communicated to the patient and recorded in the case sheet as well.
10.44.
Patient identity, medication, dose, route, timing, expiry date shall be verified prior to administration of medication.
10.45.
Patients shall be monitored after medication administration and adverse drug reactionorevents if any shall be recorded and reported.
10.46.
The hospital shall follow standard precautions like practicing hand hygiene, use of personal protection equipment etc.so as to reduce the risk of healthcare associated infections.
10.47.
Security and safety of patients, staff, visitors and relatives shall be ensured by provision of appropriate safety installations and adoption of appropriate safety measures.
10.48.
The patient andoror family members are explained about the disease condition, proposed care, including the risks, alternatives and benefits. They shall be informed on the expected cost of the treatment. They shall also be informed
10.49.
about the progress and any change of condition.
Informed consent shall be obtained from the patientor next of kinor legal guardian as and when required as per the prevailing Guidelines or Rules and regulations in the language patient can understand (for e.g. before Invasive procedures, Blood transfusion, HIV testing, etc.).Appendix 9
10.50.
A Discharge summary shall be given to all patients discharged from the hospital.
10.51.
DischargeorDeath summary shall also be given to patient andoror attendant in case of transfer LAMAorDAMA or death
10.52.
The discharge summary shall include the points as mentioned in the Appendix in an understandable language and format. For content of discharge summary refer to Appendix 10.
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
APPENDIX 1
Minimum space requirements in a hospital level 1 shall be as follows:
Note: Structural changes should be applicable to the Nursing home or Hospitals constructed after the implementation of CEA since it is not possible to change the existing structures, especially with restrictions of building bye-laws
CEAorHospital – 001
Area (Desirable)
Wards
1.
Ward bed and surrounding space
6sqmor bed;
Desirable: in addition circulation space of 30% as indicated in total area shall be provided for Nursing station, Ward store, Sanitary etc
Minor Operation TheatreorProcedure room
2.
OT for minor procedures (where applicable)
10.5sqm
(Desirable)
Labour room
3.
Labour Table and surrounding space
10.5 sqmor labour table
4.
Other areas- nursing station, doctors’ duty room, store, Clean and dirty utility, Circulating area, Toilets
10.5 sqm for clean utility and store and 7 sqm for dirty utility and 3.5 sqm for toilet
5.
Bio-medical Waste
5 sqm
Other functional areas( laboratory, diagnostics, front officeorreception, waiting area, administrative area etc.) should be appropriately sized as per the scope of service and patient load of the hospital
Other requirements:
Wards:
6. The ward shall also have designated areas for nursing station, doctors’ duty room, store, clean and dirty utility, janitor room, toilets and this shall be provided from circulation area.
7. For a general ward of 12 beds, a minimum of 1working counter and 1 hand wash basin shall be provided.
8. Distance between beds shall be 1.0 metres(Desirable).
9. Space at the head end of bed shall be 0.25 metres.
10. Door width shall be 1.2 metres (Desirable) and corridor width 2.5 metres(Desirable).
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
Labour room:
6. The obstetrical unit shall provide privacy, prevent unrelated traffic through the unit and provide reasonable protection of mothers from infection and from cross-infection.
7. Measures shall be in place to ensure safety and security of neonates.
8. Resuscitation facilities for neonates shall be provided within the obstetrical unit and convenient to the delivery room.
9. The labour room shall contain facilities for medication, hand washing, charting, and storage for supplies and equipment.
10. The labour room shall be equipped with oxygen and suction
Emergency room(if available)
24. Emergency bed and surrounding space shall have minimum 10.5 sq mor bed area(Desirable).
CEAorHospital – 001
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEAorHospital – 001
APPENDIX 2
FURNITURE AND FIXTURES
sn ARTICLES
1 Examination Table
2 Writing tables
3 Chairs
4 Almirah
5 Waiting Benches
6 MedicalorSurgical Beds
7 Labour Table- if applicable
8 Wheel ChairorStretcher
9 Medicine Trolley, Instrument Trolley
10 Screensorcurtains
11 Foot Step
12 Bed Side Table
13 Baby Cot- if applicable
14 Stool
15 Medicine Chest
16 Examination Lamp
17 View box
18 Fans
19 Tube Lightor lighting fixtures
20 Wash Basin
21 IV Stand
22 Colour coded bins for BMW
*This is an indicative list and the items shall be provided as per the size of the hospital and scope of service.
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEAorHospital – 001
APPENDIX 3
EQUIPMENTS
c. EMERGENCY EQUIPMENT
S. No.
Name of Emergency Equipment
1
Resuscitation equipment including Laryngoscope, endotracheal tubes, suction equipment, xylocaine spray, oropharyngeal and nasopharyngeal airways, Ambu Bag- Adult &Paediatric (neonatal if indicated)
2
Oxygen cylinders with flow meteror tubingorcatheterorface maskornasal prongs
3
Suction Apparatus
4
Defibrillator with accessories (Desirable)
5
Equipment for dressingorbandagingorsuturing
6
Basic diagnostic equipment- Non mercury Blood Pressure Apparatus, Stethoscope, weighing machine, thermometer (Non mercury)
7
ECG Machine
8
Pulse Oximeter (Desirable)
9
Nebulizer with accessories
d. Other equipment and consumables, which shall also be available in good working condition as per the scope of services and bed strength (some of the emergency equipment are already mentioned above).
Department
Equipment
Level 1A
Level 1B
Level 2
Level 3
NON MEDICAL
Administration
Office equipment
Yes
Yes
Yes
Yes
Office furniture
Yes
Yes
Yes
Yes
Electricity
Emergency lights
Yes
Yes
Yes
Yes
Water Supply
Hand-washing sinksortapsorbowls on stands in all areas
Yes
Yes
Yes
Yes
Storage tank
Yes
Yes
Yes
Yes
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEAorHospital – 001
Waste Disposal
Water purification chemicals or filter Water source for drinking water
Buckets for contaminated waste in all treatment areas Drainage system Rubbish bins in all rooms
Sanitation facilities for patients
Separate Bio-medical waste disposal Sharps containers in all treatment areas
Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes
Desirable Desirable Yes Yes
Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes
Safety
Fire extinguisher Vehicle(OwnorOutsourced)
Vehicle wheeler Ambulance
Lockable storage
4
Medical Stores
Refrigeration Kitchen(OwnorOutsourced)
Cooking pots and utensils
Cooking stove
Food refrigeration Plates, cups & cutlery
Washing and drying area facilities
Detergentorsoap
Storage Yes Yes
Yes
Yes
Laundry(OwnorOutsourced)
Washing and rinsing equipmentorbowls
Yes
Yes
Yes
Yes
Housekeeping(OwnorOutsourced)
Housekeeping Brooms, brushes and mops
Buckets
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEAorHospital – 001
Soap and disinfectant
Yes
Yes
Yes
MEDICAL
Yes
Yes
Yes
Yes Yes Yes Yes
Yes Yes
Yes Yes
Yes Yes
Yes Yes
Yes Yes
Yes Yes Yes
Yes Yes Yes
Yes
Outpatient Rooms
Non Mercury Blood Pressure Apparatus and stethoscope
Yes Yes
Yes
Container for sharps disposal
Yes Yes
Yes
Desk and chairs
Yes Yes
Yes
Examination gloves
Yes Yes
Yes
Examination table
Yes Yes
Yes
Hand washing facilities
Yes Yes
Yes
Light source
Yes Yes
Yes
Minor surgical instruments
No Yes
Yes
Ophthalmoscope
No No
Yes (as applicabl e)
Otoscope
No No
Yes (as applicabl e)
Patellar hammer
Yes Yes
Yes
Receptacle for soiled pads, dressings, etc.
Yes Yes
Yes
Separate biohazard disposal
Yes Yes
Yes
Sterile equipment storage
Yes Yes
Yes
Sutures
Yes Yes
Yes
Thermometer(Non mercury)
Yes Yes
Yes
Torch with extra batteries
Yes Yes
Yes
Weighing scale
Yes Yes
Yes
Women and Child health examination room
Non Mercury Blood Pressure Apparatus and stethoscope
Yes
Yes
Yes
Contraceptive supplies
Yes
Yes
Yes
Birth register
Yes
Yes
Yes
Examination gloves
Yes
Yes
Yes
Examination table with stirrups
Yes
Yes
Yes
Yes
Fetal stethoscope
No
Yes
Yes
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEAorHospital – 001
Doppler
No
No
No
Hand washing facility
Yes
Yes
Yes
Height measure
Yes
Yes
Yes
IUD insertion set
Yes
Yes
Yes
Pregnant woman Register
Yes
Yes
Yes
Speculum and vaginal examination kit
Yes
Yes
Yes
Syringes and needles
Yes
Yes
Yes
Tape measure
Yes
Yes
Yes
Tococardiograph
No
Yes
Yes
Labour room
Yes Yes Yes Yes Yes
Yes
Yes Yes Yes
Yes Yes
Yes Yes Yes
Yes Yes Yes Yes Yes
Yes Yes Yes
Yes
Yes
Yes Yes
Baby scales
Yes Yes
Yes
Non Mercury Blood Pressure Apparatus and stethoscope
Yes Yes
Yes
Clean delivery kits and cord ties
Yes Yes
Yes
Curtains if more than one bed
Yes Yes
Yes
Delivery bed and bed linen
Yes Yes
Yes
Fetal stethoscope
Yes Yes
Yes
Hand washing facility
Yes Yes
Yes
Instrument trolley
Yes Yes
Yes
IV treatment sets
Latex gloves and protective clothing
Oxygen cylinderorconce
ntrator
Suction machine
Yes Yes
Yes
Yes Yes
Yes Yes
Yes
Linens for newborns
Yes Yes
Yes
Mucus extractor
Yes Yes
Yes
Oral airways, various sizes
Yes Yes
Yes
Yes
Partograph charts
Yes
Yes
Yes
Yes
Yes
Self inflating bag and mask – adult and neonatal size
Yes Yes
Yes
Yes
Yes
Yes
Suturing sets
Yes Yes
Yes
Thermometer(Non mercury)
Yes
Yes
Yes
Yes
Tray with routine & emergency drugs, syringes and needles
Yes Yes
Yes
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEAorHospital – 001
Inpatient Wards
Urinary catheters and collection bags
Vacuum extractor set Work surface near bed for newborn resuscitation
Basic examination equipment (stethoscope, Non mercury BP Apparatus (etc)
Beds, washable mattresses and linen Curtains
Dressing sets Dressing trolleyorMedicine trolley
Gloves
IV stands
Medicine storage cabinet
Oxygen cylinder and concentrator Patient trolley on wheels
PPE kits
Suction machine Urinals and bedpans
Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes
Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes If available
Yes Yes
OperationTheatre
Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes
No Yes Yes Yes Yes Yes Yes
Adequate storage Yes
Ambu resuscitation set Yes with adult and child
masks
Defibrillator
Electro cautery No
Fixed operating lights
Hand washing facilities
No
No
No
Yes
Fixed suction machine No
Yes
Yes
Yes
Yes
Instrument tray Yes
Instrument trolley
Yes
Yes
Yes
Yes
Laryngoscope set No
Mayo Stand
Yes
Yes
Yes
Yes
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEAorHospital – 001
Mobile operating light Yes Ophthalmic Operating No Microscope
Yes Yes
No Yes (as
applicabl e)
Yes
Yes Yes
Yes Yes
Yes Yes
Yes
Yes (as applicable )
Yes
Yes
Yes
Yes
Yes Yes
Yes Yes
Yes
Yes Yes Yes
Yes Yes Yes Yes
Yes Yes
Yes Yes Yes
Oral airways, various No
sizes
Oxygen cylinder and Yes Yes Yes concentrator
Patient trolley on Yes
wheels
Portable suction Yes Yes Yes machine
Safety Box No
Sphygmomanometer Yes
(Non Mercury) and
stethoscope
Stool adjustable height No
Operating table No Yes Yes IV Therapy Equipment No
Anesthesia Equipment No
Anesthetic
trolleyormachine
CO2 Monitor No
O2 Monitor No Yes
Yes Yes Yes
Yes No No
Endoscopic equipment No
and necessary
accessories
Bronchoscope No No Desirable
Colonoscope No
Endoscope No No Desirable
No Desirable No Desirable
Fiber Optic No
Laryngoscope Central Supply
Amputation set No
Caesareanorhysterecto No No Yes my set
Dilatation and No
curettage set
No No No Yes
Endoscopic instrument cleaning machines
and solutions
Laparotomy set
No
Yes
No
No
Yes
No
No
Yes
Yes
Locked storage
Yes
Yes
Yes
Yes
Hernia set No Linens Yes Operating drapes No
No Yes Yes Yes Yes Yes
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEAorHospital – 001
Ophthalmic instrument
No
No
Yes
Yes
Protective caps, aprons, shoes and gowns etc.
Yes
Yes
Yes
Yes
Pelvicorfistula repair set
No
No
No
Yes
Sterile gloves
Yes
Yes
Yes
Yes
Sterilization equipment for instrument and linens
Yes
Yes
Yes
Yes
Surgical supplies (e.g., sutures, dressings, etc.)
Yes
Yes
Yes
Yes
Thoracocentesis set
No
No
No
Yes
Thoracostomy set with appropriate tubes and water seal bottles
No
No
No
Yes
Thoracotomy set
No
No
No
Yes
ThyroidorParathyroid set
No
No
No
Yes
Tracheostomy set
No
No
Yes
Yes
Tubal ligation set
No
No
Yes
Yes
Vascular repair set
No
No
Yes
Yes
Other equipment as per the specialized services available shall also be there.
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEAorHospital – 001
APPENDIX 4
DRUGS, MEDICAL DEVICES AND CONSUMABLES
Name of the Drug
1. INJECTIONECTIONS
2. INJECTION. DIAZEPAM 10 MG
3. INJECTION. FRUSEMIDE 20 MG
4. INJECTION. ONDANSETRON 8 MGor4ML
5. INJECTION. RANITIDINE
6. INJECTION NOR ADRENALINE 4 MG
7. INJECTION. PHENYTOIN 50 MG
8. INJECTION DICLOFENAC 75 MG
9. INJECTION. DERIPHYLLINE
10. INJECTION CHLORPHENIRAMINE MALEATE
11. INJECTION. HYDROCORTISONE 100 MG
12. INJECTION. ATROPINE 0.6 MG
13. INJECTION. ADRENALINE 1 MG
14. INJECTION. KCL
15. STERILE WATER
16. INJECTION. SODA BICARBONATE
17. INJECTION. DOPAMINE
18. INJECTION. NALAXONE 400 MCG
19. INJECTION. LIGNOCAINE 50 ML
20. TAB. SORBITRATE
21. TAB. ASPIRIN
22. INJECTION. TETANUS
23. OTHER
24. NEB. SALBUTAMOL2.5 ML
25. NEB. BUDESONIDE
c. List of Emergency Drugs and consumables (Essential in all hospitals)
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEAorHospital – 001
26.
LIGNOCAINE JELLY 2%
27.
ACTIVATED CHARCOAL
28.
CALCIUM (INJECTION or TAB)
29.
FLUIDS
30.
RL 500 ML
31.
NS 500 ML
32.
NS 250 ML
33.
NS 100 ML
34.
DNS 500 ML
35.
DEXTROSE 5% 500 ML
36.
DEXTROSE 10% 500 ML
37.
PEDIATRIC IV INFUSION SOLUTION 500 ML
d. The other drugs and consumables shall be available as per the scope of services, bed strength and patient turnover.
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
APPENDIX 5
HUMAN RESOURCE
The Human Resource requirement for any hospital depends on the scope of services provided by the hospitals, bed strength and workload of the hospital.
However on the basis of level of care provided the minimum staffing requirements for Hospital level 1 shall be as follows:
CEAorHospital – 001
7.
Doctor
Qualified doctor shall be available round the clock on site(Desirable for 1A). Level 1A shall have a MBBS qualified doctor.
(Qualified doctor is a MBBS approved as per state government rules & regulations as applicable from time to time).
Level 1B shall have MBBS doctor with required post-graduation qualification.
8.
Nurses
Qualified nurses per unit per shift shall be available as per requirement laid down by“The Indian Nursing Council, 1985”, occupancy rate and distribution of bed.
(Desirable)
9.
Pharmacist (If in house pharmacy available)
1 in a hospital
10.
Lab Technician (if in house laboratory service available)
1 in a hospital (minimum DMLT) BSc, MSc ,MLT(Desirable)
11.
X-ray Technician (if in house X-ray facility available)
1 in a hospital (minimum Diploma in X Ray Technician course)
Minimum 1
12.
Multi Task staff
Requirement of other staff (Support and administrative) will depend on the scope of the hospital.
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
APPENDIX 6
LIST OF LEGAL REQUIREMENTS
Below is the list of legal requirements to be complied with by a hospital as applicable by the localorstate health authority (all may not be applicable):
CEAorHospital – 001
SN Name of Document
1 Registration under Nursing Home Actor Medical Establishment Act
2 Bio-medical Waste Management Licenses Authorization of HCO by PCB
MOU with Vendor
3 AERB Licenses (As per AERB regulations)
4 NOC from Fire Department
5 Ambulance
Commercial Vehicle Permit Commercial Driver License Pollution Control Licenses
6 Building Completion Licenses
7 Lift license for each lift
8 DG Set Approval for Commissioning*
9. Diesel Storage Licenses*
10 Retail and bulk drug license (pharmacy)
11 Food Safety Licenses*
12 Narcotic Drug Licenses*
13 Medical Gases Licensesor Explosives Act*
14 Clinical Establishments and Registration (if
applicable)
15 Blood Bank Licenses
16 MoU or agreement with outsourced human
resource agencies as per labor laws
17 Spirit License
18 Electricity rules
19 Provident fundorESI Act
20 MTP Act
21 PNDT Act
23 PAN
25 Arms Act, 1950 (if guards have weapons) * (as per regulations of State)
Valid Valid From Till
Send for renewal by
Remark
(Expiredo r validorNA )
22
Sales Tax registration
24
No objection certificate under Pollution Control Act (AirorWater)
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEAorHospital – 001
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
APPENDIX 7
CONTENT OF MEDICAL RECORD
Medical record shall contain, at the least, the following information:
CEAorHospital – 001
sn
Content
1
Name & Registration number of treating doctor
2
Name, demographic details & contact number of patient
3
Relevant Clinical history, Assessment and re-assessment findings, nursing notes and Diagnosis
4
Investigation reports
5
Details of medical treatment, invasive procedures, surgery and other care provided
6
Applicable consents
7
Discharge summary
8
Cause-of-death certificate & Death Summary (where applicable)
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
APPENDIX 8 Patients’ rights and responsibilities:
A patient and hisorher representative has the following rights with respect to the clinical establishment-
51. To adequate relevant information about the nature, cause of illness, proposed investigations and care, expected results of treatment, possible complications and expected costs;
53. To access a copy of case papers, patient records, investigations reports and detailed bill.
54.To informed consent priorto specific testsortreatment (e.g. surgery, chemotherapy)
55. To seek second opinion from an appropriate clinician of patients’ choice, with records and information being provided by treating hospital
56. To confidentiality, human dignity and privacy during treatment.
57. To have ensured presence of a female person, during physical examination of
a female patient by a male practitioner.
58. To non-discrimination about treatment and behaviour on the basis of HIV
status
59. To choose alternative treatment if options are available
Provide all health related information
Cooperate with Doctors during examination, treatment
Follow all instructions
Pay hospitals agreed fees on time
Respect dignity of doctors and other hospital staff
Never resort to violence
CEAorHospital – 001
Patients’ Rights
52. To information on the Rates charged for each type of service provided and
facilities available. Clinical Establishment shall display the same at a
conspicuous place in the local as well as in English language.
Patients’ Responsibilities
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
CEAorHospital – 001
APPENDIX 9
INFORMED CONSENTorCONSENT GUIDELINES
The informed consent shall at the least contain the following information in an understandable language and format (desirably which a lay person can easily understand)
sn
Content
1
Name of the patientor guardian (in case of minorormentally disabled).
2
Registration number of patient
3
Date of admission
4
Name & Registration number of treating doctor
5
Name of procedureoroperationorinvestigationorblood transfusionoranaesthesia and potential complications should be explained
6
Signature of patientorguardian with date and time
Clinical Establishments Act Standards for Hospital (LEVEL 1A &1B))
APPENDIX 10
DISCHARGE SUMMARY
The discharge summary shall at the least contain the following information in any understandable language and format:
CEAorHospital – 001
sn
Content
1
Name & Registration number of treating doctor
2
Name, demographic details & contact number of patient, if available
3
Date of admission and discharge
4
Relevant clinical history, assessment findings and diagnosis
5
Investigation results,
6
Details of medical treatment, invasive procedures, surgery and other care provided
7
Discharge advice (medications and other instructions).
8
Instruction about when and how to obtain urgent care.
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
Clinical Establishments Act
Standard for
HOSPITAL (LEVEL 2) Standard No. CEA orHospital – 002
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
Table of Contents
sn
Particulars
Page No.
1
Categorization of Hospitals
4
2
Definition
6
3
Scope
7
4
Infrastructure
8
5
Equipments
9
6
Human Resource
9
7
LegalorStatutory Requirements
11
8
Record Maintenance and Reporting
11
9
Basic Processes
11
10
Appendix 1
15
11
Appendix 2
20
12
Appendix 3
21
13
Appendix 4
28
14
Appendix 5
30
15
Appendix 6
31
16
Appendix 7
34
17
Appendix 8
35
18
Appendix 9
36
19
Appendix 10
37
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
Categorization of Hospitals
The minimum standards for Allopathic hospitals Under Clinical Establishment Act, 2010 are developed on the basis of level of care provided, as defined below:
Hospital Level 1 (A)-
General Medical services with indoor admission facility provided by recognized allopathic medical graduate(s) and may also include general dentistry services provided by recognized BDS graduates.
Example: PHC, Government and Private Hospitals and Nursing Homes run by MBBS Doctors etc.
Hospital Level 1(B) –
This level of hospital shall include all the general medical services provided at level 1(A) above and specialist medical services provided by doctors from one or more basic specialties namely General Medicine, General Surgery, Paediatrics, Obstetrics & Gynaecology and Dentistry, providing indoor and OPD services.
Level 1(A) and Level 1(B) Hospitals shall also include support systems required for the respective services like Pharmacy, Laboratory, etc.
Example: General Hospital, Singleor Multiple basic medical Specialties provided at Community Health Centre, Sub Divisional Hospital, and Private Hospital of similar scope, Nursing Home, Civil or District Hospital in few places etc.
Hospital Level 2 (Non-Teaching)
This level may include all the services provided at level 1(A) and 1(B) and services through other medical specialties given as under ,in addition to basic medical specialty given under 1(B) like:
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
1. Orthopaedics
2. ENT
3. Ophthalmology
4. Dental
5. Emergency with or without ICU
6. Anaesthesia
7. Psychiatry
8. Skin
9. Pulmonary Medicine
10. Rehabilitation, etc.
And support systems required for the above services like Pharmacy, Laboratory, Imaging facilities, Operation Theatre etc.
Example: District Hospital, Corporate Hospitals, Referral Hospital, Regionalor State Hospital, Nursing Home and Private Hospital of similar scope etc.
Hospital Level 3 (Non-Teaching) Super-specialty services –
This level may include all the services provided at level 1(A), 1(B) and 2 and services of one or more of the super specialty with distinct departments andoror also Dentistry if available. It will have other support systems required for services like pharmacy, Laboratory, and Imaging facility, Operation Theatre etc.
Example: Corporate Hospitals, Referral Hospital, RegionalorState Hospital, Nursing Home and Private Hospital of similar scope etc.
Hospital Level 4 (Teaching) –
This level will include all the services provided at level 2 and may also have Level 3 facilities. It will however have the distinction of being teaching or training institution and it may or may not have super specialties. Tertiary healthcare services at this level can be provided through specialists and may be super specialists (if available). It will have other support systems required for these services. It shall also include the requirement of MCIorother registering body for teaching hospitals and will be governed
Clinical Establishments Act Standards for Hospital (LEVEL 2)
by their rules. However registration of teaching Hospitals will also be required under Clinical Establishment Act for purpose other than those covered under MCI such as, records maintenance and reporting of information and statistics, and compliance to range of rates for Medical and Surgical procedures, etc.
Clinical Establishment Act Standards for Hospital (LEVEL 2)
21. Definition
A hospital is a clinical establishment providing patient treatment by qualified and trained staff and equipment through Allopathy – Modern system of medicine; where the patients are ‘admitted’ and stay overnight or more and they are referred as ‘inpatients’; while some patients may go to a hospital just for diagnosis, treatment, or therapy and then leave, they are referred as ‘outpatients’ without staying overnight.
Hospitals usually have facility to admit and care for inpatients whilst the other clinical establishments are described as clinicsorpolyclinics or day care centres. There are other exceptions too like Hospice etc
The general hospital, may have multiple departments taking care of many kinds of disease and Injectionury, and normally has an emergency department to deal with immediate and urgent care.
Specialized hospitals may include trauma centers, rehabilitation hospitals, children’s hospitals, Mental hospitals or, and hospitals for dealing with specific medical needs such as psychiatric problems (psychiatric hospital) or Sanatorium, certain disease categories such as neurology, cardiology, oncology, or orthopaedic, IVF and so forth.
Some hospitals are affiliated with universities for medical research and the training of medical personnel such as physicians and nurses, often called teaching hospitals. Guidelines laid down by MCI or other legal bodies shall be applicable to such hospitals.
A hospital can be situated in rural or urban setting. It can be run by Public Sector (Central governmentorState governmentorLocal governmentorPublic Sector undertakingorRegistered Society etc) or by Private Sector (Individual Proprietorshipor Registered PartnershiporRegistered Company orCo-operative SocietyorTrust orCharitable etc).
Hospital Level 2 (Non-Teaching)
CEA orHospital- 002
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
This level may include all the services provided at level 1(A) and 1(B) and services through other medical specialties given as under ,in addition to basic medical specialty given under 1(B) like:
a. Orthopaedics
b. ENT
c. Ophthalmology
d. Dental
e. Emergency with or without ICU
f. Anaesthesia
g. Psychiatry
h. Skin
i. Pulmonary Medicine
j. Rehabilitation, etc.
And support systems required for the above services like Pharmacy, Laboratory, Imaging facilities, Operation Theatre etc.
Example: District Hospital, Corporate Hospitals, Referral Hospital, Regionalor State Hospital, Nursing Home and Private Hospital of similar scope etc.
22. Scope
The scope of services that may be provided at a hospital level 2 practising Allopathy – Modern system of Medicine may include patient-care services in any or all of the following specialities, but not necessarily limited to:
Clinical Services:
2.1. General Medicine
2.2. General Surgery
2.3. Obstetrics and Gynaecology
2.4. Paediatrics including new born care
2.5. Orthopaedics
2.6. Anaesthesiology
2.7. Emergency Medicine & Trauma
2.8. Critical Care Medicine (e.g. HDU, ICU)
2.9. ENT
2.10. Ophthalmology
Clinical Establishments Act Standards for Hospital (LEVEL 2)
2.11. Psychiatry
2.12. Dermatology
2.13. Community Health and Family Medicine
2.14. Palliative Medicine
2.15. Geriatric Care
2.16. Dentistry including sub specialities
2.17. Physical Medicine & Rehabilitation
2.18. Transfusion MedicineorBlood Storage CentreorBlood Bank 2.19. Other emerging sub-specialities in any of the above fields.
Support services:
2.20. Registration or help desk and billing
2.21. Diagnostic Services (OwnorOutsourcedorTie up)
a. Laboratory
b. Imaging Services
c. Non-imaging services
2.22. Pharmacy and Stores
2.23. CSSD or Sterilization Area
2.24. Linen management
2.25. Kitchen & Dietary Services (OwnorOutsourced)
2.26. Waste Management Services (General and Biomedical) 2.27. Medical Gas Supply, Storage & Distribution
2.28. Ambulance services (OwnorOutsourced)
23.Infrastructure Requirements:
CEA orHospital- 002
3.1
Signage
3.1.1
The Hospital shall display appropriate signage which shall be in at least two languages
3.1.2
The building shall have a board displaying the name of the hospital at a prominent location
3.1.3
Directional signage shall be placed within the facility to guide the patient.
Following informative signage shall be displayed:
3.1.4
Name of the care provider with registration number
3.1.5
Registration details of the hospital as applicable.
3.1.6
Availability of fee structure of the various services provided (refer to CEA 2010 rules & regulation).
3.1.7
Timings of the facility and services provided.
3.1.8
Mandatory information such as under PNDT Act etc. prominently as applicable.
3.1.9
Important contact numbers such as Blood Banks, Fire Department, Police and Ambulance Services available in the nearby area.
Following safety signage shall be displayed:
3.1.11
Safety Hazard and Caution signs, for e.g. hazards from electrical shock,
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
inflammable articles, radiation etc.at appropriate places, and as applicable under law.
3.1.12
Appropriate Fire exit signage.
3.1.13
Signage for “No Smoking”.
3.2.
Other requirements
3.2.1
Access to the hospital shall be comfortable for the patient andoror attendantsorvisitors.
3.2.2
Access shall be provided within the requirements of “Persons with Disabilities Act” and shall be easy for all those whose mobility may be restricted due to
3.2.3
whatever cause.
The hospital shall be developed and maintained to provide safe, clean and hygienic environment for patients, their attendants, staff and visitors
3.2.4
The hospital shall have 24hr provision of potable water for drinking & hand hygiene. It shall also have 24hr supply of electricity, either through direct supply or from other sources.
3.2.6
The hospital shall have clean public toilet(s) separate for males and females.
3.2.7
The hospital shall have mechanism for timely maintenance of the hospital building and equipment.
3.2.8
The hospital shall have appropriate internal and external communication facilities.
3.2.9
Furniture and fixtures shall be available in accordance with the activities and workload of the hospital. They shall be functional and properly maintained.
For minimum space requirements refer to Appendix 1
For indicative list of furniture and fixtures refer to Appendix 2
24. Medical Equipment and Instruments:
25.Drugs, Medical devices and Consumables:
4.1
The hospital shall have adequate medical equipment and instruments, commensurate to the scope of service and number of beds
4.2
There shall be established system for maintenance of critical Equipment
4.3
All equipment shall be kept in good working condition through a process of periodic inspection, cleaning and maintenance. Advisory-Annual Maintenance.
For indicative list of medical equipment and instruments refer toAppendix 3.
5.1
The hospital shall have adequate drugs, medical devices and consumables commensurate to the scope of services and number of beds
5.2
Emergency drugs and consumables shall be available at all times.
5.3
Drug storage shall be in a clean, well lit, and safe environment and shall be in consonance with applicable laws and regulations.
5.4
The facility has defined procedures for storage, inventory management and dispensing of drugs in pharmacy and patient care areas.
For indicative list of drugs, medical devices and consumables refer toAppendix 4.
26.Human Resource Requirements:
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
6.1
The hospital shall have qualified andoror trained medical staff as per the scope of service provided and the medicalcare.
6.2
The hospital shall have qualified andoror trained nursing staff as per the scope of service provided and the nursing care
6.3
The supportorparamedical staff shall be qualified andoror trained as per the scope of services provided.
6.4
For every staff (including contractual staff), there shall be personal record containing the appointment order, documentary evidence of qualification andoror training (and professional registration where applicable).
For Human resource requirements refer toAppendix 5
27. Support Services:
RegistrationorHelp desk and Billing:
7.1
The Hospital shall have a Registrationor Help-desk & Billing counter, and the scope of this shall also include provision of patient guidance in matters like services available, cost estimation, healthcare insurance etc.
Diagnostic Services:.
7.2
Diagnostic services may be in-house or outsourced. For minimum standards for diagnostic services refer to CEA standards for Imaging and laboratory services.
7.3
Whether in house or outsourced, the services shall fulfil the requirements of safe and timely patient care.
7.4
The diagnostic services, whether in house or outsourced, shall be commensurate with the scope of services
Pharmacy Services
7.5
Pharmacy services in a hospital can be in-house or outsourced.
7.6
All applicable legal requirements shall be complied with.
7.7
Medicine storage shall be in a clean, well lit, and safe environment, and as per manufacturer’s requirements
CSSD or Sterilization Area
7.8
Provision for instrument and linen sterilization and storage of sterile items shall be made available as per the scope of services.
7.9
Validation of Sterilization shall be done for ensuring the effectiveness of sterilization process.
Linen management:
7.10
Soiled linen shall be collected, transported and washed separately in clean and hygienic environment.
7.11
Where linen is contaminated, appropriate decontamination shall be carried prior to despatch for washing.
Waste Management Services:
7.12
Segregation, collection, transportation, storage and disposal of biomedical waste shall be as per Bio medical waste handling rules.
7.14
Segregation, collection, transportation, storage and disposal of general waste shall be as per applicable local laws
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
Medical Gas
7.15
Oxygen for medical use shall be available. In addition other gases like Nitrous oxide, Carbon dioxide etc. may be available in consonance with the scope of services and bed strength.
7.16
Medical gases shall be stored and handled in a safe manner.
7.17
All applicable legal requirements shall be complied with.
7.18
Appropriate back-up and safety measures shall be in place to ensure patient safety at all times.
Ambulance services(OwnorOutsourced)
7.19
The establishment shall have provision of transporting patients for transferorreferralorinvestigations etc in safe manner.
7.20
Ambulance Services may be in-house or outsourced. The Ambulance services shall comply with the applicable local laws, even if they are outsourced.
28.LegalorStatutory Requirements:
29.Record Maintenance and reporting:
8.1
Every application must be accompanied with the documents confirming compliance with local regulations and law.
Indicative list is as per Appendix 6.
9.1
The minimum medical records to be maintained and nature of information to be provided by the Hospitals shall be as prescribed in Section 12 (1) (iii) of this Act.
9.2
Medical Records may be maintained in physical or digital format.
9.3
Confidentiality, security and integrity of records shall be ensured at all times
9.4
The medical records of IPD patients shall be maintained in consonance with National or local law, MCI guidelines, and court orders.
9.5
Every Hospital shall maintain health information and statistics in respect of national programmes, notifiable diseases and emergenciesordisastersor epidemics and furnish the same to the district authorities in the prescribed formats and frequency.
Content of medical record shall be as per Appendix 7
30.Basic Processes:
Registration or help desk and billing services
10.1.
The hospital shall register all patients who visit the hospital except if the required services are not available in the facility, in which case the patient is guided to the appropriate nearest facility. (Please also see Emergency Services)
10.2.
Once registered, depending on the clinical need, patient is guided to appropriate service area like OPD, ER etc.
10.3.
Patient shall be guided and informed regarding Patients’ rights & responsibilities, cost estimates, third party services (e.g. Insurance) etc. Please refer to Appendix 8.
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
10.4.
The billing shall be as per the Hospital tariff list, which shall be available to patients in a suitable format.
Assessment and Plan of care
10.5.
Each patient shall undergo an initial assessment by qualified andoror trained personnel.
10.6.
Further management of patient shall be done by a Doctor on the basis of findings of initial assessment; for example, OPD treatment, admission, transferorreferral, investigation etc.
10.7.
At the time of admission of patient, General Consent for admission shall be taken.
10.8.
In case of non-availability of beds or where clinical need warrants, the patient shall be referred to another facility along with the required clinical information or notes.
10.9.
Reassessments of the admitted patients shall be done at least once in a day andoror according to the clinical needs and these shall be documented.
10.10.
Any examination, treatment or management of female patient shall be done in the presence of an employed female attendantorfemale nursing staff, if conducted by male personnel inside the hospital and vice versa.
Informed Consent Procedure
10.11.
Informed consent shall be obtained from the patientor next of kinor legal guardian as and when required as per the prevailing Guidelines or Rules and regulations in the language patient can understand (for e.g., before Invasive procedures, anaesthesia, Blood transfusion, HIV testing, Research, etc). Please refer to Appendix 9.
Care of Patient
10.12.
The Hospital shall provide care of patient as per Standard Treatment Guidelines that may be notified by the Central orState Government (Desirable)
10.13.
Patient andoror families shall be educated on preventive, curative, promotive and rehabilitative aspects of care either verbally, or through printed materials.
10.14.
All the relevant documents pertaining to any invasive procedures performed shall be maintained in the record.
10.15.
Monitoring of patient shall be done during and after all the procedures and same shall be documented (for example, after anaesthesia, surgical procedures, blood transfusion, etc.).
10.16.
Staff involved in direct patient care shall receive basic training in CPR
Emergency Services:
10.17.
Emergency patients shall be attended on priority. The Emergency department shall be well equipped with trained staff.
10.18.
The Clinical Establishment shall undertake to provide within the staff and facilities available, such medical examination and treatment as may be required to stabilize the emergency medical condition of any individual who comes or is brought to such clinical establishment.
Medication Prescription, Administration And Monitoring
10.19.
Prescription shall include name of the patient, date, name of medication,
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
dosage, route, frequency, duration, name, signature and registration number of the medical practitioner in legible writing
10.20.
Drug allergies shall be ascertained before prescribing and administration; if any allergy is discovered, the same shall be communicated to the patient and recorded in the Case sheet as well.
10.21.
Patient identity, medication, dose, route, timing, expiry date shall be verified prior to administration of medication
10.22.
Safe Injectionection practices shall be followed as per WHO guidelines.
10.23.
High Risk Medicines shall be identified and verified by trained healthcare personnel before administration.
10.24.
Patients shall be monitored after medication administration and adverse drug reactionorevents if any shall be recorded and reported
Infection Control
10.25.
The hospital shall follow standard precautions like practicing hand hygiene, use of personal protection equipment, etc to reduce the risk of healthcare associated infections.
10.26.
The hospital shall ensure adequate and proper spacing in the patient care area so as to prevent transmission of infections.
10.27.
Regular cleaning of all areas with disinfectant shall be done .
10.28.
Prescribed & documented Infection Control Practices shall be followed in High risk areas like Operation theatre, ICU, HDU, etc as per good clinical practice guidelines.
10.29.
Housekeepingorsanitary services shall ensure appropriate hygiene and sanitation in the establishment.
Safety of the patient, staff, visitors and relative in a hospital
10.30.
Security and safety of patients, staff, visitors and relatives shall be ensured by provision of appropriate safety installations and adoption of appropriate safety measures. E.g. identification of mother and baby in obstetric facility, etc
10.31.
The Hospital shall undertake all necessary measures, including demonstration of preparedness for fire and non-fire emergencies, to ensure the safety of patients, attendants, staff and visitors. (Please also see section on Infrastructure and Security and Fire)
10.32.
All applicable fire safety measures as per local law shall be adopted. This includes fire prevention, detection, mitigation, evacuation and containment measures. Periodic training of the staff and mock drills shall be conducted and the same shall be documented.
10.33.
In case of any epidemic, natural calamity or disaster, the ownerorkeeper of every Hospital shall, on being requested by the designated supervising Authority, cooperate and provide such reasonable assistance and medical aid as may be considered essential by the supervising authority at the time of natural calamity or disastrous situation
Patient Information and Education
10.34.
The patient andoror family members shall be explained about the disease condition, proposed care, including the risks, alternatives and benefits. They shall be informed regarding the expected cost of the treatment. They shall also be informed about the progress and any change of condition.
10.35.
Patient andoror family are educated about the safe and effective use of
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
medication, food drug interaction, diet, and disease prevention strategies.
Discharge
10.36.
A Discharge summary shall be given to all patients discharged from the hospital. For content of discharge summary refer to Appendix 10.
10.37.
The discharge summary shall include the points as mentioned in the Appendix in an understandable language and format
10.38.
Discharge summary shall also be given to patient andoror attendant in case of transfer LAMAorDAMA or death.
APPENDIX 1
Minimum space requirements in a hospital level 2 shall be as follows:
Area(Desirable)
Wards
1.
Ward bed and surrounding space
6sq mor bed; in addition circulation space of 30% as indicated in total area shall be provided for Nursing station, Ward store, Sanitary etc
Intensive Care Unit (if available)
2.
For medicalorsurgical ICUorHDU bed and surrounding space
10.5sqmor bed; in addition circulation space of 30% as indicated in the total area shall be provided for nursing station, doctors’ duty room, store, clean and dirty utility, circulating area for movement of staff, trolley, toilet etc.
Minor Operation TheatreorProcedure room
3.
OT for minor procedures (where applicable)
10.5 sq m; in addition circulation space of 30% as indicated in total area shall be provided for nursing station, scrub station, clean and dirty utility, dressing room, toilet etc.
Labour room
4.
Labour Table and surrounding space
10.5 sq mor labour table
5.
Other areas- nursing station, doctors’ duty room, store, Clean and dirty utility, Circulating area, Toilets
10.5 sqm for clean utility and store and 7 sqm for dirty utility and 3.5 sqm for toilet.
Operation Theatre (OT)
6.
Operating Room Area
24.5sq m per operating room.
Emergency & Casualty (if separate):
7.
Emergency bed and surrounding
10.5 sq mor bed
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
space
8.
Other areas- nursing station, doctors’ duty room, store, Clean and dirty utility, Dressing area, Toilets
Nurse station out of circulation. Doctor duty room of 7sqm and a toilet of 3.5sqm. Store of 7sqm
Pharmacy
9.
Pharmacy
The size should be adequate to contain 5 percent of the total clinical visits to the OPD in one session at the rate of 0.8 m2 per
patient.
Bio-medical Waste
10.
<50 beds
5 sq m
11.
50-100 beds
>100 beds
10 sq m
12.
20 sq m
Other functional areas(laboratory, diagnostics, front officeorreception, waiting area, administrative area etc) should be appropriately sized as per the scope of service and patient load of the hospital.
Other requirements:
Wards:
1. The ward shall also have designated areas for nursing station, doctors’ duty room, store, clean and dirty utility, janitor room, toilets and this shall be provided from circulation area.
2. For a general ward of 12 beds, a minimum of 1 WC and 1 hand wash basin shall be provided.
3. Distance between beds shall be 1.0 metres
4. Space at the head end of bed shall be 0.25 metres.
5. Door width shall be 1.2 metres and corridor width 2.5 metres
Intensive Care Unit (if available)
1. The unit is to be situated in close proximity of operation theatre, acute care medical and surgical ward units.
2. Suction, oxygen supply and compressed air should be provided for each bed.
3. Adequate lighting and uninterrupted power supplyshall be provided.
4. Adequate multi-sockets with 5 ampere and 15 ampere sockets andoror as per requirement to be provided for each bed.
Clinical Establishments Act Standards for Hospital (LEVEL 2)
5. Nurse call system for each bed is desirable
6. ICU shall have designated area for nursing station, doctors’ duty room, store, clean and dirty utility, circulating area for movement of staff, trolley, toilet, shoe change, trolley bay, janitor closet etc
Labour room:
11. The obstetrical unit shall provide privacy, prevent unrelated traffic through the unit and provide reasonable protection of mothers from infection and from cross-infection.
12. Measures shall be in place to ensure safety and security of neonates.
13. Resuscitation facilities for neonates shall be provided within the obstetrical unit and convenient to the delivery room.
14. The labour room shall contain facilities for medication, hand washing, charting, and storage for supplies and equipment.
15. The labour room shall be equipped with oxygen and suction
Operation Theatre
1. The operation theatre complex shall have appropriate zoning.
2. The operation theatre complex shall provide appropriate space for other areas- nursing station, doctors’ duty room, scrub station, sterile store, Clean and dirty utility, Dress change room, Toilets.
a. Sterile area – consists of operating room sterile store and anesthesia room
b. Clean zone- consists of equipmentormedical store, scrub area, pre andoror post-operative area and linen bay
c. Protective zone- consists of change room, doctors room and toilets
d. Dirty area
e. Due considerations are to be given to achieve highest degree of asepsis to
provide appropriate environment for staff and patients.
3. Doors of pre-operative and recovery room are to be 1.5 m clear widths.
CEA orHospital- 002
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
4. Air Conditioning to be provided in all areas. Window AC and split units should preferably be avoided as they are pure re circulating units and become a source of infection.
5. Appropriate arrangements for air filtration to be made.
6. Temperature and humidity in the OT shall be monitored.
7. Oxygen, Nitrous Oxide, suction and compressed air supply should be provided in
all OTs.
8. All necessary equipment such as shadow-less light, Boyle’s apparatus shall be available and in working condition.
9. Uninterrupted power supply to be provided.
Note: For Eye Hospitals only where procedures are done in local andoror regional anaesthesia, Minor OT criteria may be applicable.
Emergency room
25. Emergency bed and surrounding space shall have minimum 10.5 sq mor bed area.
Clinical Laboratory
1. The laboratory area shall be appropriate for activities including test analysis, washing, biomedical waste storage and ancillary services like Storage of records, reagents, consumables, stationary etc eating area for staff.
Imaging
1. The department shall be located at a place which is easily accessible to both OPD and wards and also to emergency and operation theatre.
2. As the department deals with the high voltage, presence of moisture in the area shall be avoided.
3. The size of the department shall depend upon the type of equipment installed.
4. The departmentorroom shall have a sub-waiting area preferably with toilet facility and a change room facility, if required.
Central Sterilization and Supply
1. Department (CSSD) — Sterilization, being one of the most essential services in a hospital, requires the utmost consideration in planning.
2. Centralization increases efficiency, results in economy in the use of equipment and ensures better supervision and control.
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
3. The materials and equipment dealt in CSSD shall fall under three categories: a) Those related to the operation theatre department,
b) Common to operating and other departments, and
c) Pertaining to other departments alone.
Other Departments
Other departments shall have appropriate infrastructure commensurate to the scope of service of the hospital.
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
APPENDIX 2 Furniture and Fixtures:
ARTICLES
Examination Table Writing tables Chairs
Almirah
Waiting Benches
MedicalorSurgical Beds
Labour Table- if applicable
Wheel ChairorStretcher
Medicine Trolley, Instrument Trolley Screensorcurtains
Foot Step
Bed Side Table
Baby Cot- if applicable
Stool
Medicine Chest
Examination Lamp
View box
Fans
Tube Lightor lighting fixtures
Wash Basin
IV Stand
Colour coded bins for BMW
*This is an indicative list and the items shall be provided as per the size of the hospital and scope of service.
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
APPENDIX 3 EQUIPMENTS
e. Emergency Equipment
Sr No
Name of Emergency Equipment
1
Resuscitation equipment including Laryngoscope, endotracheal tubes, suction equipment, xylocaine spray, oropharyngeal and nasopharyngeal airways, Ambu Bag- Adult & Paediatric (neonatal if indicated)
2
Oxygen cylinders with flow meteror tubingorcatheterorface maskornasal prongs
3
Suction Apparatus
4
Defibrillator with accessories
5
Equipment for dressingorbandagingorsuturing
6
Basic diagnostic equipment- Non Mercury Blood Pressure Apparatus, Stethoscope, weighing machine, thermometer(Non mercury)
7
ECG Machine
8
Pulse Oximeter
9
Nebulizer with accessories
f. Other equipment and consumables, which shall also be available in good working condition as per the scope of services and bed strength (some of the emergency equipment are already mentioned above).
Department
Equipment
Level 1A
Level 1B
Level 2
Level 3
NON MEDICAL
Administration
Office equipment
Yes
Yes
Yes
Yes
Office furniture
Yes
Yes
Yes
Yes
Electricity
Emergency lights
Yes
Yes
Yes
Yes
Water Supply
Hand-washing sinksortapsorbowls on stands in all areas
Yes
Yes
Yes
Yes
Storage tank
Yes
Yes
Yes
Yes
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
Waste Disposal
Water purification chemicals or filter Water source for drinking water
Buckets for contaminated waste in all treatment areas Drainage system Rubbish bins in all rooms
Sanitation facilities for patients
Separate Bio-medical waste disposal Sharps containers in all treatment areas
Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes
Desirable Desirable Yes Yes
Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes
Safety
Fire extinguisher Vehicle(OwnorOutsourced)
Vehicle wheeler Ambulance
Lockable storage
4
Medical Stores
Refrigeration Kitchen(OwnorOutsourced)
Cooking pots and utensils
Cooking stove
Food refrigeration Plates, cups & cutlery
Washing and drying area facilities
Detergentorsoap
Storage Yes Yes
Yes
Yes
Laundry(OwnorOutsourced)
Washing and rinsing equipmentorbowls
Yes
Yes
Yes
Yes
Housekeeping(OwnorOutsourced)
Housekeeping Brooms, brushes and mops
Buckets
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
Soap and disinfectant
Yes
Yes
Yes
MEDICAL
Yes
Yes Yes
Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes
Yes (as Yes applicabl
e)
Yes (as Yes applicabl
e)
Yes Yes Yes Yes
Yes Yes Yes Yes
Yes Yes Yes Yes
Yes Yes Yes Yes
Yes Yes
Yes Yes Yes Yes
Outpatient Rooms
Non Mercury Blood Pressure Apparatus and stethoscope
Yes Yes
Container for sharps disposal
Yes Yes
Desk and chairs
Yes Yes
Examination gloves
Minor surgical instruments
Yes Yes
Examination table
Yes Yes
Hand washing facilities
Yes Yes
Light source
Yes Yes
No Yes
Ophthalmoscope
No No
Otoscope
No No
Patellar hammer
Yes Yes
Receptacle for soiled pads, dressings, etc.
Yes Yes
Separate biohazard disposal
Yes Yes
Sterile equipment storage
Weighing scale
Yes Yes
Sutures
Yes Yes
Thermometer(Non mercury)
Yes Yes
Torch with extra batteries
Yes Yes
Yes Yes
Women and Child health examination room
Non Mercury Blood Pressure Apparatusand stethoscope
Yes Yes
Contraceptive supplies
Yes Yes
Birth register
Yes Yes
Yes
Yes
Examination gloves
Yes Yes
Examination table with stirrups
Yes
Yes
Yes
Yes
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
Labour room
Fetal stethoscope Doppler
Hand washing facility Height measure
IUD insertion set Pregnant woman Register
Speculum and vaginal examination kit Syringes and needles Tape measure Tococardiograph
Baby scales
Non Mercury Blood Pressure Apparatus and stethoscope
Clean delivery kits and cord ties
Curtains if more than one bed Delivery bed and bed linen
Fetal stethoscope
Hand washing facility Instrument trolley
IV treatment sets
Latex gloves and protective clothing Linens for newborns Mucus extractor
Oral airways, various sizes
Oxygen
cylinderor concentrator
Self inflating bag and mask – adult and neonatal size
No Yes Yes Yes No No No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes
Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes
Partograph charts
Suction machine
Thermometer(Non mercury)
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Suturing sets
Tray with emergency
routine & drugs,
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
Inpatient Wards
syringes and needles Urinary catheters and collection bags
Vacuum extractor set Work surface near bed for newborn resuscitation
Basic examination equipment (stethoscope, Non mercury BP Apparatus (etc)
Beds, washable mattresses and linen Curtains
Dressing sets Dressing trolleyorMedicine trolley
Gloves
IV stands
Medicine storage cabinet
Oxygen cylinder and concentrator Patient trolley on wheels
PPE kits
Suction machine Urinals and bedpans
Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes
Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes If available
Yes Yes
OperationTheatre
Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes
No
No Yes Yes Yes Yes Yes Yes
Adequate storage Yes
Ambu resuscitation set Yes with adult and child
masks
Defibrillator
Electro cautery No
Fixed operating lights
No
No
Yes
Fixed suction machine No
Hand washing facilities
Yes
Yes
Yes
Yes
Instrument tray Yes
Instrument trolley
Yes
Yes
Yes
Yes
Laryngoscope set No
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
Mayo Stand Yes Yes Yes
Yes
Yes
Yes (as applicable )
Yes
Yes
Yes
Yes
Yes Yes
Yes Yes
Yes
Yes Yes Yes
Yes Yes Yes Yes
Yes Yes
Yes Yes
Mobile operating light Yes Ophthalmic Operating No Microscope
Yes Yes
No Yes (as
applicabl e)
Yes
Oral airways, various No
sizes
Oxygen cylinder and Yes Yes Yes concentrator
Patient trolley on Yes
wheels
Portable suction Yes
machine
Safety Box No
Sphygmomanometer Yes
(Non Mercury) and
stethoscope
Stool adjustable height No
Operating table No Yes Yes IV Therapy Equipment No
Anesthesia Equipment No
Anesthetic
trolleyormachine
CO2 Monitor No
O2 Monitor No Yes
Yes Yes Yes Yes
Yes Yes Yes
Yes Yes
Yes Yes
Yes No No
Endoscopic equipment No
and necessary
accessories
Bronchoscope No No Desirable
Colonoscope No
Endoscope No No Desirable
No Desirable No Desirable
No No No Yes
No Yes Yes Yes
Fiber Optic No
Laryngoscope Central Supply
Amputation set No
Dilatation and No curettage set
Hernia set No Linens Yes
Caesareanorhysterecto my set
Endoscopic instrument cleaning machines
and solutions
Laparotomy set
Locked storage
No
No
No
No
No
Yes
Yes
No
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
Operating drapes
Ophthalmic instrument
Sterilization equipment for instrument and
No
Yes
Yes
Yes
Yes
Yes
No
No
Yes
Yes
Protective caps, aprons, shoes and gowns etc.
Yes
Yes
Yes
Yes
Pelvicorfistula repair set
No
No
No
Yes
Sterile gloves
Yes
Yes
Yes
Yes
Yes
Yes
linens
Surgical supplies (e.g., sutures, dressings, etc.)
Yes
Yes
Yes
Yes
Thoracocentesis set
Thoracostomy set with appropriate tubes and water seal bottles
No
No
No
Yes
No
No
No
Yes
Thoracotomy set
ThyroidorParathyroid set
No
No
No
No
No
Yes
No
Yes
Tracheostomy set
No
No
Yes
Yes
Tubal ligation set
No
No
Yes
Yes
Vascular repair set
No
No
Yes
Yes
Other equipment as per the specialized services available shall also be there
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
APPENDIX 4
DRUGS, MEDICAL DEVICES AND CONSUMABLES
Name of the Drug
INJECTIONECTIONS
INJECTION. DIAZEPAM 10 MG INJECTION. FRUSEMIDE 20 MG INJECTION. ONDANSETRON 8 MGor4ML INJECTION. RANITIDINE
INJECTION NOR ADRENALINE 4 MG INJECTION. PHENYTOIN 50 MG
INJECTION DICLOFENAC 75 MG
INJECTION. DERIPHYLLINE
INJECTION CHLORPHENIRAMINE MALEATE INJECTION. HYDROCORTISONE 100 MG INJECTION. ATROPINE 0.6 MG
INJECTION. ADRENALINE 1 MG INJECTION. KCL
STERILE WATER
INJECTION. SODA BICARBONATE INJECTION. DOPAMINE INJECTION. NALAXONE 400 MCG INJECTION. LIGNOCAINE 50 ML TAB. SORBITRATE
TAB. ASPIRIN INJECTION. TETANUS
e. List of Emergency Drugs and consumables (Essential in all hospitals)
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
INJECTION. ADENOSINE
OTHER
NEB. SALBUTAMOL2.5 ML
NEB. BUDESONIDE
LIGNOCAINE JELLY 2%
ACTIVATED CHARCOAL
CALCIUM (INJECTION or TAB)
FLUIDS
RL 500 ML
NS 500 ML
NS 250 ML
NS 100 ML
DNS 500 ML
DEXTROSE 5% 500 ML
DEXTROSE 10% 500 ML
PEDIATRIC IV INFUSION SOLUTION 500 ML
f. The other drugs and consumables shall be available as per the scope of services, bed strength and patient turnover.
g. Medical devices shall be available as per the scope of services, bed strength and patient turnover.
Clinical Establishments Act Standards for Hospital (LEVEL 2)
APPENDIX 5
HUMAN RESOURCE
The Human Resource requirement for any hospital shall be as per the scope of services provided by the hospital.
The requirement mentioned below is the minimum requirement for upto 50 bedded Hospital Level 2 and it shall be prorated as required:
CEA orHospital- 002
SN
Human Resource
Requirement
1
Doctor
MBBS doctor shall be available round the clock on site per unit.
Availability of specialist as per the Minimum standards of that specialty.
2
Nurses
Qualified nurses per unit per shift shall be available as per requirement laid down by “The Indian Nursing Council, 1985”, occupancy rate and distribution of bed.
3
Pharmacist (If in house pharmacy available)
1 in a hospital
4
Lab Technician (if in house laboratory service available)
1 in a hospital (minimum DMLT)
5
X-ray Technician (if in house X-ray facility available)
1 in a hospital (minimum Diploma in X Ray Technician course)
6
Multi-purpose Worker
Minimum 2
*Requirement of other staff (support and administrative) will depend on the scope of the hospital.
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
APPENDIX6
LIST OF LEGAL REQUIREMENTS
Below is the list of legal requirements to be complied with by a hospital as applicable by the localorstate health authority (all may not be applicable):
Sl.
Name of Document
Valid From
Valid Send for Till renewal
by
Remark
(Expiredor validorNA)
1.
Registration under Nursing Home Actor Medical Establishment Act
2.
Bio-medical Waste Management Licenses
Authorization of HCO by PCB
MOU with Vendor
3.
AERB Licenses
4.
NOC from Fire Department
5.
Ambulance
Commercial Vehicle Permit
Commercial Driver License
Pollution Control Licenses
6.
Building Completion Licenses
7.
Lift license for each lift
8.
DG Set Approval for Commissioning
9.
Diesel Storage Licenses
10.
Retail and bulk drug license (pharmacy)
11.
Food Safety Licenses
12.
Narcotic Drug Licenses
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
13.
Medical Gases Licensesor Explosives Act
14.
Clinical Establishments and Registration (if applicable)
15.
Blood Bank Licenses
16.
MoU or agreement with outsourced human resource agencies as per labor laws
17.
Spirit Licence
18.
Electricity rules
19.
Provident fundorESI Act
20.
MTP Act
21.
PNDT Act
22.
Sales Tax registration
23.
PAN
24.
No objection certificate under Pollution Control Act (AirorWater)
25.
Wireless operation certificate from Indian P&T
26.
Arms Act, 1950 (if guards have weapons)
Clinical Establishments Act Standards for Hospital (LEVEL 2)
APPENDIX 7 CONTENT OF MEDICAL RECORD
Medical record shall contain, at the least, the following information:
CEA orHospital- 002
Content
Name & Registration number of treating doctor
Name, demographic details & contact number of patient
Relevant Clinical history, Assessment and re-assessment findings, nursing notes and Diagnosis
Investigation reports
Details of medical treatment, invasive procedures, surgery and other care provided
Applicable consents
Discharge summary
Cause-of-death certificate & Death Summary (where applicable)
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
APPENDIX 8 Patients’ rights and responsibilities:
A patient and hisorher representative has the following rights with respect to the clinical establishment-
60. To adequate relevant information about the nature, cause of illness, proposed investigations and care, expected results of treatment, possible complications and expected costs;
61. Rate of services provided by the clinical establishment would be displayed prominently.
62. To access a copy of case papers, patient records, investigations reports and detailed bill
63. To informed consent prior to specific testsortreatment (e.g. surgery, chemotherapy)
64. To seek second opinion from an appropriate clinician of patients’ choice, with records and information being provided by treating hospital
65. To confidentiality, human dignity and privacy during treatment.
66. To have ensured presence of a female person, during physical examination of
a female patient by a male practitioner
67. To non-discrimination about treatment and behaviour on the basis of HIV
status
68. To choose alternative treatment if options are available
69. Rate of services provided by the clinical establishment would be displayed
prominently.
Provide all health related information
Cooperate with Doctors during examination, treatment
Follow all instructions
Pay hospitals agreed fees on time
Respect dignity of doctors and other hospital staff
Never resort to violence
Patients’ Rights
Patients’ Responsibilities
Clinical Establishments Act Standards for Hospital (LEVEL 2)
CEA orHospital- 002
APPENDIX 9
INFORMED CONSENTorCONSENT GUIDELINES
The informed consent shall at the least contain the following information in an understandable language and format(desirably which a lay person can easily understand)
.
Content
Name of the patientor guardian (in case of minorormentally disabled).
Registration number of patient
Date of admission
Name & Registration number of treating doctor
Name of procedureoroperationorinvestigationorblood transfusionoranaesthesiaor potential complications
Signature of patientorguardian with date and time
Clinical Establishments Act Standards for Hospital (LEVEL 2)
APPENDIX 10 Discharge Summary
The discharge summary shall at the least contain the following information in an understandable language and format.
CEA orHospital- 002
Sl. No.
Content
Name & Registration number of treating doctor
Name, demographic details & contact number of patient, if available
Date of admission and discharge
Relevant clinical history, assessment findings and diagnosis
Investigation results,
Details of medical treatment, invasive procedures, surgery and other care provided
Discharge advice (medications and other instructions).
Instruction about when and how to obtain urgent care.
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
Clinical Establishment Act Standard for
HOSPITAL (LEVEL 3) Standard No. CEA or Hospital – 003
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
Table of Contents
Particulars
Page No.
Categorization of Hospitals
4-5
Definition
6-8
Scope
8-9
Infrastructure
8-9
Equipments
9
Human Resource
10
LegalorStatutory Requirements
11
Record Maintenance and Reporting
11-12
Basic Processes
12-14
Appendix 1
15-19
Appendix 2
20
Appendix 3
21-26
Appendix 4
27-28
Appendix 5
29-30
Appendix 6
31-32
Appendix 7
33-38
Appendix 8
39
Appendix 9
40
Appendix 10
41
Appendix 11
42
References
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
Categorization of Hospitals
The minimum standards for Allopathic hospitals Under Clinical Establishment Act, 2010 are developed on the basis of level of care provided, as defined below:
Hospital Level 1 (A)-
General Medical services with indoor admission facility provided by recognized allopathic medical graduate(s) and may also include general dentistry services provided by recognized BDS graduates.
Example: PHC, Government and Private Hospitals and Nursing Homes run by MBBS Doctors etc.
Hospital Level 1(B) –
This level of hospital shall include all the general medical services provided at level 1(A) above and specialist medical services provided by Doctors from one or more basic specialties namely General Medicine, General Surgery, Paediatrics, Obstetrics & Gynaecology and Dentistry, providing indoor and OPD services.
Level 1(A) and Level 1(B) Hospitals shall also include support systems required for the respective services like Pharmacy, Laboratory, etc.
Example: General Hospital, Singleor Multiple basic medical Specialties provided at Community Health Centre, Sub Divisional Hospital, and Private Hospital of similar scope, Nursing Home, Civil or District Hospital in few places etc.
Hospital Level 2 (Non-Teaching)
This level may include all the services provided at level 1(A) and 1(B) and services through other medical specialties given as under ,in addition to basic medical specialty given under 1(B) like:
1. Orthopaedics 2. ENT
3. Ophthalmology 4. Dental
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
5. Emergency with or without ICU
6. Anaesthesia
7. Psychiatry
8. Skin
9. Pulmonary Medicine
10. Rehabilitation, etc.
And support systems required for the above services like Pharmacy, Laboratory, Imaging facilities, Operation Theatre etc.
Example: District Hospital, Corporate Hospitals, Referral Hospital, Regionalor State Hospital, Nursing Home and Private Hospital of similar scope etc.
Hospital Level 3 (Non-Teaching) Super-specialty services –
This level may include all the services provided at level 1(A), 1(B) and 2 and services of one or more of the super specialty with distinct departments andoror also Dentistry if available. It will have other support systems required for services like pharmacy, Laboratory, and Imaging facility, Operation Theatre etc.
Example: Corporate Hospitals, Referral Hospital, RegionalorState Hospital, Nursing Home and Private Hospital of similar scope etc.
Hospital Level 4 (Teaching) –
This level will include all the services provided at level 2 and may also have Level 3 facilities. It will however have the distinction of being teaching or training institution and it may or may not have super specialties. Tertiary healthcare services at this level can be provided through specialists and may be super specialists (if available). It will have other support systems required for these services. It shall also include the requirement of MCIorother registering body for teaching hospitals and will be governed by their rules. However registration of teaching Hospitals will also be required under Clinical Establishment Act for purpose other than those covered under MCI such as, records maintenance and reporting of information and statistics, and compliance to range of rates for Medical and Surgical procedures, etc.
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
Clinical Establishment Act Standards for Hospital (LEVEL 3)
31. Definition
A hospital is a clinical establishment providing patient treatment by qualified and trained staff and equipment through Allopathy – Modern system of medicine; where the patients are ‘admitted’ and stay overnight or more and they are referred as ‘inpatients’; while some patients may go to a hospital just for diagnosis, treatment, or therapy and then leave, they are referred as ‘outpatients’ without staying overnight.
Hospitals usually have facility to admit and care for inpatients whilst the other clinical establishments are described as clinicsorpolyclinics or day care centres. There are other exceptions too like Hospice etc
The general hospital, may have multiple departments taking care of many kinds of disease and Injectionury, and normally has an emergency department to deal with immediate and urgent care.
Specialized hospitals may include trauma centers, rehabilitation hospitals, children’s hospitals, Mental hospitals or, and hospitals for dealing with specific medical needs such as psychiatric problems (psychiatric hospital) or Sanatorium, certain disease categories such as neurology, cardiology, oncology, or orthopaedic, IVF and so forth.
Some hospitals are affiliated with universities for medical research and the training of medical personnel such as physicians and nurses, often called teaching hospitals. Guidelines laid down by MCI or other legal bodies shall be applicable to such hospitals.
A hospital can be situated in rural or urban setting. It can be run by Public Sector (Central government or State government or Local government or Public Sector undertaking or Registered Society etc) or by Private Sector (Individual Proprietorshipor Registered Partnership or Registered Company or Co-operative Society or Trust or Charitable etc).
Hospital Level 3 (Non-Teaching) Super-specialty services –
This level may include all the services provided at level 1(A), 1(B) and 2 and services of one or more of the super specialty with distinct departments andoror also Dentistry if available. It will have other support systems required for services like pharmacy, Laboratory, and Imaging facility, Operation Theatre etc.
These hospitals may provide following specialized services Cardiology, Cardiothoracic surgery, Neurology, Neurosurgery, Nephrology, Joint replacement, Plastic and reconstructive surgery, Rheumatology, Endocrinology, Respiratory Medicine, Oncology,
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
Nuclear Medicine, Paediatric Surgery, Gastroenterology, GI surgery, Transplantation Services, Blood Storage Centre or Blood Bank etc.
Example: Corporate Hospitals, Referral Hospital, RegionalorState Hospital, Nursing Home and Private Hospital of similar scope etc.
32. Scope
The scope of services that may be provided at a hospital level 3 practising Allopathy – Modern system of Medicine may include patient-care services in any or all of the following specialities, but not necessarily limited to:
Clinical Services:
2.1. General Medicine
2.2. General Surgery
2.3. Obstetrics and Gynaecology
2.4. Fertility and Assisted Reproduction
2.5. Paediatrics
2.6. Paediatric Intensive Care
2.7. Paediatric surgery
2.8. Neonatology
2.9. Orthopaedics
2.10. Orthopaedics with Joint Replacement
2.11. Anaesthesiology
2.12. Emergency Medicine & Trauma
2.13. Critical Care Medicine (e.g. HDU, ICU)
2.14. ENT
2.15. Ophthalmology
2.16. Neurology
2.17. Neurosurgery
2.18. Cardiology
2.19. Cardiothoracic surgery
2.20. Urology
2.21. Nephrology & Dialysis
2.22. Gastroenterology
2.23. GI Surgery (Surgical Gastroenterology)
2.24. Minimally Invasive Surgery or Minimal Access Surgery
2.25. Respiratory Medicine
2.26. Endocrinology
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
2.27. Rheumatology
2.28. Clinical Immunology
2.29. Psychiatry & Mental Health
2.30. Medical Oncology
2.31. Surgical Oncology
2.32. Radiation Oncology
2.33. Nuclear Medicine
2.34. Plastic & Reconstructive Surgery
2.35. Dermatology
2.36. Community Health
2.37. Palliative Medicine
2.38. Geriatric Care
2.39. Family Medicine
2.40. Clinical Haematology
2.41. Organ transplantation
2.42. Genetics
2.43. Dentistry including sub specialities
2.44. Physical Medicine & Rehabilitation
2.45. Transfusion MedicineorBlood Storage CentreorBlood Bank
2.46. Other emerging sub-specialities in any of the above fields, or emerging
independent specialities
Support services:
33.
2.29. Registration or help desk and billing
2.30. Diagnostic Services (OwnorOutsourceorTie up):
a. Laboratory
b. Imaging Services
c. Non-imaging services e.g. Audiology Lab, TMT,
Echocardiography, Neurophysiology, Urodynamics, PFT,
Sleep Studies (Polysomnography), etc.
2.31. Pharmacy and Stores
2.32. CSSD or Sterilization Area
2.33. Linen and Laundry
2.34. Kitchen & Dietary Services
2.35. Waste Management Services (General and Biomedical)
2.36. Medical Gas Supply, Storage & Distribution
2.37. Ambulance services
Infrastructure Requirements:
3.1
Signage
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
3.1.1
The Hospital shall display appropriate signage which shall be in at least two languages
3.1.2
The building shall have a board displaying the name of the hospital at a prominent location
3.1.3
Directional signage shall be placed within the facility to guide the patient.
Following informative signage shall be displayed:
3.1.4
Name of the care provider with registration number
3.1.5
Registration details of the hospital as applicable
3.1.6
Availability of fee structure of the various services provided (refer to CEA 2010 rules & regulation).
3.1.7
Timings of the hospital and services provided
3.1.8
Mandatory information such as under PNDT Act etc. prominently as applicable.
3.1.9
Important contact numbers such as Blood Banks, Fire Department, Police and Ambulance Services available in the nearby area.
Following safety signage shall be displayed:
3.1.11
Safety Hazard and Caution signs, for e.g. hazards from electrical shock, inflammable articles, radiation etc. at appropriate places, and as applicable under law.
3.1.12
Appropriate Fire exit signage.
3.1.13
Signage for “No Smoking” in prominent places.
3.2.
Other requirements
3.2.1
Access to the hospital shall be comfortable for the patient andor or attendantsorvisitors.
3.2.2
Access shall be provided within the requirements of “Persons with Disabilities Act” and shall be easy for all those whose mobility may be restricted due to whatever cause.
3.2.3
The hospital shall be developed and maintained to provide safe, clean and hygienic environment for patients, their attendants, staff and visitors
3.2.4
The hospital shall have 24 hour provision of potable water for drinking & hand hygiene. It shall also have 24 hour supply of electricity, either through direct supply or from other sources.
3.2.5
The building shall be planned as such that sensitive areas, such as wards, consulting and treatment rooms and operation theatres are placed away from the outdoor source of noise. The hospital shall be well illuminated and ventilated
3.2.6
The hospital shall have clean public toilet(s) separate for males and females.
3.2.7
The hospital shall have mechanism for timely maintenance of the hospital building and equipment.
3.2.8
The hospital shall have appropriate internal and external communication facilities.
3.2.9
Furniture and fixtures shall be available in accordance with the activities and workload of the hospital. They shall be functional and properly maintained.
For minimum space requirements refer to Appendix 1.
For indicative list of furniture and fixtures refer to Appendix 2.
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
34. Medical Equipment and Instruments:
4.1
The hospital shall have adequate medical equipment and instruments, commensurate to the scope of service and number of beds.
4.2
There shall be established system for maintenance of critical equipment
4.3
All equipment shall be kept in good working condition through a process of periodic inspection, cleaning and maintenance. Advisory-Annual Maintenance. Log Book to be maintained.
For indicative list of medical equipment and instruments refer to Appendix 3.
35. Drugs, Medical devices and Consumables:
5.1
The hospital shall have adequate drugs, medical devices and consumables commensurate to the scope of services and number of beds
5.2
Emergency drugs and consumables shall be available at all times.
5.3
Drug storage shall be in a clean, well lit, and safe environment and shall be in consonance with applicable laws and regulations.
5.4
The hospital shall have defined procedures for storage, inventory management and dispensing of drugs in pharmacy and patient care areas
For indicative list of drugs, medical devices and consumables refer to Appendix 4.
36.Human Resource Requirements:
6.1
The hospital shall have qualified andoror trained medical staff as per the scope of service provided and the medical care shall be provided as per the requirements of professional and regulatory bodies.
6.2
The hospital shall have qualified andoror trained nursing staff as per the scope of service provided and the nursing care shall be provided as per the requirements of professional and regulatory bodies
6.3
The support or paramedical staff shall be qualified and or or trained as per the scope of services provided, and as per the requirement of the respective professional or regulatory bodies.
6.4
For every staff (including contractual staff), there shall be personal record containing the appointment order, documentary evidence of qualification and or training (and professional registration where applicable).
For human resource requirements refer to Appendix 5
37.Support Services:
RegistrationorHelp desk and Billing:
7.1.
The hospital shall have a Registration or Help-desk & Billing counter, and the scope of this shall also include provision of patient guidance in matters like services available, cost estimation, healthcare insurance etc.
Diagnostic Services:
7.2.
Diagnostic services may be in-house or outsourced. For minimum standards for diagnostic services refer to CEA standards for Imaging and laboratory services.
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
7.3. 7.4.
Pharmacy Services 7.5.
7.6.
7.7.
7.8.
CSSD or Sterilization Area 7.9.
7.10.
Linen management: 7.11.
7.12.
Waste Management Services: 7.13.
7.14. 7.15.
Medical Gas 7.16.
7.17. 7.18. 7.19.
Ambulance services 7.20.
7.21. 7.22.
38.LegalorStatutory Requirements:
Whether in house or outsourced, the services shall fulfil the requirements of safe and timely patient care.
The diagnostic services, whether in house or outsourced, shall be commensurate with the scope of services
Pharmacy services in a hospital can be in-house or outsourced.
All applicable legal requirements shall be complied with.
Medicine storage shall be in a clean, well lit, and safe environment, and as per manufacturer’s requirements
Quality of drugs, medical devices and consumables shall be ensured
Provision for instrument and linen sterilization and storage of sterile items shall be made available as per the scope of services.
Validation of Sterilization shall be done for ensuring the effectiveness of sterilization process
Soiled linen shall be collected, transported and washed separately in clean and hygienic environment.
Where linen is contaminated, appropriate decontamination shall be carried prior to despatch for washing.
Segregation, collection, transportation, storage and disposal of biomedical waste shall be as per Bio Medical Waste Handling Rules.
Waste management guidelines shall be followed in the case of Mercury & other toxic materials as per applicable local laws.
Segregation, collection, transportation, storage and disposal of general waste shall be as per applicable local laws
Oxygen for medical use shall be available. In addition other gases like Nitrous oxide, Carbon dioxide etc. may be available in consonance with the scope of services and bed strength.
Medical gases shall be stored and handled in a safe manner.
All applicable legal requirements shall be complied with.
Appropriate back-up and safety measures shall be in place to ensure patient safety at all times.
The hospital shall have provision of transporting patients for transfer or referral or investigations etc in safe manner.
The ambulance service shall be in-house and shall comply with the applicable local laws.
Critical patient shall be transported under supervision of trained and qualified staff.
Appropriate ambulance services should be available.
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
39.Record Maintenance and reporting:
8.1
Every application must be accompanied with the documents confirming compliance with local regulations and law.
For indicative list refer to Appendix 6.
9.1
The minimum medical records to be maintained and nature of information to be provided by the Hospitals shall be as prescribed in Section 12 (1) (iii) of this Act
9.2
Medical Records may be maintained in physical or digital format.
9.3
Confidentiality, security and integrity of records shall be ensured at all times
9.4
The medical records of IPD patients shall be maintained in consonance with National or local law, MCI guidelines, and court orders.
9.5
Every Hospital shall maintain health information and statistics in respect of national programmes, notifiable diseases and emergencies or disasters or epidemics and furnish the same to the district authorities in the prescribed formats and frequency.
Content of medical record shall be as per Appendix 7
40.Basic Process:
Registration or help desk and billing services
10.39.
The hospital shall register all patients who visit the hospital except if the required services are not available in the facility, in which case the patient is guided to the appropriate nearest facility. (Please also see Emergency Services)
10.40.
Once registered, depending on the clinical need, patient is guided to appropriate service area like OPD etc
10.41.
Patient shall be guided and informed regarding Patients’ rights & responsibilities, cost estimates, third party services (e.g. Insurance) etc. (Refer Appendix 8)
10.42.
The billing shall be as per the Hospital tariff list, which shall be available to patients in a suitable format.
Assessment and Plan of care
10.43.
Each patient shall undergo an initial assessment by qualified andoror trained personnel.
10.44.
Further management of patient shall be done by a registered medical practitioner on the basis of findings of initial assessment; for example, OPD treatment, admission, transferorreferral, investigation etc.
10.45.
At the time of admission of patient, General Consent for admission shall be taken.
10.46.
In case of non-availability of beds or where clinical need warrants, the patient shall be referred to another facility along with the required clinical information or notes.
10.47.
Reassessments of the admitted patients shall be done at least once in a day andoror according to the clinical needs and these shall be documented.
10.48.
Any examination, treatment or management of female patient shall be done in
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
Informed Consent Procedure 10.49.
Care Of Patient 10.50.
10.51. 10.52. 10.53.
10.54.
Emergency Services: 10.55.
10.56.
Medication Prescription, Administration And Monitoring 10.57.
10.58.
10.59.
10.60. 10.61.
10.62.
Infection Control 10.63.
10.64.
the presence of an employed female attendant or female nursing staff, if conducted by male personnel inside the hospital and vice versa.
Informed consent shall be obtained from the patientor next of kinor legal guardian as and when required as per the prevailing Guidelines or Rules and regulations in the language patient can understand (for e.g. before Invasive procedures, anaesthesia, Blood transfusion, HIV testing, Research, etc.). Appendix 9
The Hospital shall provide care of patient as per the best clinical practices and reference may be made to Standard Treatment Guidelines as notified on the website of Clinical Establishments Act 2010.
Patient andoror families shall be educated on preventive, curative, promotive and rehabilitative aspects of care either verbally, or through printed materials.
All the relevant documents pertaining to any invasive procedures performed shall be maintained in the record, including the procedure safety checklist.
Monitoring of patient shall be done during and after all the procedures and same shall be documented (for example, after anaesthesia, surgical procedures, blood transfusion, etc).
Staff involved in direct patient care shall receive basic training in CPR
Emergency patients shall be attended on priority. The Emergency department shall be well equipped with trained staff.
If emergency services are not available in the hospital, the hospital shall provide first aid to the patients and arrange appropriate transferorreferral of the patient.
Prescription shall include name of the patient, date, name of medication, dosage, route, frequency, duration, name, signature and registration number of the medical practitioner in legible writing
Drug allergies shall be ascertained before prescribing and administration; if any allergy is discovered, the same shall be communicated to the patient and recorded in the Case sheet as well.
Patient identity, medication, dose, route, timing, expiry date shall be verified prior to administration of medication
Safe Injectionection practices shall be followed as per WHO guidelines.
High Risk Medicines shall be identified and verified by two trained healthcare personnel before administration.
Patients shall be monitored after medication administration and adverse drug reaction or events if any shall be recorded and reported.
The hospital shall follow standard precautions like practicing hand hygiene, use of personal protection equipment etc. to reduce the risk of healthcare associated infections.
10.65
The hospital shall ensure adequate and proper spacing in the patient care area so as to prevent transmission of infections.
.
Regular cleaning of all areas with disinfectant shall be done as per prescribed &
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
documented procedure.
10.66.
Prescribed & documented Infection Control Practices shall be followed in High risk areas like Operation theatre, ICU, HDU, etc as per good clinical practice guidelines.
10.67.
Housekeeping or sanitary services shall ensure appropriate hygiene and sanitation in the hospital.
Safety of the patient, staff, visitors and relative in a hospital
10.68.
Security and safety of patients, staff, visitors and relatives shall be ensured by provision of appropriate safety installations and adoption of appropriate safety measures. E.g. identification of mother and baby in obstetric facility, etc
10.69.
The Hospital shall undertake all necessary measures, including demonstration of preparedness for fire and non-fire emergencies, to ensure the safety of patients, attendants, staff and visitors.
10.70.
All applicable fire safety measures as per local law shall be adopted. This includes fire prevention, detection, mitigation, evacuation and containment measures. Periodic training of the staff and mock drills shall be conducted and the same shall be documented.
10.71.
In case of any epidemic, natural calamity or disaster, the ownerorkeeper of every Hospital shall, on being requested by the designated supervising Authority, cooperate and provide such reasonable assistance and medical aid as may be considered essential by the supervising authority at the time of natural calamity or disastrous situation
Patient Information and Education
10.72.
The patient and oror family members are explained about the disease condition, proposed care, including the risks, alternatives and benefits. They shall be informed regarding the expected cost of the treatment. They shall also be informed about the progress and any change of condition.
10.73.
Patient and or or family shall be educated about the safe and effective use of medication, food drug interaction, diet, and disease prevention strategies.
Discharge
10.74.
A Discharge summary shall be given to all patients discharged from the hospital. For content of discharge summary refer to Appendix 10.
10.75.
The discharge summary shall include the points as mentioned in the Appendix in an understandable language and format
10.76.
Discharge summary shall also be given to patient andoror attendant in case of transfer LAMAorDAMA or death.
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
APPENDIX 1
Minimum space requirements in a hospital level 3 shall be as follows:
Area (Desirable)
Wards
1.
Ward bed and surrounding space
6 sq mor bed; in addition circulation space of 30% as indicated in total area shall be provided for nursing station, ward store, sanitary etc.
Intensive Care Unit
2.
For ICUorCCUorNeurology ICUorHDUorTrauma ICUorRenal ICU bed and surrounding space
10.5 sq mor bed; in addition circulation space of 30% as indicated in the total area shall be provided for nursing station, doctors’ duty room, store, clean and dirty utility, circulating area for movement of staff, trolley, toilet etc.
Minor Operation TheatreorProcedure room
3.
OT for minor procedures
10.5 sq m; in addition circulation space of 30% as indicated in total area shall be provided for nursing station, scrub station, clean and dirty utility, dressing room, toilet etc.
Labour room
4.
Labour Table and surrounding space
10.5 sq mor labour table
5.
Other areas- nursing station, doctors’ duty room, store, Clean and dirty utility, Circulating area, Toilets
10.5 sq m for clean utility and store and 7 sq m for dirty utility and 3.5 sq m for toilet.
Operation Theatre (OT)
6.
Operating Room Area
30.5 sq m per operating room.
Emergency & Casualty (if separate):
7.
Emergency bed and surrounding space
10.5 sq mor bed: in addition circulation space of 30% as indicated in total area shall be provided for nurse station, doctor duty room store, clean and dirty utility, dressing area, toilet etc.
Pharmacy (Own or Outsourced)
8.
Pharmacy
The size should be adequate to contain 5 percent of the total clinical visits to the OPD in one session at the rate of 0.8 m2 per patient.
Bio-medical Waste
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
Other requirements:
Wards:
6. The ward shall also have designated areas for nursing station, doctors’ duty room, store, clean and dirty utility, janitor room, toilets and this shall be provided from circulation area.
7. For a general ward of 12 beds, a minimum of 1 WC and 1 hand wash basin shall be provided.
8. Distance between beds shall be 1.0 metres
9. Space at the head end of bed shall be 0.25 metres.
10. Door width shall be 1.2 metres and corridor width 2.5 metres
Intensive Care Unit:
7. The unit is to be situated in close proximity of operation theatre, acute care medical and surgical ward units.
8. Suction, oxygen supply and compressed air to be provided for each bed.
9. Adequate lighting and uninterrupted power supply shall be provided.
10. Adequate multi-sockets with 5 ampere and 15 ampere sockets and or or as per requirement to be provided for each bed.
11. Nurse call system for each bed is desirable.
12. ICU shall have designated area for nursing station, doctors’ duty room, store, clean and dirty utility, circulating area for movement of staff, trolley, toilet, shoe change, trolley bay, janitor closet etc.
Labour room:
16. The obstetrical unit shall provide privacy, prevent unrelated traffic through the unit and provide reasonable protection of mothers from infection and from cross-infection.
9.
<50 beds
5 sq m
10.
50-100 beds
10 sq m
11.
>100 beds
20 sq m
Other functional areas (laboratory, diagnostics, front officeorreception, waiting area, administrative area etc) should be appropriately sized as per the scope of service and patient load of the hospital.
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
17. Measures shall be in place to ensure safety and security of neonates.
18. Resuscitation facilities for neonates shall be provided within the obstetrical unit and convenient to the delivery room.
19. The labour room shall contain facilities for medication, hand washing, charting, and storage for supplies and equipment.
20. The labour room shall be equipped with oxygen and suction
Operation Theatre
10. The operation theatre complex shall have appropriate zoning.
11. The operation theatre complex shall provide appropriate space for other areas- nursing station, doctors’ duty room, scrub station, sterile store, Clean and dirty utility, Dress change room, Toilets. Following zoning is recommended: –
a. Sterile area – consists of operating room sterile store and anesthesia room
b. Clean zone- consists of equipment or medical store, scrub area, pre and or or post-operative area and linen bay.
c. Protective zone- consists of change room, doctors’ room and toilets.
d. Dirty area.
e. Due considerations are to be given to achieve highest degree of asepsis to
provide appropriate environment for staff and patients.
12. Doors of pre-operative and recovery room are to be 1.5 m clear widths.
13. Air Conditioning to be provided in all areas. Window AC and split units should preferably be avoided as they are pure re circulating units and become a source of infection.
14. Appropriate arrangements for air filtration to be made.
15. Temperature and humidity in the OT shall be monitored.
16. Oxygen, Nitrous Oxide, suction and compressed air supply should be provided in all OTs.
17. All necessary equipment such as shadow-less light, Boyle’s apparatus shall be available and in working condition.
18. Uninterrupted power supply to be provided.
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
Note: For Eye Hospitals only where procedures are done in local and oror regional anaesthesia, Minor OT criteria may be applicable.
Emergency room
26. Emergency bed and surrounding space shall have minimum 10.5 sq mor bed area.
27. There shall be designated space for nurse station, doctor duty room store, clean and dirty utility, dressing area, toilet etc.
Clinical Laboratory (own orOut sourced)
2. The laboratory area shall be appropriate for activities including test analysis, washing, biomedical waste storage and ancillary services like Storage of records, reagents, consumables, stationery etc eating area for staff.
Imaging (own orOutsourced)
5. The department shall be located at a place which is easily accessible to both OPD and wards and also to emergency and operation theatre.
6. As the department deals with high voltage, presence of moisture in the area shall be avoided.
7. The size of the department shall depend upon the type of equipment installed.
8. The departmentorroom shall have a sub-waiting area preferably with toilet facility and a change room facility, if required.
Central Sterilization and Supply
4. Department (CSSD) — Sterilization, being one of the most essential services in a hospital, requires the utmost consideration in planning.
5. Centralization increases efficiency, results in economy in the use of equipment and ensures better supervision and control.
6. The materials and equipment dealt in CSSD shall fall under three categories: a) Those related to the operation theatre department,
b) Common to operating and other departments, and
c) Pertaining to other departments alone.
Other Departments
Other departments shall have appropriate infrastructure commensurate to the scope of service of the hospital.
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
APPENDIX 2 FURNITURE AND FIXTURES:
ARTICLES
Examination Table Writing tables Chairs
Almirah
Waiting Benches
MedicalorSurgical Beds
Labour Table- if applicable
Wheel ChairorStretcher
Medicine Trolley, Instrument Trolley Screensorcurtains
Foot Step
Bed Side Table
Baby Cot- if applicable
Stool
Medicine Chest
Examination Lamp
View box
Fans
Tube Lightor lighting fixtures
Wash Basin
IV Stand
Colour coded bins for BMW
*this is an indicative list and the items shall be provided as per the size of the hospital and scope of service.
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
APPENDIX 3 EQUIPMENTS
g. Emergency Equipment
S.No.
Name of Emergency Equipment
1
Resuscitation equipment including Laryngoscope, endotracheal tubes, suction equipment, xylocaine spray, oropharyngeal and nasopharyngeal airways, Ambu Bag- Adult & Paediatric (neonatal if indicated)
2
Oxygen cylinders with flow meteror tubingorcatheterorface maskornasal prongs
3
Suction Apparatus
4
Defibrillator with accessories
5
Equipment for dressingorbandagingorsuturing
6
Basic diagnostic equipment- Blood Pressure Apparatus, Stethoscope,, weighing machine, thermometer(Non mercury)
7
ECG Machine
8
Pulse Oximeter
9
Nebulizer with accessories
h. Other equipment and consumables, which shall also be available in good working condition as per the scope of services and bed strength (some of the emergency equipment are already mentioned above).
Department
Equipment
Level 1A
Level 1B
Level 2
Level 3
NON MEDICAL
Administration
Office equipment
Yes
Yes
Yes
Yes
Office furniture
Yes
Yes
Yes
Yes
Electricity
Emergency lights
Yes
Yes
Yes
Yes
Water Supply
Hand-washing
Yes
Yes
Yes
Yes
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
Waste Disposal
sinksortapsorbowls on stands in all areas Storage tank
Water purification chemicals or filter Water source for drinking water
Buckets for contaminated waste in all treatment areas Drainage system Rubbish bins in all rooms
Sanitation facilities for patients
Separate Bio-medical waste disposal Sharps containers in all treatment areas
Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes
Desirable Desirable Yes Yes
Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes
Safety
Fire extinguisher Vehicle (OwnorOutsourced)
Vehicle wheeler Ambulance
Lockable storage
4
Medical Stores
Refrigeration Kitchen (OwnorOutsourced)
Cooking pots and utensils
Cooking stove
Food refrigeration Plates, cups & cutlery
Storage
Washing and drying area facilities
Laundry (OwnorOutsourced) Detergentorsoap
Washing and rinsing equipmentorbowls
Yes
Yes
Yes
Yes
Housekeeping Brooms, brushes and
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
mops
Housekeeping (OwnorOutsourced)
Outpatient Rooms
MEDICAL
Yes Yes
Yes
Yes
Yes Yes Yes Yes
Yes Yes
Buckets
Soap and disinfectant
Yes
Yes
Yes
Yes
Yes
Yes
Non Mercury Blood Pressure Apparatus and stethoscope
Yes Yes
Yes
Yes
Yes Yes Yes Yes
Yes Yes
Container for sharps disposal
Yes Yes
Desk and chairs
Yes Yes
Examination gloves
Yes Yes
Examination table
Yes Yes
Hand washing facilities
Minor surgical instruments
Yes Yes
Light source
Yes Yes
No Yes
Ophthalmoscope
No No
Otoscope
No No
e)
Patellar hammer
Separate biohazard disposal
Thermometer (Non mercury)
Yes Yes
Receptacle for soiled pads, dressings, etc.
Yes Yes
Yes Yes
Sterile equipment storage
Yes Yes
Sutures
Yes Yes
Yes Yes
Torch with extra batteries
Yes Yes
Weighing scale
Yes Yes
Women and Child health examination room
Yes (as Yes applicabl
e)
Yes (as Yes applicabl
Yes Yes Yes Yes
Yes Yes Yes Yes
Yes Yes Yes Yes
Yes Yes Yes Yes
Yes Yes
Non Mercury Blood Pressure Apparatus and stethoscope
Yes
Yes
Yes
Yes
Contraceptive supplies
Birth register
Yes Yes
Yes
Yes
Yes
Yes
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
Examination gloves Yes Yes
Examination table with Yes Yes Yes Yes stirrups
Fetal stethoscope No Yes
Doppler No No No Yes
Yes Yes
Yes Yes
Hand washing facility Yes Yes
Height measure Yes Yes Yes Yes
Yes Yes
IUD insertion set Yes Yes
Pregnant woman Yes Yes Yes Yes Register
Speculum and vaginal Yes Yes
examination kit
Syringes and needles Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes
Tape measure Yes Yes
Tococardiograph No Yes Yes Yes
Labour room
Baby scales Yes Yes Yes Yes
Non Mercury Blood Yes Yes
Pressure Apparatus and
stethoscope
Clean delivery kits and Yes Yes Yes Yes cord ties
Yes Yes
Curtains if more Yes Yes than one bed
Delivery bed and bed Yes Yes linen
Yes Yes Yes Yes Yes Yes
Fetal stethoscope Yes Yes
Hand washing facility Yes Yes Yes Yes
Instrument trolley Yes Yes
Latex gloves and Yes Yes protective clothing
Mucus extractor Yes Yes
Oxygen Yes Yes cylinderor
concentrator
Self inflating bag and Yes Yes mask – adult and
neonatal size
Suturing sets Yes Yes
Yes Yes Yes Yes
Yes Yes Yes Yes
Yes Yes
Yes Yes
IV treatment sets
Yes
Yes
Yes
Yes
Linens for newborns Yes Yes
Yes
Yes
Oral airways, various sizes
Yes
Yes
Yes
Yes
Partograph charts
Suction machine
Thermometer (Non
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
Inpatient Wards
Yes Yes
Yes Yes
Yes Yes Yes Yes
Yes Yes
Yes Yes
Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes
Yes Yes
Yes Yes
Yes Yes Yes Yes
Yes Yes
Yes Yes
Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes
Operation Theatre
If available
Yes Yes Yes Yes Yes Yes
Yes Yes Yes No Yes
No Yes Yes Yes Yes
mercury)
Tray with routine & emergency drugs, syringes and needles
Urinary catheters and collection bags
Vacuum extractor set
Work surface near bed for newborn resuscitation
Basic examination equipment (stethoscope, Non mercury BP Apparatus (etc)
Beds, washable mattresses and linen
Curtains
Dressing sets
Dressing trolleyor Medicine trolley
Gloves
IV stands
Medicine storage cabinet
Oxygen cylinder and concentrator
Patient trolley on wheels
PPE kits
Suction machine
Urinals and bedpans
Adequate storage
Yes
Ambu resuscitation set with adult and child masks
Yes
Defibrillator
Electro cautery
Yes
Yes
No
Fixed operating lights
No
No
Fixed suction machine
No
Hand washing facilities
Yes
Yes
Yes
Yes
Instrument tray
Yes
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
Yes
Yes
Yes
Yes
Yes (as applicabl e)
Yes
Yes
Yes
Yes
Yes Yes
Yes Yes
Yes
Yes Yes No
Desirable Desirable
Desirable No
Yes
Yes
Yes
Yes
Yes
Yes
Yes (as applicable )
Yes
Yes
Yes
Yes
Yes Yes
Yes Yes
Yes
Yes Yes Yes
Yes Yes
Yes Yes Yes
Yes
Instrument trolley
Yes Yes
Laryngoscope set
No
Mayo Stand
Yes Yes
Mobile operating light
Yes Yes
Ophthalmic Operating Microscope
No No
Oral airways, various sizes
No No
Oxygen cylinder and concentrator
Yes Yes
Patient trolley on wheels
Yes Yes
Portable suction machine
Yes Yes
Safety Box
No
Sphygmomanometer (Non Mercury) and stethoscope
Yes Yes
Stool adjustable height
No Yes
Operating table
No Yes
IV Therapy Equipment
No
Anesthesia Equipment Anesthetic trolleyor machine
No Yes
CO2 Monitor
No No
O2 Monitor
No No
Endoscopic equipment and necessary accessories
No No
Bronchoscope
No No
Colonoscope
No No
Endoscope
No
No
Desirable
Yes
Fiber Optic Laryngoscope
No No
Central Supply
Amputation set
No No
Caesareanor hysterectomy set
Endoscopic instrument cleaning machines
and solutions
No
No
Yes
Yes
Dilatation and curettage set
No No
No
No
No
Yes
Hernia set
No No
Laparotomy set
No
No
Yes
Yes
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
Linens
Yes
Yes
Yes
Yes
Locked storage
Yes
Yes
Yes
Yes
Operating drapes
No
Yes
Yes
Yes
Ophthalmic instrument
No
No
Yes
Yes
Protective caps, aprons, shoes and gowns etc.
Yes
Yes
Yes
Yes
Pelvicor fistula repair set
No
No
No
Yes
Sterile gloves
Yes
Yes
Yes
Yes
Sterilization equipment for instrument and linens
Yes
Yes
Yes
Yes
Surgical supplies (e.g., sutures, dressings, etc.)
Yes
Yes
Yes
Yes
Thoracocentesis set
No
No
No
Yes
Thoracostomy set with appropriate tubes and water seal bottles
No
No
No
Yes
Thoracotomy set
No
No
No
Yes
Thyroidor Parathyroid set
No
No
No
Yes
Tracheostomy set
No
No
Yes
Yes
Tubal ligation set
No
No
Yes
Yes
Vascular repair set
No
No
Yes
Yes
Other equipment as per the specialized services available shall also be there
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
APPENDIX 4
DRUGS, MEDICAL DEVICES AND CONSUMABLES
Name of the Drug
INJECTIONECTIONS
INJECTION. DIAZEPAM 10 MG INJECTION. FRUSEMIDE 20 MG INJECTION. ONDANSETRON 8 MGor4ML INJECTION. RANITIDINE
INJECTION NOR ADRENALINE 4 MG INJECTION. PHENYTOIN 50 MG
INJECTION DICLOFENAC 75 MG
INJECTION. DERIPHYLLINE
INJECTION CHLORPHENIRAMINE MALEATE INJECTION. HYDROCORTISONE 100 MG INJECTION. ATROPINE 0.6 MG
INJECTION. ADRENALINE 1 MG INJECTION. KCL
STERILE WATER
INJECTION. SODA BICARBONATE INJECTION. DOPAMINE INJECTION. NALAXONE 400 MCG INJECTION. LIGNOCAINE 50 ML TAB. SORBITRATE
TAB. ASPIRIN INJECTION. TETANUS
h. List of Emergency Drugs and consumables (Essential in all hospitals)
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
INJECTION. ADENOSINE
OTHER
NEB. SALBUTAMOL2.5 ML
NEB. BUDESONIDE
LIGNOCAINE JELLY 2%
ACTIVATED CHARCOAL
CALCIUM (INJECTION or TAB)
FLUIDS
RL 500 ML
NS 500 ML
NS 250 ML
NS 100 ML
DNS 500 ML
DEXTROSE 5% 500 ML
DEXTROSE 10% 500 ML
PEDIATRIC IV INFUSION SOLUTION 500 ML
i. The other drugs and consumables shall be available as per the scope of services, bed strength and patient turnover.
j. Medical devices shall be available as per the scope of services, bed strength and patient turnover.
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
APPENDIX 5
HUMAN RESOURCE
The Human Resource requirement for any hospital shall be as per the scope of services provided by the hospital.
The requirement mentioned below is the minimum requirement for a multispecialty hospital with less than 50 beds and it can be prorated as required.
Based on the levels of care provided, the minimum staffing requirements for Hospital level 3 shall be as follows:
Human Resource
Requirement
Doctor
MBBS doctor shall be available round the clock on site per unit
Availability of specialist and super specialist as per the Minimum standards of that specialty.
In ICU, 1 MBBS for every 6 beds, on- site for 24X7
Nurses
Qualified nurses per unit per shift shall be available as per requirement laid down by “The Indian Nursing Council, 1985”, occupancy rate and distribution of bed.
Pharmacist
2 in a hospital
Lab Technician
2 in a hospital (minimum DMLT)
X-ray Technician
2 in a hospital (minimum Diploma in X Ray Technician course)
Other Technicians
As per requirement
Nutritionist
As per requirement
Social worker
As per requirement
Administrative Assistant
As per requirement
Medical Record Technician
As per requirement
Driver
As per requirement
Security Guard
As per requirement
Multi-purpose Worker
Minimum 2 (minimum 12th pass)
Requirement of other staff (Support and administrative) will depend on the scope of the hospital.
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
APPENDIX 6
LIST OF LEGAL REQUIREMENTS
Below is the list of legal requirements to be complied with by a hospital as applicable by the localorstate health authority (all may not be applicable):
Sl.
Name of Document
Valid From
Valid Till
Send for renewal by
Remark
(Expiredor validorNA)
1.
Registration under Nursing Home Actor Medical Establishment Act
2.
Bio-medical Waste Management Licenses
Authorization of HCO by PCB
MOU with Vendor
3.
AERB Licenses
Type approval
Layout Approval
License for CT- interventionalor Registration for other machines
4.
NOC from Fire Department
5.
Ambulance
Commercial Vehicle Permit
Commercial Driver License
Pollution Control Licenses
6.
Building Completion Licenses
7.
Lift licenses for each lift
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
8.
9. 10.
11. 12. 13.
14.
15. 16.
17. 18. 19. 20. 21. 22.
23. 24. 25.
26. 27.
DG Set Approval for Commissioning
Diesel Storage Licenses
Retail and bulk drug license (pharmacy)
Food Safety Licenses
Narcotic Drug Licenses
Medical Gases Licensesor Explosives Act
Clinical Establishments and Registration (if applicable)
Blood Bank Licenses
MoU or agreement with outsourced human resource agencies as per labor laws
Spirit License
Electricity rules
Provident fundorESI Act
MTP Act
PNDT Act
Transplantation of Human organs Act
Sales Tax registration
PAN
No objection certificate under Pollution Control Act (AirorWater)
Wireless operation certificate from Indian P&T
Arms Act, 1950 (if guards have
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
APPENDIX 7 CONTENT OF MEDICAL RECORD
Medical record shall contain, at the least, the following information:
weapons)
Content
Name & Registration number of treating doctor
Name, demographic details & contact number of patient
Relevant Clinical history, Assessment and re-assessment findings, nursing notes and Diagnosis
Investigation reports
Details of medical treatment, invasive procedures, surgery and other care provided
Applicable consents
Discharge summary
Cause-of-death certificate & Death Summary (where applicable)
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
APPENDIX 8 Patients’ rights and responsibilities:
A patient and hisorher representative has the following rights with respect to the clinical establishment-
70. To adequate relevant information about the nature, cause of illness, proposed investigations and care, expected results of treatment, possible complications and expected costs;
71. Rate of services provided by the clinical establishment would be displayed prominently.
72. To access a copy of case papers, patient records, investigations reports and detailed bill
73.To informed consent prior specific testsortreatment (e.g. surgery, chemotherapy)
74. To seek second opinion from an appropriate clinician of patients’ choice, with records and information being provided by treating hospital
75. To confidentiality, human dignity and privacy during treatment.
76. To have ensured presence of a female person, during physical examination of
a female patient by a male practitioner
77. To non-discrimination about treatment and behaviour on the basis of HIV
status
78. To choose alternative treatment if options are available
79. Rate of services provided by the clinical establishment would be displayed
prominently.
Provide all health related information
Cooperate with Doctors during examination, treatment
Follow all instructions
Pay hospitals agreed fees on time
Respect dignity of doctors and other hospital staff
Never resort to violence
Patients’ Rights
Patients’ Responsibilities
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
APPENDIX 9
INFORMED CONSENTorCONSENT GUIDELINES
The informed consent shall at the least contain the following information in an understandable language and format.
Content
Name of the patientor guardian (in case of minorormentally disabled).
Registration number of patient
Date of admission
Name & Registration number of treating doctor
Name of procedureoroperationorinvestigationorblood transfusionoranaesthesiaor potential complications
Signature of patientorguardian with date and time
Clinical Establishment Act Standards for Hospital (LEVEL 3)
CEAorHospital- 003
APPENDIX 10 DISCHARGE SUMMARY
The discharge summary shall at the least contain the following information in an understandable language and format.
Content
Name & Registration number of treating doctor
Name, demographic details & contact number of patient, if available
Date of admission and discharge
Relevant clinical history, assessment findings and diagnosis
Investigation results,
Details of medical treatment, invasive procedures, surgery and other care provided
Discharge advice (medications and other instructions).
Instruction about when and how to obtain urgent care.
Clinical Establishment Act Standards for Dental Laboratory
CEA orDental Lab
Clinical Establishment Act Standard for
Dental Lab Standard No.CEA or Dental Lab
Clinical Establishment Act Standards for Dental Laboratory
MINIMUM STANDARDS FOR DENTAL LABORATORY
CEA orDental Lab
DEFINITION Dental laboratory
SCOPE of SERVICES PROVIDED
Will provide laboratory work pertaining to different specialities of dentistry
PHYSICAL INFRASTRUCTURE
1 Walls shall be painted with proper quality paint with no sharp edges; floors shall be made of easily washable material e.g. ceramic tiles.
2 Proper day lighting and ventilation within the laboratory
3 Specified place to mould the metal (specially Crowns, bridges, chrome cobalt) and shall include the following machines:
Casting machine for casting all dental alloy
Preheating furnace.
Wax elimination furnace.
Soldering unit.
4 Specific place to mould ceramics that is isolated from the Laboratory other parts and dust protection (ante-dust). Shall include the following machines:
Porcelain furnace
Ultra sonic unit
5 Specified place for polishing process that includes the following:
Polishing unit for dry and wet polish.
Electrolytic polishing unit.
High-speed grinder.
6 Specified place that includes the following:
Polymerization unit.
Flask press.
Boil – out unit
7 Specified place for Models that includes the following:
Model trimmer (single or double disc).
Vibrator.
Plaster dispenser.
Model duplicate unit
8 Staff room or area
9 Store to keep the Laboratory materials
10 Aroomforthetechnicalincharge(optional)
11 Generalsafetyandsecurityconditionstobeprovidedinthebuildingandfirefighthoses
12 Dedicated area for storing records
OUTSIDE SIGNAGES
name of the dental laboratory
INSIDE SIGNAGES
Name of laboratory technician
working hours
Services provided
Charges of the services offered
INFRASTRUCTURE CONSIDERATIONS
• floors and walls – these must be non-porous, without carpets, smooth and easily cleaned
Clinical Establishment Act Standards for Dental Laboratory
CEA orDental Lab
• Lighting:
Provide a proper lighting for the working tables and working area and natural lighting for the ceramics room area to differentiate the ceramics colours.
Working table requirements and specifications:
1 A hard stone surface
2 Bench with light
3 Suction unit for dust extraction.
4 Drawers
5 Hand piece and controller
6 Bunsen burner
7 Laboratory chairs
WATER DRAINAGE
1 Water drainage system shall be wide enough to allow easy passage of water and be clean
2 Special filters shall be placed under the basins to collect all dirt and left over of plaster so as to prevent it from going through the drainage system
VENTILATION:
1 Providing suctioning fans to refine the atmosphere
2 Premises provided with special suctions placed above the thermal ovens to suck the
ascending vapours and gases out of the ovens
3 Dental laboratory technicians work in clean, well-lighted, and well-ventilated areas. Technicians can have their own workbenches, which can be equipped with Bunsen burners, grinding and polishing equipment, and hand instruments, such as wax spatulas and wax carvers.
SAFETY CONDITIONS:
1 Make the Emergency Exits in the building free of obstacles
2 Providing fire-extinguisher
3 Laboratory floor shall be made of anti-fire ceramics
4 Provide the Laboratory with fire alarms
HUMAN RESOURCES
TECHNICAL STAFF
2. LABORATORY TECHNICIAN registered with the dental council of India.
NON TECHNICAL STAFF
GRADE IV staff employed full timeorpart timeoroutsourced.
Periodic health check up, vaccination of staff
Once in a year health check up of all the staff.
Mandatory hepatitis B vaccination of the staff.
Clinical Establishment Act Standards for Dental Laboratory
CEA orDental Lab
EQUIPMENT (FUNCTIONAL)
10. Hand piece and controller
11. Bunsen burner
12. Casting machine for casting all
dental alloy
13. Preheating furnace.
14. Wax elimination furnace.
15. Soldering torch
16. Porcelain furnace
17. Ultra sonic unit
18. Polishing unit for dry and wet
polish.
19. Electrolytic polishing unit.
20. High-speed grinder.
21. Polymerization unit.
22. Flask press.
23. Boil – out unit
24. Model trimmer (single or double
disc).
25. Vibrator.
26. Plaster dispenser.
27. Model duplicate unit
28. Consumables- should be available
in adequate number.
Facemask
Gloves
Dental plaster
Dental stone
Die stone
Modelling wax
Impression compound
Sticky wax
Anatomic ,semianatomic
and flat denture teeth
Cold cure resin powder
and liquid
Heat cure resin powder
and liquid
Self cure and light cure
composite resin
Stainless steel wires-19
gauge to 23 gauge
Soldering flux
QUANTITY 1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
SUPPORT SERVICES
BMW MANAGEMENT
Segregation of waste should be done in black, yellow, red and blue bags. It is mandatory to segregate the waste at the site of waste generation.
Contract for disposal of BMW should be
Clinical Establishment Act Standards for Dental Laboratory
CEA orDental Lab
given to government environmentorCPCB.
a company approved by of Indiaor ministry of
There should be a written contract for BMW management along with the economy involved.
Logbook should be maintained mentioning weight of the waste(infected) and date on which waste (neworold) was lifted.
RECORD MAINTENANCE AND REPORTING
Daily record keeping for mentioning lab work rendered along with charges.
STANDARDS ON BASIC PROCESSESES
INFECTION CONTROL
There must be good supply of clean water, through a quality piping that support good
water hygiene
All general purpose cleaning equipment and agents should be stored in a separate part of
the premises
There must be a specific space (not less than 1.5 sq. meter) for cleaning and sterilisation
of dental instruments and should not be used other than above.
Use trash bin lined with commercial color coded plastic bag for the medical waste
Keep cleaning equipment always in a very clean condition before use; type of floor
sanitizing and cleaning agents must be approved for clinical use.
There should be no cotton or wool fabric curtains in dental labs.
Non-wooden storage cabinet shall be used for storing cleaning equipment and agents labcoats,gowns,facemask,glovesetc shouldbeutilized.
FACILITIES FOR HAND WASHING
Hand-washing facilities must not be combined with sinks used for other purposes, such as decontamination and instrument cleaning.
FACILITIES FOR STERILIZATION
Disinfectants- 2 percent glutaraldehyde, sodium hypochlorite, chlorhexidine etc
POLICY ON OUTSOURCED SERVICES
cleaning staff and pest control are some of the other services which can be outsourced
Clinical Establishment Act Standards for Dietetics
CEAorDietetics
Clinical Establishment Act Standard for
Dietetics
Standard No. CEA orDietetics
Clinical Establishment Act Standards for Dietetics
CEAorDietetics
Table of Contents
Sr. No.
Particulars
Page No.
1.
Definition
3
2.
Scope
4
3.
Infrastructure
4
4.
Equipments orInstruments
5
5.
Human Resources
5
6.
Record Maintenance and Reporting
6
7.
Basic Process
6
8.
Appendix 1
7
9.
Appendix 2
8
10.
Appendix 3
9
Clinical Establishment Act Standards for Dietetics
1. Definition
CEAorDietetics
Dietary Counseling Centre
A dieteticsclinicorpolyclinicor center may be defined as a clinical establishment providing consultation to outpatients orinpatients by Dietician (s) or Clinical Nutritionist (s).
Dietary counseling provides personalized nutritional care for encouraging modification of eating habits. It may also assist in prevention or treatment of nutrition-related illnesses such as cardiovascular disease, cancer, obesity, diabetes, and hyperlipidemia. It also involves meal planning for the patient.
It can be a stand-alone unit, or a part of polyclinicorhospital.
2. Scope (as applicable)
2.1 These set of common minimum standards framed are applicable to a single practitionerormore than one Dietician or Clinical Nutritionist or a group of Dietician or Clinical Nutritionist who are themselves providing patient care services like:
a) Nutritional Assessment
b) Prescribing specific Diets, health or Nutritional Supplements
c) Health Education and Health Promotion related to nutritional aspect of health care.
3. Infrastructure Requirements
3.1. Facility
3.1.1 The physical facility shall be developed and maintained to provide safe and secure environment for patients, their families, staff and visitors.
3.1.2 The minimum space requirement for carrying out the basic functions of the facility shall be as per Appendix 1.
3.1.3 The area should be well illuminated, ventilated and clean with adequate water supply.
Clinical Establishment Act Standards for Dietetics
3.2. Signage
3.2.1 The centreorclinic shall have a prominent boardorsignage displaying the name of the clinic in local language at the gate or on the building of the clinic.
3.2.2 The following other signage shall be well displayed in the language understood by the local public in the area:
a) Name of the Clinical Nutritionist(s)
b) Fee structure of the various services
c) Timings of the clinics (For e.g.: From 8am -2pm)
d) Services provided within the facility
3.3. Furniture & Fixtures
3.3.1 Furniture and fixtures shall be available in accordance with the activities and workload of the Clinicor Polyclinic.
3.3.2 The furniture and fixtures shall be functional.For indicative list of items refer toAppendix 2. This list is indicative and not exhaustive.
4. EquipmentsorInstruments
4.1 Equipment’s shall be of adequate capacity to meet workload requirement.
4.2 All equipment shall be kept in good working condition.
4.3 Periodic inspection, cleaning, maintenance of equipment should be done. An equipment logbook should be maintained for all major equipment. For indicative list for equipmentorinstrument refer toAppendix 3. This list is indicative and not exhaustive.
5. Human Resources
CEAorDietetics
Clinical Establishment Act Standards for Dietetics
5.1 Clinical NutritionistorDietician shall have graduate or postgraduate in Food & Nutrition from a recognized instituteoruniversity as applicable.
5.2 Personnel record containing personal and professional information shall be maintained for each staff.
5.3 Periodic skill enhancementorup gradation orrefresher trainings shall be provided for all categories of the staff relevant to their job profile.
6. Record Maintenance and Reporting
6.1 The Dietary center orclinic shall have the following forms:
a) Nutritional Assessment Forms
b) Diet Charts
c) Patient education Materials
6.2 Every centreorclinic shall maintain medical records of patients treated by it and health information and statistics in respect of national programmes and furnish the same to the district authorities in form of quarterly reports.
6.3 Copies of all records and statistics shall be kept with the clinical establishment concerned for at least 3 or 5 years or in accordance with any other relevant Act in force at the time under Section 12(1) (iii) of CEA 2010).
6.4 Records shall be maintained in physical or digital format.
6.5 Confidentiality, security and integrity of records shall be maintained.
7. Basic Processes
7.1 Registration
7.1.1 Every patient visiting the dietary clinicorpolyclinic shall be registered on each visit.
7.2Assessment
CEAorDietetics
Clinical Establishment Act Standards for Dietetics
CEAorDietetics
7.2.1 Each patient shall undergo nutritional assessment and the same should be documented.
7.2.2 During assessmentorre-assessment, the patient findings shall be co-related with the nutritional advice, which includesmedications, investigations, food drug interactionsorallergies etc.
7.2.3 Prescription in form ofDiet Charts andoror Nutritional or Health Supplements based on Clinical Evaluation shall be given to patient and documented.
7.3.Clinical Records
7.3.1. A copy of OPD Records shall be maintained.
Clinical Establishment Act Standards for Dietetics
APPENDIX 1
Minimum infrastructure requirements shall be as follows (Desirable):
CEAorDietetics
SN
LOCATION
AREA REQUIRED
REMARKS
1
Common area (Reception and waiting)
20 sq ft carpet area
2
Consultation room (ancillary area)
50 sq ft carpet area including storage
Area specified under consultation room is only for single clinic and shall be multiplied accordingly by the number of consultation chambers.
*Reception, waiting, consultation room etc shall be adequate as per the requirement and workload of the clinic.
Clinical Establishment Act Standards for Dietetics
APPENDIX 2
Furniture and Fixtures
CEAorDietetics
Articles
1
Table
2
Chairs
3
Computer or Lap Top with Printer facility (optional)
4
Storage Cabinet for records
Clinical Establishment Act Standards for Dietetics
Equipments
APPENDIX 3
CEAorDietetics
S.No.
Equipments
1
Body Composition Analysis Machine or BMI Machine
2
Height and Weight Scale or Weighing Machine
Clinical Establishments Act Standards for Integrated Counselling and Testing Centre CEA orICTC
Clinical Establishments Act Standard for
Integrated Counselling and Testing Centre
Clinical Establishments Act Standards for Integrated Counselling and Testing Centre CEA orICTC
Table of Contents
Page No.
Sr. No.
Particulars
1. Definition 2. Scope
3. Infrastructure
4. Human Resource
5.
6. 7.
EquipmentorInstrumentsorConsumables
Support Service LegalorStatutory Requirements
8. Record Maintenance and Reporting
9.
Others
Appendix 2 Appendix 3 Appendix 4 Appendix 5
References
10.
11. Appendix 1
12.
13. 14. 15.
16 Glossary
Clinical Establishments Act Standards for Integrated Counselling and Testing Centre CEA orICTC
1. Definition:
1.1 An integrated counselling and testing centre is a place where a person is counselled and tested and checked for HIV, Tuberculosis, ANC and postnatal follow up on his own free will or as advised by a medical provider.
1.2 An ICTC shall be located in health facilities owned by the government, in the privateornot for-profit sector, in public sector organizationsorother government departments such as the Railways, Employees’ State Insurance Department (ESID), etc. and in sectors where nongovernmental organizations (NGOs) have a presence.
1.3 In the health facility, the ICTC shall be well coordinated with the Department of Medicine, Microbiology, Obstetrics and Gynecology, Pediatrics, Psychiatry, Dermatology, Preventive and Social Medicine, etc.
2. Scope
2.1 Provision of basic information on modes of transmission and prevention of HIVorAIDS, ANC for promoting behavioral change and reducing vulnerability.
2.2 Preventive health education.
2.3 Psychosocial support.
2.4 Referral and linkages.
2.5 Monitoring and supervision.
2.6 Training of existing staff.
2.7 ICTCs can be classified into two types:
a) Fixed-facility ICTCs
b) Mobile ICTCs
2.8 Fixed-facility ICTCs:
2.8.1 Fixed-facility ICTCs are those that are located within an existing health-care facilityor hospitalorcentre.
Clinical Establishments Act Standards for Integrated Counselling and Testing Centre CEA orICTC
2.8.2 A fixed-facility ICTC can be of two types:
a) “Stand-alone”: ICTC having a full-time counsellor and laboratory technician who undertake HIV counselling and testing. Such facilities exist in medical colleges and district hospitals, and in some sub district hospitals.
b) “Facility-integrated”: ICTC which does not have full-time staff and provides HIV counselling and testing as a service along with other services. Existing staff such as the auxiliary nurse midwife (ANM)orstaff nurseorhealth visitororlaboratory technician (LT)orpharmacist are expected to undertake HIV counselling and testing. Such ICTCs will usually be established in facilities that do not have a very large client load and where it would be uneconomical to establish a stand-alone ICTC.
c) Such facilities are 24-hour PHCs as well as private sectorornot-for-profit hospitals, private laboratories, public sector organization-run hospitals or facilities, and in the NGO sector.
2.9 Mobile ICTCs
2.9.1 Mobile ICTCs is the one which take healthservices into the community.
2.9.2 A mobile ICTC is a temporary clinic with flexible working hours in hard-to-reach areas, where services are provided ranging from regular health check-up, syndromic treatment for STIorreproductive tract infection (RTI) and other minor ailments, antenatal care, immunization, as well as HIV counselling and testing services.
2.9.3 Mobile ICTCs can thus cater to a larger audience and be a more effective preventive intervention by ensuring the reach of services.
3. Infrastructure Requirements
3.1 The ICTC centre shall have all appropriate signage in at least local languages.
3.2 The building shall have sign board displaying Integrated Counselling and Testing Centre at prominent location.
3.3 NACO logo shall be used for illiterate clients to locate the ICTC.
3.1. Signage
Clinical Establishments Act Standards for Integrated Counselling and Testing Centre CEA orICTC
3.3.1 Following informative signage shall be displayed: Registration details of the ICTC as applicable
a. Timings of the facility and services
3.3.2 Following safety signage shall be displayed: a) Appropriate fire exit signage.
b) Signage for no smoking in prominent places.
3.4 Facility Premises
3.4.1 In a facility, the ICTC shall be located in a place that is easily accessible and
visible to the public.
3.4.2 The ICTC shall consist of a counselling room and a blood collection and testing room.
3.4.3 The counselling room shall be an enclosed space, ideally 10′ X 10′ in area so that one-on-one and one-on-group counselling sessions may be undertaken in an atmosphere of privacy.
3.4.4 The blood collection room shall have an area of at least 10′ x 10′. Blood testing could be done either in the blood collection room or in the main laboratory of the facility.
3.4.5 The facility shall be developed and maintained to provide safe, clean and hygienic environment for clients, their families, staff and visitors.
3.4.6 The facility shall be well illuminated and ventilated.
3.4.7 The facility shall have provision of water and electricity through regular or alternate sources.
3.4.8 The facility shall provide appropriate privacy during provision of services.
3.4.9 The facility shall have provision for hand washing arrangements.
3.4.10 The facility shall have appropriate communication facilities like telephone, internet etc.
3.4.11 A mobile ICTC shall consist of a van with a room to conduct a general
Clinical Establishments Act Standards for Integrated Counselling and Testing Centre CEA orICTC
examination and counseling, and a space for the collection and processing of blood samples, etc.
3.4.12 Mobile ICTC shall have a team of paramedical health-care providers (a health educatororANM, counselor and Lab Technician).
Refer Appendix 1 for norms for setting up an ICTC.
3.5 Furniture and Fixtures
3.5.1 Furniture and fixtures shall be available in accordance with the activities and
workload of the ICTC,
3.5.2 The furniture and fixtures shall be functional. For indicative list of items refer to Appendix 2 (This list is indicative and not exhaustive).
4. Human Resource Requirement
4.1 The ICTC shall have qualified andoror trained staff as per the scope of services provided.
4.2 Personnel record containing personal and professional information shall be maintained for each staff.
4.3 Periodic skill enhancementorup gradation orrefresher trainings shall be provided for all categories of the staff relevant to their job profile.
4.4 All health care staff shall be made aware of the hospital Post Exposure Prophylaxis (PEP) procedures and the name and contact information of the PEP focal pointorperson as well as the location where the PEP drugs are stored. For Human Resource requirement refer to Appendix 3.
5. EquipmentorInstrumentsorConsumables
5.1 The centre shall ensure that the minimum space, as well as equipment and communication material required for an ICTC is provided.
5.2 The centre shall ensure that blood testing is done either in the blood collection room or in the main laboratory of the facility.
5.3 The centre shall ensure that adequate equipment is available to meet the work load requirement.
Clinical Establishments Act Standards for Integrated Counselling and Testing Centre CEA orICTC
5.4 All equipment shall be in good working condition at all times.
5.5 The centre have provision of periodic inspection, cleaning and maintenance of the equipment. An equipment log book shall be maintained for all major equipment. For indicative list of equipmentorinstrument refer to Appendix 4 (this list is indicative and not exhaustive).
5.6 The ICTC shall ensure availability of:
a) Information, education and communication (IEC) material required for an
ICTC such as flip charts, posters, etc.
b) Rapid HIV testing kits.
c) Protective kits and prophylactic drugs for post-exposure prophylaxis (PEP) for staff.
6.1. Waste Management
6.1.1 Segregation, collection, transportation, storage and disposal of biomedical waste shall be as per Bio medical waste management rules, 2016.
7. LegalorStatutory Requirements
7.1 Every application shall be accompanied with the documents confirming compliance with local regulations and law.
8. Record Maintenance and Reporting
8.1 Records shall be maintained in physical or digital format.
8.2 Confidentiality, security and integrity of records shall be maintained.
8.3 Record shall contain at least Registration number, client details like name, address, district, phone number and brief history, etc.
8.4 The minimum medical records to be maintained and nature of information to be provided by the Clinical Establishments shall be as prescribed in CEA rules of the Act.
6. Support Service
Clinical Establishments Act Standards for Integrated Counselling and Testing Centre CEA orICTC
8.5 The centre shall maintain health information and statistics in respect of national programmes, notifiable diseases and emergenciesordisastersor
epidemics and furnish the same to the district authorities in the prescribed formats and frequency.
8.6 The centre shall have various registers maintained as per Appendix 5 (This list is indicative not exhaustive).
9. Others
9.1 Registration
9.1.1 Every clientorpatient visiting the facility shall be registered at the registration counter.
9.1.2 All the relevant records pertaining to the programme shall be maintained.
9.2 Consent and Assessment
9.2.1 Informed Consent: Informed consent shall be obtained from the client orpatientor next of kinor legal guardian as and when required as per the prevailing guidelines or rules and regulations in the language patient can understand (e.g. HIV testing).
9.2.2 Each clientorpatient shall undergo an assessment and the same shall be documented legiblyin relevant record.
9.2.3 ICTC shall ensure that each clientorpatient is provided pre-test informationorcounselling, post-test counseling and follow-up counselling in a friendly atmosphere.
9.2.4 In ICTCs which do not have a doctor such as mobile ICTCs and ICTCs located in hot spots, the counsellor is authorized to sign the counselling and testing reports after duly verifying the records. The ICTC manager shall cross-check at regular intervals the reports signed by the counsellor.
9.2.5 Records of all such assessments shall be maintained as per applicable laws.
9.3 Infection Control
9.3.1 Adherence to standard precautions shall be maintained by all staff.
9.3.2 Running tap water for hand washing of staff shall be available.
Clinical Establishments Act Standards for Integrated Counselling and Testing Centre CEA orICTC
9.3.3 Sanitation of the toilets and hygiene of the staff shall be maintained.
Mopping of all areas with clean mops and disinfectant shall be done at least once a day.
9.3.4 Adequate amount of bleaching solution shall be available for disinfection purpose and mopping of all areas with disinfectant shall be done at least once a day.
9.3.5 Facility for syringe and needle destruction shall be available and practiced.
9.3.6 Drugs for PEP shall be made available to any staff member who is accidentally exposed to HIV in all facilities which have an ICTC as early as 2 hours and within 24 hours of the accidental exposure and not later than 72 hours.
9.3.7 The facility shall have an assigned PEP focal pointorperson.
10. References
10.1 Operational Guidelines for Integrated Counseling and Testing Centres, July 2007, National Aids Control Organization, Ministry of Health and Family welfare, Government of India and its amendments if any.
Clinical Establishments Act Standards for Integrated Counselling and Testing Centre CEA orICTC
Norms for Setting up an ICTC
1. Government health sector
Appendix 1
An ICTC can be set up in any government health facility such as a medical college, district hospital, sub-district hospital, community health centre (CHC) or a 24-hour primary health centre (PHC) which caters to a population of 30,000– 40,000 and has:
a) a minimum of 30 beds,
b) >50 deliveries in a month, or
c) a TB microscopy centre.
2. Privateornot-for-profit sector
ICTCs can be set up in the privateornot-for-profit sector in a facility which meets any of the criteria given below:
a) Maternity homesorhospitals with >50 deliveries in a month in “A” and “B” category
b) Districts and >100 deliveries in a month in “C” and “D” category districts;
c) Hospitalsorclinics which treat >100 TB patients in a month;
d) Hospitalsorclinics which have a case load of >100 sexually transmitted infections (STIs) in a month;
e) Diagnostic laboratories which perform >150 diagnostic HIV tests in a month;
f) Industrial zones that employ a large number of people, particularly migrantsorcasual
g) Labour on an informalorcontractual basis.
3. Public sectororother government departments
ICTCs can be set up by public sector organizationsorother government departments.
Clinical Establishments Act Standards for Integrated Counselling and Testing Centre CEA orICTC
Some suggested locations are:
a) Railway stations and bus terminals located at major junctions on trunk routes and
b) handle a large volume of passengers every day;
c) Central prisons with a large number of inmates;
d) Health facilities run by StateorCentral Police OrganizationsorArmed Forces;
e) Health facilities run by public sector organizations catering to large volumes of
a. migrant workers;
f) Health facilities run by public sector organizations which handle >100 deliveries in amonth or have a TB microscopy centre;
g) Public sector organizations such as those in the mining industry which employ large number of persons, particularly migrantsorcasual labour;
h) University campuses.
4. NGO sector
a) Hot spots such as dhabas, halting points on highways, markets, fairs, etc. where there is a congregation of high-risk groups and their clients;
b) TB microscopy centresorReproductive and Child Health (RCH) centres run by NGOs.
An ICTC may be located in health facilities owned by the government, in the privateornot for- profit sector, in public sector organizationsorother government departments such as the Railways, Employees’ State Insurance Department (ESID), etc. and in sectors where nongovernmental organizations (NGOs) have a presence. In the health facility, the ICTC should be well coordinated with the Department of Medicine, Microbiology, Obstetrics and Gynaecology, Paediatrics, Psychiatry, Dermatology, Preventive and Social Medicine, etc. As the HIV test is a relatively low- cost test and since the risk perception is generally low, travelling a long distance to get tested could be a strong disincentive. Therefore, it is important to ensure that facilities for counselling and testing be located as close to the people as possible. ICTCs should ideally be located such that they provide maximum access to at- riskorvulnerable populations.
4.1
ICTCs can be set up in the NGO sector in
Clinical Establishments Act Standards for Integrated Counselling and Testing Centre CEA orICTC
Appendix 2 Furniture and Fixtures
The minimum requirement of furniture for a counselling room in an ICTC is:
a) Desk for the counselor.
b) 10–15 chairs for one-on-one and group counselling sessions as well as for the waiting area.
c) Lockable filing cabinet for keeping records.
d) Computer with printer and UPS.
e) Computer table, preferably with a chair.
f) Waste basket.
g) TV and DVD player in a lockable stand for provision of information on HIVorAIDS, non-communicable disease, etc. to clients.
h) Posters and information materials on the walls.
i) Communication aids such as flip charts.
j) Condom use demonstration models.
k) Leafletsorpamphlets as take-home material for clients.
Clinical Establishments Act Standards for Integrated Counselling and Testing Centre CEA orICTC
Appendix 3
Human Resource Requirements
1.1Manager (Medical officer)-1: The administrative head of the facility where the ICTC is located must identify and nominate a medical officer as manager in-charge of the ICTC.
1.2Counsellor-1: The counsellor should be a graduate in PsychologyorSocialWorkorSociologyorAnthropologyor Human Development or hold a diploma in Nursing with a minimum of 3–5 years of experience in the field of HIVorAIDS. In the case of those recruited from the community of people infected with or affected by HIVorAIDS, graduates from any field or those with a diploma in Nursing may be considered if they have a minimum of one year of experience in the field of HIVorAIDS.
1.3 Lab Technican-1: Should hold a Diploma in Medical Laboratory Technology(DMLT) from an institution which is approved by the state government. The services of existing LTs who do not hold a DMLT may be continued if they have done a Certificate Course in Medical Laboratory Technology and have more than 5 years’ experience of working in the ICTC.
1.4An outreach worker would be necessary in high-prevalence districts:
Outreach workers should be educated at least till the eighth standard with reasonable writing and speaking skills, and should be from the community of people who are infected with or affected by HIVorAIDS. A person affected with HIVorAIDS may be the spouse or the sonordaughter of a person infected with HIVorAIDS. It is desirable that outreach workers should have passed the tenth standard and are women. Outreach workers are recommended only in ICTCs which are located in high-prevalence settings such as in A and B category districts.
Clinical Establishments Act Standards for Integrated Counselling and Testing Centre CEA orICTC
Appendix 4
Equipments or Instruments or Consumables
1. The equipment required for testing in an ICTC are:
a) Refrigerator
b) Centrifuge
c) Needle destroyer
d) Micropipette
e) Colour-coded waste disposal bins.
2. The consumables required for collection and testing of blood in an ICTC are:
a) Sterile needles and syringes
b) Disposable gloves
c) Vials and tubes for collection and storage of blood
d) Cotton swabs
e) Cleaning material such as spiritorantiseptic lotion
f) Bleachorhypochlorite solution
g) Microtips for use in micropipettes.
h) Prophylactic nevirapine tablets and syrup (for HIV-positive pregnant women and their infants).
i) Contraceptives.
Clinical Establishments Act Standards for Integrated Counselling and Testing Centre CEA orICTC
Appendix 5 Records or Registers to be maintained:
a) PID Register for General Clients and Pregnant Women
b) ICTC Register for General Clients (Non-ANC Cases)
c) ICTC Register for ANC Clients
d) ICTC Post-natal Follow-up Register
e) ICTC HIV–TB Collaborative Activities Register
f) Laboratory register
g) Stock Register
h) Monthly reports
i) Monthly ICTC report on the number of clients counselled, tested, HIV status, NVP administration, and gender and age-wise distribution
j) Monthly HIV–TB report on HIV–TB collaborative activities
k) Details of referrals to and from various facilities
l) Stock of drugs, equipment and consumables
Clinical Establishments Act Standards for Integrated Counselling and Testing Centre CEA orICTC
Glossary
Volunatry
Client
“Self-referred clients”
“Provider- referred clients”
Seeking knowledge of the HIV status is voluntary. The decision to pursue testing for HIV must be made by the client who seeks counselling and testing services.
A person seeking health-care services, including in an ICTC, is a client and not a patient. Patients are considered passive recipients of treatmentorcareorhospitalization, whereas clients are “consumers” who make a choice whether or not to avail of a certain service.
“Self-referred clients” or direct walk-in clients are clients who present themselves at the ICTC of their own volition and free will. The motivation to visit and avail of ICTC services could be based on individual risk behaviour or information and advice received, for example, from a newspaper advertisement, a friend, sexual partner or NGO.
“Provider-referred clients” are clients who are referred by health- care providers to the ICTC for HIV counselling and testing based on clinical symptoms suggestive of an HIV infection. An HIV test as part of the medical investigation can be beneficial for their ongoing medical care and treatment. The decision to undergo an HIV test is voluntary but should be encouraged in view of the clinical benefits. Not undergoing an HIV test should not lead to withholding required medical investigations or operations.
Confidential Information gathered during counselling must not be shared with others. The HIV test result must be reported only to the client
unless the client states the desire to share the test result with a family member, partner or close friend. Confidentiality is defined as the state of being “private”. Maintaining the client’s privacy by restricting access to personal and confidential information, especially HIV test results, demonstrates sensitivity towards and respect for the basic rights of the client.
Informed The client agrees to HIV testing through giving hisorher informed
consent for HIV testing
consent. Informed consent is a deliberate and autonomous permission given by a client to a health-care provider to proceed with the proposed HIV test procedure. This permission is based on an adequate understanding of the advantages, risks, potential consequences and implications of an HIV test result,
Clinical Establishments Act Standards for Integrated Counselling and Testing Centre CEA orICTC
which could be both positive and negative. This permission is entirely the choice of the client and can never be implied or presumed.
Informed
The law gives paramount importance to the best interests of the child. In the context of HIVorAIDS, the best interests of the child are served by promoting access to information and services including counselling and testing services. Whenever possible, minors areencouraged to involve their parentsorguardians in supervising their health care. However, unwillingness to inform parentsorguardians should not interfere with the minor’s access to information and services. Access to ICTC services should be available to children and young people under the age of 18
years based on an assessment of their evolving capacities and their ability to comprehend the nature and implications of HIVorAIDS and an HIV test result. It is the role of the trained counsellor to assess these abilities.
However, the informed consent of parentsorguardians is required prior to testing minors for HIV.
consent for HIV
testing of
minors
Clinical Establishments Act Standards for Physiotherapy Centre
Clinical Establishments Act Standard for
Physiotherapy Centre
Standard No. CEAorPhysiotherapy Centre
Clinical Establishments Act Standards for Physiotherapy Centre
Table of Contents
Particulars
Page No.
Definition
4
Scope
4
Infrastructure
5
Furniture & Fixtures
6
EquipmentorInstruments
6
Human Resource
7
Support Service
7
Legalorstatutory Requirements
7
Record Maintenance and Reporting
7
Process
8
Appendix 1
10
Appendix 2
11
Appendix 3
12
Appendix 4
14
Clinical Establishments Act Standards for Physiotherapy Centre
50 Definition
A physiotherapy centre is an allied Healthcareestablishment providing, physicaltherapy services by a physiotherapist to patients with a recent prescription or referral from a licensed medical doctor (physicianorsurgeon). Depending on the disease condition a review and re-prescription by atreating medical doctor is required for continuing physiotherapy services.
51 Scope (as applicable)
These set of common minimum standards framed shall be applicable to standalone physiotherapy centre with one or more physiotherapists
2.1 And physiotherapy sections attached to hospitals or polyclinic.
2.2 Various therapies under the scope is as follows:
2.2.1Electrotherapy (Adult or Paediatrics)
a) Hydrocollator (Hot Packs).
b) Paraffin Wax Bath InfraredorUltra violet radiation lamps. (Cold) – Cryotherapy.
c) Shortwave diathermy
d) Ultra sound Therapy (1 & 3 MHz).
e) Electrical energy- TENS (Trans cutaneous Nerve Stimulator).
f) Low and Medium frequency currents: IFT(Interferrential Therapy)or
g) Electrical muscle stimulator.
2.2.2 Exercise therapy
a) Shoulder exercise unit
b) Wrist and Hand exercise units
Clinical Establishments Act Standards for Physiotherapy Centre
c) Abduction ladder
d) Over head Pulley systemor Multiple Pulley exercise unit
e) Weight cuffs(Optional)
f) Dumbbell exercise set, Mat exercise (floor) mat
g) Parallel Bars and Wall bars
h) Examination couches (number according to the patient load)
i) Quadriceps table, MobilizationorStabilizing belts, Patient evaluation kit (including Goniometer, Percussion Hammer, Measuring tape etc.), Walking aids(sticks, crutches, frames and wheel chairs etc.)
2.2.3Mechano Therapy
a) Cervical and Lumber Traction systems(Intermittent and Constant) with
traction table
2.2.4 Hydrotherapy
2.2.5 Manual therapy
a) To deliver primary service in health education and health promotion.
b) To deliver health care services of physiotherapy and rehabilitative nature.
52 Infrastructure Requirements
3.1 The physical facility shall be developed and maintained to provide safe and secure environment for patients, their families, staff and visitors. It shall be situated in a place having clean surroundings and shall comply with local byelaws in force, if any from time to time.
3.2 The minimum space requirement for carrying out the basic functions of the facility shall be as per Appendix 1.
Clinical Establishments Act Standards for Physiotherapy Centre
3.3 The area shall be well illuminated, ventilated and clean with adequate water supply.
3.4 The total area requirement can be broadly classified into two categories viz. Common Area and Treatment area. The common area shall include facilities such as reception, waiting, toilet, consultation, etc. The treatment area shall include space requirements for main equipment and for ancillary services.
3.5 The facility shall be adequately provided with working space to allow orderly and logical placement of equipment, material and movement of personnel so as to maintain safe operations.
3.6 The space requirement in treatment area shall be as per as per the scope of service and workload. The ancillary area like facility for storage (cabinet etc), facility for backup equipment like UPSorgenerator etc. shall also be available, please refer to Appendix 1.
3.7 Common area can be shared between the different divisionsorsections of the centreorHCO. Within the centre various work sections can also share the resources and space however not compromising the quality of work.
3.8 The physiotherapy centre shall have a prominent boardorsignage displaying the name of the centre in local language at the gate or on the building.
3.9 The following other signage shall be well displayed in the language understood by the local public in the area:
a) Name of the physiotherapist with registration number.
b) Fee structure of the physiotherapistor physical therapy services.
c) Timings (For ex – from 8am -2pm)
d) Services provided within the facility
4.1 Furniture and fixtures shall be available in accordance with the activities and workload of the physiotherapy centre.
53
Furniture & Fixtures
Clinical Establishments Act Standards for Physiotherapy Centre
4.2 The furniture and fixtures shall be functional all the time. For indicative list of items refers to Appendix 2. (This list is indicative and not exhaustive).
54 EquipmentorInstruments
5.1 The physiotherapy centre shall have essential equipments as per Appendix 4.
5.2 Other physiotherapy equipments as per the scope of service and work load requirement shall be available.
5.3 Adequate space for storage of equipments
5.4 All equipment shall be in good working condition at all times. Periodic inspection, cleaning, maintenance of equipments should be done.
55 Human Resource
6.1 Physiotherapist as per the scope of the physiotherapy centre shall be registered with State physiotherapy & Occupational Therapy Council, wherever applicable.
6.2 The services provided by the physiotherapy professionals shall be in consonance with their qualifications, training and registration.
6.3 Personnel record containing personal and professional information shall be maintained for each staff.
6.4 Periodic skill enhancementorup gradation orrefresher trainings shall be provided for all categories of the staff relevant to their job profile.For Human resource requirement refer to Appendix 3.
56 Support Service
7.1 Support services like registration, billing, waste management, etc., can be shared with the hospital.
7.2 Support Staff: In a physiotherapy centre minimum one support staff shall be available to meet the care treatment and service needs of the patient. However number may depend upon the workload and scope of the service being provided by the clinical establishment.
57 Legalorstatutory Requirements
Clinical Establishments Act Standards for Physiotherapy Centre
8.1 Every application must be accompanied with the documents confirming compliance with local regulations and law.
58 Record Maintenance and Reporting
9.1 Copies of all records and statistics shall be kept with the clinical establishment concerned for at least 3 or 5 years or in accordance with the CEA act.
9.2 All clinical establishments shall be responsible for submission of information and statistics in time of emergency or disaster or epidemic situationor as required from time to time by National Council CEA 2010.
59 Process
10.1 Registration: Every patient visiting the physiotherapy centre shall be registered.
10.2 Assessment and plan of care The physiotherapist cardorslip of every registered patient must bear the minimum following legibly at every visit:Working diagnosis as provided by the treating medical doctor who has referred the patient, Relevant history and examination findings, Plan of care listing the exercises and physical modalities, Signature and date of the physical therapist, A review and re-prescription from the treating medical doctor after three weeks for continuing plan of care.
10.3 Infection Control:
a) The physiotherapy centre shall take all precautions to control infections
like practicing hand hygiene etc.
b) Availability of clean water for hand washing orliberal use of sanitizer shall be maintained throughout the working hours of the physiotherapy centre.
c) Sanitation and hygiene of the toilets if available shall be maintained.
d) Mopping of all patient care areas with disinfectant shall be done at least once a day.
10.4 Safety Considerations
Clinical Establishments Act Standards for Physiotherapy Centre
a) The establishment shall make effort shall to take care of patient safety aspects like patient fall, etc.
b) The establishment shall make effort to keep the centre pest and termite free.
10.5Biomedical waste Management
a) Biomedical waste shall be managed in accordance with the BMW
management and handling Rules, 1998.
10.6.FirstAid
a) Provision shall be made for providing First Aid.
b) Contact details of ambulance hospital etc shall be available.
c) Staff shall be trained on BLS.
Clinical Establishments Act Standards for Physiotherapy Centre
Appendix – 1
Minimum infrastructure requirements shall be as follows:
S.No
Minimum Area
1
Reception, Waiting & Consultation
Reception, waiting, consultation room etc. shall be adequate as per the requirement and workload of the physiotherapy center
2
Ancillary area or space
Ancillary areaorspace for storage of records, reagents, consumables, stationary etc including eating area for staff shall be available in accordance with the workload
3
Electrotherapy (Adult or Paediatrics)
Minimum one chamber of 10 ft.X7 ft for Diathermy unit and another chamber of same size for other electrotherapy modalities with examination couches, linen and electric fitting of required load, as per the specifications of the modalities. Separate space for Wax Bath and Hydrocollator as per the patient load and equipment specifications
4
Exercise Therapy
Minimum one consultation room (15 ftX10 ft at least), Treatment roomsorcabins (at least three of 10ftX10ft each) and space for the Parallel bars, Gait training and Floorormat exercises. The centre should have essential facilities like wash basins, wash rooms etc.
5
Mechano Therapy
Minimum one chamber of 10 ft.X7 ft to accommodate Cervical and Lumber Traction systems (Intermittent and Constant) with traction table and other material so as to provide adequate working space to carry out safe procedure.
6
Manual therapy
Manual therapy couch or the Examination couch. can be accommodated in the Exercise therapy space.
7
Hydrotherapy
Optional. If there, should be placed in the separate chamber of the size as per the equipment specifications. For example if Hubbard’s equipment is used, it requires a chamber of not less than 15ftX15ft along with the facility of changing room and wash room.
Clinical Establishments Act Standards for Physiotherapy Centre
Appendix –2 Furniture and Fixtures
S.N.
ARTICLES
1.
Table
2.
Chairs
3.
Examination Tableorcouch
4.
Screens
5.
Foot Step
6.
Stools
7.
Storage Cabinet for records etc.
8.
BMW storage area
Clinical Establishments Act Standards for Physiotherapy Centre
Appendix- 3
Indicative list of minimum equipmentorinstrument required is as follows:
I. Essential Equipment:
S. No.
Name of the equipment
Minimum Specifications
No. of equipment
1
Stethoscope
1
2
Thermometer
Digital
1
3
Torch (flash lights)
1
4
Sphygmomanometer (B.P. Apparatus)
Digital
1
5
Weighing machine (Optional)
Adult
1
II. Emergency Equipment:
III. PHYSIOTHERAPY EQUIPMENT
The physiotherapy equipment relevant to the scope and workload shall be available as follows:
S. No.
Name of the Equipment
Minimum Specifications
No. of Equipment
3
Fire Extinguisher
–
1
PHYSIOTHERAPY EQUIPMENT
Electrotherapy Equipment
1
Short Wave Diathermy
2
Ultrasonic Therapy
3
Interferential Therapy
4
Hot Pack Unit
5
Paraffin Wax Bath
6
TENS
7
LASER (Optional)
Clinical Establishments Act Standards for Physiotherapy Centre
8
9 10
Exercise Therapy Equipment
13
14
15
16
17
18
19 20
21
22
23
24
25
26
27
28
29 30
31
Mechano Therapy
32
Manual therapy
33
Hydrotherapy
33
Muscle Stimulator
Cold Packs
C.P.M.
Shoulder Wheel
Over Head Pulley
Wall Ladder
Supinator Pronator Exerciser
Heel Exerciser
Ankle Exerciser
Parallel Bars(optional)
Tilt Table (optional)
Walker or Crutches or Canes
Stationary Bicycle
Treadmill (Optional)
Vibrator for Chest Physiotherapy(Optional)
Swiss Ball (Optional)
Dumbbells or Weight Cuffs (Optional)
Gripper or Gel Balls (Optional)
Thera Bands or Thera Tubes (Optional)
Spiro meter (Optional)
Peak flow meter(Optional)
Hydrotherapy (Optional)
Traction Unit (Cervicalor Lumbar)
Manual Therapy couchorExamination couch (Optional)
Hydrotherapy pool or Hubberd tank (Optional)
Clinical Establishments Act Standards for Physiotherapy Centre
Appendix- 4
Minimum human resource requirement shall be as follows:
S. no.
Category
Minimum Qualifications
(from recognized university)
Registration with the concerned council
(if applicable)
Remarks
1
Physiotherapist-1
BPT from recognized universityorDPT awarded till 1991 from recognized University
State Physiotherapy& Occupational Therapy Council
Where council registration is not applicable, registration shall be done with Indian association of physiotherapy
CONTENTS
Minimum Standards of specific speciality / Super speciality Clinical
Departments / Establishments
S.No. Title
Page No.
1 -5 6-8 9-10 11-12 13-15 16-17 18-19 20-21 22-25 26-27 28-29 30 31-32 33-34 35-37 38-39 40-41 42-43 44-45 46-47 48-49 50-51 52-53
25 Gynaecology and Obstetrics Services in Hospital 54-55
26 Gynaecology and Obstetrics Clinic 56-57
27 IVF Clinic ( ICMR Norm)
28 Imaging Centers- X Ray Clinic/ Cath lab/ DSA/ OPG and Dental / DEXA Scan 60-63
29 Imaging Centres-Sonography(Color Doppler)Clinic 64-66
1 Anaesthesiology/Intensive Care/Emergency Dept
2 Burn Care Facility in Hospital
3 Plastic Surgery in Hospital
4 Clinic with Plastic Surgeon
5 Cardiology Services in Hospital
6 Clinic with Cardiology Service
8 CTVS in Hospital
9 Clinic with CTVS Service
10 Dental set up-stand alone/Hospital set up
11 Dermatology Services in Hospital
12 Dermatology clinic
13 STD clinic
14 Endocrinology Services in Hospital
15 Endocrinology clinic
16 Otorhinolaryngology Services in Hospital
17 Clinic with Otorhinolaryngology Services
18 Deaf and Dumb Clinic
19 Gastroenterology Services in Hospital
20 Clinic with Gastroenterology Services
21 Gastrointestinal Surgery Services in Hospital
22 Clinic with Gastrointestinal Surgery Services
23 General Surgery in Hospital
24 General Surgery Clinic
30 Imaging Centres-CT Scan Centres/PET CT Scan
31 Imaging Centers- MRI
32 Medical Diagnostic Laboratories
33 Medicine and Geriatric Services in Hospital
34 Medicine and Geriatric Clinic
35 Nephrology Services in Hospital
36 Nephrology Clinic
37 Dialysis Centre
38 Neurology Services in Hospital
39 Neurology Clinic
40 Neurosurgery Services in Hospital
41 Clinic with neurosurgery services
42 Medical Oncology / Clinical Haematology
43 Medical oncology / Clinical Hematology Clinic / Polyclinic
44 Gynaecological Oncology
58-59
67-70 71-73 74-80 81-82 83-84 85-87 88-89 90-91 92-93 94-95 96-97 98-99
100-101 102-103 104-105
Gynaecological Oncology Clinic/ Polyclinic
Surgical Oncology
Surgical Oncology Clinic / Polyclinic
Ophthalmology Services in Hospital
Clinic with Ophthalmology Services
Optometrist Services
Orthopaedic Services in Hospital
Clinic with Orthopaedic Services
Paediatric Services in Hospital
Paediatric Clinic
Neonatology
Neonatology Clinic
Psychiatric Services in Hospital
Psychiatry Clinic
De addiction Centre
Paediatric Surgery
Paediatric Surgery Clinic/ Polyclinic
Palliative Care
PMR Clinic
Pulmonology Services in Hospital
Pulmonology Clinic
Radiotherapy Services
Rheumatology Services in Hospital
Rheumatology Clinic / Polyclinic
Urology
Clinic with urology services
45 106-107 46 108-109 47 110-111 48 112-114 49 115-116 50 117-118 51 119-121 52 122-123 53 124-126 54 127-128 55 129-131 56 132-133 57 134-136 58 137-139 59 140-141 60 142-143 61 144-145 62 146-147 63 148-149 64 150-151 65 152-153 66 154-156 67 157-158 68 159-160 69 161-162 70 163-164
Template for Minimum standards for Hospital
BASIC (General purpose)
Advance (Non Teaching)
Remarks
1 Definition
2 Scope
Providing Anaesthesia services for Surgical Specialities eg. (General Hospital with Single Specialities/Multiple Specialities example CHC SDH,DH,Civil Hospital,Private Hospital,Nursing Home)etc
ProvidingAnaesthesiaservicesforSurgical Specialities and Superspecialities example Civil Hospital, Regional Hospital,Nursing Home,Private Hospital etc.
I Services Provided 1.General purpose 2.Single Speciality 3.Multispeciality 4.Superspeciality
Yes Yes Yes NA
Yes Yes Yes
3 Human resources 1.1 Doctors
Duty Doctors
1 MBBS Doctor/6 ICU Beds /for round the clock medical cover **
* D ** M
1.2 Nurses Nursing head General nurses
1 Head Nurse/OT 1 Nurse/OT
1 Head Nurse/OT 2 Nurses/OT
As per Nursing Council norm M
ANAESTHESIOLOGY/INTENSIVE CARE/EMERGENCY DEPT
1 Qualified Anaesthetist/OT/per operation
1 Qualified Anaesthetist/OT/per operation
M-MandatoryOneAnaesthetist per OT per 8hour shift, subject to a maximum of 42 hours per week per anaesthetist. Full time employment not mandatory
MD/DNB/Diploma Anaesthesia
MD/DNB/Diploma Anaesthesia
1 consultant Intensivist/6 ICU Beds **
M-Mandatory
D-Desirable
*D-Desirable(MBBSDoctorwith training in emergency Medicine or Sr. Resident)
** M- Mandatory
Trained Nurses for ICU/OT/HDU
1.3 Pharmacist
1 Nurse/1 Ventilator patient; 1 Nurse/1NICU Beds;1 Nurse/2 ICU beds
M
part of hospital
1.4 Para Medical staff Lab Tech
Xray Technician
OT Technician
NA for Anaesthesia NA for Anaesthesia 1/OT;I Supervisor/2 NA for Anaesthesia NA for Anaesthesia NA for Anaesthesia NA for Anaesthesia NA for Anaesthesia
OT
NA for Anaesthesia
NA for Anaesthesia 1/OT;I Supervisor/2 OT NA for Anaesthesia
NA for Anaesthesia
NA for Anaesthesia
NA for Anaesthesia
NA for Anaesthesia
M- Mandatory
ECG Technician
Dietitician
Physiotherapist
Psychologist
Medicosocial worker
1.5 Support Staff
a.Receptionist & Billing
Yes Yes Yes
Yes Yes Yes
part of hospital part of hospital part of hospital
b.MRD Office
c.Securityclosed circuit surveillance and sanitation d.Transport facility including driver
Yes
Yes
Own or outsource
e.Data entry operators
Yes Yes Yes
Yes Yes Yes
part of hospital M
part of hospital
f.House keeping
1.6 Rapid Response Team
1.7 others
Policy Manpower/ posting/ rotation/ of medical and ALLIED HEALTH PROFESSIONAL STANDARD PERTAINING TO PERSONAL RECORD KEEPING AND TRAINING
Yes Yes
Yes Yes
M
PAYMENT/ROSTER OF STAFF
Yes Yes
Yes Yes
part of hospital
part of hospital policy
OTHER REQUIREMENT LIKE PERIODIC HEALTH CHECK UPS,vaccination of staff in lab,bld bank,TLD badges
4 Equipment
M
Therapeutic
D type Oxygen cylinders / O2 tank and / or concentrator .Liquid oxygen set up with emergency cylider supply, Nitrous oxide supplythroughcylidersbank,MedicalAir supplyandvacuumsetup.Pipedmedical gases.Anesthesia EquipmentAnesthetic /machine with hypoxic guard and inbuilt oxygen analyser.Anesthesia monitor with
Surgical Diagnostic
Magill`s forceps
Intubating stylet and bougie
Oral and nasal airways (all sizes)Anesthesia Equipment Laryngoscope with blades of all sizes Endotracheal tubes of all sizes
Magill`s forceps
Intubating stylet and bougie
Oral and nasal airways (all sizes) Laryngeal mask airway (classic/proseal , all sizes)
Anatomical face masks all sizes Breathing circuits (Adult and pediatric) Laryngeal mask airway (classic/proseal , all percutaneous tracheostomy set, cricothyrotomy set,
ultrasound for nerve blocks and central venous cannulation
OT- Anaesthesia Work Station (Anaesthesia
Delivery System) attached to cylinders and
/or piped gases, Defibrillator for one OT complexoftwintheatredependinguponthe typeofcases,canbereducedforASAgrade
1or2cases, Laryngoscopeswithbladesof
all sizes. Endotracheal tubes of all sizes,
Anatomical face masks of all sizes, Guedal’s Airwayofallsizes,LaryngealMaskAirwayof facility for monitoring SpO2, Pulse rate, all sizes, Intubating Stylet and Bougie.
Central venous canulation set, Spinal and epidural set
NIBP, ECG and EtCO2.Anesthesia monitor with facility for monitoring SpO2, Pulse rate, NIBP, ECG, temperature and EtCO2 . Flexible FIbreoptic BronchoscopeSelf inflating resuscitator bag and mask – adult and neonatal sizeAnesthesia Equipment Laryngoscope with blades of all sizes Endotracheal tubes of all sizes
Emergency
Equipment:DifficultAirwayCart,Oxygen Equipment:DifficultAirwayCart,Oxygen
Difficultairwaycartwould include the following items: Resuscitation equipment including Laryngoscope with cells and different blades, endotracheal tubes of all sizes (2.5 TO 8.5mm ID),suctionequipment(electrical and manual, central optional ), lignocaine spray, oropharyngeal andnasopharyngealairways, anatomicalfacemasks(allsizes) self inflating resuscitator bag- Adult & Paediatric (neonatal if indicated)laryngealmaskairway.
Sterlizing
Yes Yes
M-Mandatory
cylinders with flow
meter/tubing/catheter/face mask/nasal
prongs, Suction apparatus (electrical and
manual, central optional, Portable
defibrilator with accessoriesa, Equipment
for dressing/bandage/suturing, Basic
Diagnostic equipment: BP apparatus,
stethoscope, weighing machine,
thermometer,ECGmachine,Pulseoximeter,
nebulizer andaccessories.
Emergency Drugs: Injections: Diazepam,
Furosemide, Ondasetron, Ranitidine, Nor- Furosemide, Ondasetron, Ranitidine, Nor-
adrenaline, Phenytoin, Diclofenac,
Deriphylline, Chlorpheniramine maleate,
Hydrocortisone, Atropine, Adrenaline, KCl,
Sterile water, Sodium bicarbonate,
Dopamine, Naloxone (400mcg), Lignocaine (preservativefree(50m)l,Suxamethoium,
Atracurium/ Vecuronium/ Rocroronium,
Neostigmine, Calcium Chloride and
gluconate, Morphine/ Pethidine,
Metoclopramide, Tramadol, Salbutamol
Nebulizer, Steroid (Budesonide) Nebulizer,
Lignocaine Jelly, Activated Charcoal: IV
Fluids: Ringer lactate/acetate, Normal saline,
(500, 250, 100 ml), 5% dextrose, 10%
dextrose,10%Dextrose,PaediatricInfusion 100ml),5%dextrose,10%dextrose,10% solution, Dextrose, Paediatric Infusion slolution,
cylinders with flow meter/tubing/catheter/face mask/nasal prongs,Suctionapparatus(electricaland manual, central optional, Portable defibrilator with accessoriesa, Equipment for dressing/bandage/suturing, Basic Diagnostic equipment: BP apparatus, stethoscope, weighing machine, thermometer,ECGmachine,Pulse oximeter, nebulizer and accessories Emergency Drugs: Injections: Diazepam,
adrenaline, Phenytoin, Diclofenac, Deriphylline,Chlorpheniraminemaleate, Hydrocortisone, Atropine, Adrenaline, KCl, Sterile water, Sodium bicarbonate, Dopamine, Naloxone (400mcg), Lignocaine(preservativefree(50m)l, Suxamethoium, Atracurium/ Vecuronium/Rocroronium, Neostigmine, Calcium Chloride and gluconate, Morphine/ Pethidine, Metoclopramide, Tramadol, Salbutamol Nebulizer, Steroid (Budesonide) Nebulizer, Lignocaine Jelly, Activated Charcoal: IV Fluids: Ringer lactate/acetate,Normalsaline,(500,250,
Drugs,Medical devices and consumables
Anaesthesia Inductions Agents: Thiopentone/ Propofol/ Ketamine / Etomidate (optional), Inhalational Agents: Sevoflurane/Isoflurane/Halothane:Muscle Relaxants: Suxamethonium, Vecuronium/ Pancuronium/ Atracurium/ Rocuronium, Opioids:Pentazocine/Tramadol/Morphine/ Pethidine, Fentanyl/ Buprenorphine,Others: Neostigmine, Atropine, Glycopyrolate, Midazolam, Diazepam (Inj & Tab), Alpralozolam (tab), Diclofenac (Injection, and suppositories), Paracetamol (Inj and suppositries), Adrenaline, Magnesium sulphate and other emergency drugs to be finalized in themeeting
Anaesthesia Inductions Agents: Thiopentone/ Propofol/ Ketamine / Etomidate (optional), Inhalational Agents: Sevoflurane/ Isoflurane/ Halothane: Muscle Relaxants: Suxamethonium, Vecuronium/ Pancuronium/ Atracurium/ Rocuronium,Opioids:Pentazocine/ Tramadol/ Morphine/ Pethidine, Fentanyl/ Buprenorphine, Others: Neostigmine, Atropine, Glycopyrolate, Midazolam, Diazepam (Inj & Tab), Alpralozolam (tab), Diclofenac (Injection, and suppositories), Paracetamol (Inj and suppositries), Adrenaline, Magnesium sulphate and other emergency drugs to be finalized in themeeting
List of disposables
Endotracheal tubes, Spinal sets, Epidural sets, Central venous canulation sets
Endotracheal tubes, Spinal sets, Epidural sets, Central venous canulation
M
Annual Maintenance records
Yes
Yes
M
of equip
5 Support Service
Reception &Billing Laboratory
Imaging
Pharmacy sterlization/CSSD Laudry/Kitchen Medical Gas/Manifold
Yes Yes Yes Yes Yes Yes
Yes
part of hospital part of hospital part of hospital part of hospital M
Blood storage unit/blood Bank Amb service
With adequate storage of all blood groups and blood products depending upon the requirement of Hospital set up
With adequate storage of all blood groups and blood products depending upon the requirement of Hospital set up
part of hospital
part of hospital Own or Outsource
Liquid oxygen set up with emergency cylider
Liquid oxygen set up with emergency cylider supply, Nitrous oxide supply
supply, Nitrous oxide supply through
cyliders bank, Medical Air supply and vacuum set up
through cyliders bank, Medical Air supply and vacuum set up
Yes
Yes
sets,arterial cannula, laryngeal mask airways
Yes
Yes
Yes
Yes
Yes
part of hospital part of hospital
1 Scope
OPD Services, Short stay services eg, treating dehydration, nebulization, immunization (e.g CHC, SDH, District Hospital, Civil Hospital, Private Hospital, Nursing Home etc)
Provide advance paediatrics care Eg. CivilHospital,regionalHospital,Nursing Home,Private Hospitaletc
Minimum standards for Hospital
BASIC (General purpose)
ADVANCE (Non Teaching)
Remarks
Services Provided
1.1General purpose 1.2Single Speciality 1.3Multispeciality 1.4Superspeciality
Yes Yes Yes NA
Yes Yes Yes
2 Human resources 2.1 Doctors
Medpersonincharge
MDPAEDIATRICS/DNB/DCH/MDMedicine
SeniorConsultant-1
M-Mandatory M-Mandatory
Full time consultant Part time consultant visiting consultant Duty Doctors
MBBS Doctor to provide round the clock Medical cover
Junior consultant-1 or
or 1
or 1
MBBS Doctor to provide the clock Medical cover
M
2.2 Nurses
Nursing head
General nurses TrainedNursesforICU/OT/HDU Yes
Nurse-1/4 beds Yes*
2.3 Pharmacist
own / outsource
1
PAEDIATRIC SERVICES IN HOSPITAL
As per norms of Nursing Council
2.4 Para Medical staff a. Lab Tech
b. Xray Technician
c. OT Technician
Yes Yes
Yes Yes
M- if own lab
M- if own
part of Hospital
D Part of Hospital *Desirable **Mandatory part of Hospital (if required) *Desirable
d. ECG Technician e. Dietician
f. Physiotherapist
Yes Yes* Yes*
Yes Yes** Yes*
g. Psychologist
h. Medicosocial worker
Yes* Yes*
M IF PSYCHIATRIST *Desirable
3 Equipment
a.Therapeutic
For neonatal service-phototherapy unit-1 radiant warmer-2 suction-1
Yes
Yes
For neonatal service-phototherapy unit- 1 radiant warmer-2 suction-1
Yes
Yes
M
b.Surgical c.Emergency
if applicable
Refer to documents on Hospital
M
Refer to Documents on Hospital
M
M
d.Sterlizing
e. Drugs,Medical devices and consumables
f. List of disposables
g. Annual Maintenance records of equip
Yes Yes
Yes Yes
4 Support Services
a.Laboratory b.Imaging
Yes Yes
Yes Yes
M; own/ Outsource/ Tie up M; own/ Outsource/ Tie up
Yes Yes
Yes Yes
*Desirable
c.Pharmacy Yes* Yes
M-IN ADVANCED *Desirable
d.sterlization/CSSD Yes Yes e.Medical Gas/Manifold Yes Yes f.Bloodstorageunit/bloodBank Yes Yes
M
M
M-own/ outsourced/ TIE UP
g.Amb service Yes Yes h.other requirement
M-own/ outsourced/ TIE UP
M-Mandatory D- Desirable
D – separate enclosure for male and female PATIENTS AGED 12 yrs AND ABOVE
Template for Minimum standards for Clinics/ Polyclinics
Minimum Standards
Remarks
1 Definition
2 Scope
General/Specialist
OPD consultation, Immunization (optional),
Services Provided
3 Physical Infrastructure a.Space requirement
i) Reception
ii) consultation/waiting area
Yes Yes
4 Human Services
a.Doctors
b.Tech staff
c.Non Tech staff
d.Duty and salary roster
MD/DNB/DCH-PAEDIATRICS/MBBS NURSE-1
Attendant-1
Yes
D
D
M
Either Nurse/Attendant D
e.OTHER REQUIREMENT LIKE PERIODIC HEALTH
CHECK UPS
5 Equipment
a.Stethoscope b.Thermometer c.BP Apparatus d.Glucometer
Yes Yes Yes Yes
M(paediatric)
Yes (Non Mercury) Yes (Non Mercury) D
e. Weighing machine
paediatric weighing scale, pulse oximeter*
M except pulse oximeter*
D
M-if Immunization
As provided in clinic/polyclinic document M
f.Emergency kit and medicine g.Drugs,Medical devices and consumables
Refrigerator(if immunization) Yes
Yes
PAEDIATRIC CLINIC
h.List of disposables
Yes Yes
M
D applicable for major equipment
i.Annual Maintenance records of equip
6 support services
a.sterlization/CSSD b.security
c.BMW management d.Laundry
Yes Yes Yes Yes
M if immunization
D
M
Own / Outsourced(if applicable)
7 Standard on basic processes
a.Receiving patients,privacy for patients while examining especially females
b.Infection control practices
soap and water
facilities for hand washing and disinfection Disinfection of work Area
Use of disposable services
small autoclave
c. Policy on outsourced services
Yes
M
Yes
Yes
Yes
Yes
Yes
Yes
Yes
M- Mandatory
M M M M M M D
D – Desirable
TemplateforMinimum BASIC ( Burn care facility for general
ADVANCECARE(Burnunit)
Remarks
standards for Hospital
/general surgical care )
1 Scope
PATIENTS WITH UPTO 25% TBSA (total body surfacearea)inadultand15%inchildren burns with no comorbid condition
All burns patients (Minimum 2 beds with ICUfacility)
Services Provided
1.General purpose 2.Single Speciality 3.Multispeciality 4.Superspeciality
Yes Yes Yes
Yes Yes Yes
2 Human resources 1.1 Doctors
Med person incharge Full time consultant
for Anaesthetist services refer to Doc on Anaesthetist
Part time consultant visiting consultant Duty Doctors
Need based depending on case load
Need based depending on case load
1.2 Nurses Nursing head General nurses
Yes Part of Hospital
Trained Nurses for ICU/OT/HDU
1.3 Pharmacist
1.4 Para Medical staff Lab Tech
Staff Nurses-2 ,round the clock on shared Yes Part of Hospital basis
Yes Yes Part of Hospital
Xray Technician OT Technician
Yes Yes M- Mandatory; if own lab
Yes Yes M- if own
Yes Yes M- in Major OT( In Minor OT trained Technician)
MINIMUM STANDARDS FOR BURN CARE FACILITY IN HOSPITAL
Surgeon-1 (MS General Surgeon)
MCh /DNB Plastic Surgery-1
M (Full Time)
MBBS doctor to provide round the clock medical cover
MBBS doctor to provide round the M – Mandatory clock medical cover
Need based depending on case load
1MS Surgery full time, if no. of beds exceed 6, and part time if no. of beds less than 6
Yes Yes Part of hospital
ECG Technician Yes Dietician Yes Physiotherapist Yes Psychologist
Yes Yes Yes Yes Yes
D – Desirable; part of hospital D – Desirable; part of hospital D – Desirable; part of hospital D – Desirable; part of hospital *M – Mandatory; part of hospital
Medicosocial worker
3 Equipment
Therapeutic
Vital parameter monitor2, skin graft mesher1,Humby’s knife- 2,Portable light-1
Humby’s knife 2 Mandatory and 4 – Desirable
Emergency Yes
Yes
Refer to documents on Hospital M-Mandatory
Sterlizing
Yes
Yes
Drugs,Medical devices and consumables
I/VFluids,Antibiotics,Sedatives,Anal
These are minimum requirements
List of disposables
Yes Yes
Antiseptic cream, Plasma expanders
Yes
M-Mandatory M
Annual Maintenance
Yes
records of equip
4 Support Service
sterlization/CSSD Medical Gas/Manifold
Yes
Yes Yes* Yes
M-Mandatory *M-Mandatory M-own/outsourced/Tie up
Blood storage unit/blood Bank
Amb service
Yes Yes
Yes
M-own/outsourced/Tie up
I/VFluids,Antibiotics,Sedatives,Analgesics,
Antiseptic cream, Plasma expanders gesics,
Ulrasonic therapy machine-1,
M
Overhead pulley-1, Shoulder wheels
1,Horizontal bar-1,static cycle-
1,Quadriceps table-1,Breathing
exercise equipment-1, Handgripper-
1,Electric musclestimulator- 1,Paraffin box-1
1 Definition
Surgical Speciality which deals with reconstruction of missing parts, replacement of tissue, modification and changing of existing part and changing the appearance of person to improve aesthetic appearance
2 Scope
Reconstructive Surgery,Facial skeletal surgery, Aesthetic surgery, Minor surgical procedures
Minimum standards for Hospital
Minimum Standards
Remarks
Services Provided
1.1 General purpose 1.2 Single Speciality 1.3. Multispeciality 1.4. Superspeciality
yes Yes Yes
3 Human resources 3.1 Doctors
Med person incharge
MCh / DNB Plastic Surgery-1
M-Mandatory; for Anaesthetist services refer to Doc on Anaesthetist
Duty Doctors
3.2 Nurses
Nursing head
General nurses
Trained Nurses for ICU/OT/HDU 3.3 Pharmacist
MBBS doctor for round the clock medical cover from Hospital pool
M-Mandatory; part of Hospital
3.4 Para Medical staff a. Lab Tech
b. X-ray Technician
c. OT Technician
Yes Yes Yes
M- Mandatory;if own lab M- if own
d. ECG Technician e. Dietitician
Yes Yes
M- in Major OT ( In Minor OT trained Technician)
D-Desirable; part of hospital
D; part of hospital
PLASTIC SURGERY IN HOSPITAL
MS (General Surgeon) with minimum 3 yrs training in Plastic surgery
yes Yes Yes yes
As per norms of Nursing Council As per norms of Nursing Council As per norms of Nursing Council part of hospital
f. Physiotherapist
g. Psychologist
h. Medicosocial worker
Yes Yes Yes
D ;part of hospital D ;part of hospital D ;part of hospital
4 Equipment
a. Therapeutic
Basic OT instrument;Special instrument for cleft Surgery,hand surgery,Burn reconstructive surgery,Other instruments as per facility service
M-Mandatory
b. Emergency
c. Sterlizing
d. Drugs, Medical devices and consumables e. List of disposables
f. Annual Maintenance records of equip
yes Yes Yes Yes Yes
As per Hospital Document M
As per Hospital Document M
5 Support Service
e. sterlization/CSSD
g. Medical Gas/Manifold
h. Blood storage unit/blood Bank i. Amb service
Yes Yes Yes Yes
M-mandatory; part of hospital M-mandatory; part of hospital M-own/outsourced/Tie up M-own/outsourced/Tie up
M
Template for Minimum standards for Clinics/Polyclinics
ONLY CONSULTATION
DAY CARECENTRE
Remarks
1 Definition
2 Scope
Specialist
Specialist
Services Provided
Only consultation
All day care procedures of specialty
No liposuction/lipolysis without plastic surgeon at beauty clinic.
3 Physical Infrastructure a.Space requirement
i) Reception
ii) consultation/waiting area
Yes Yes
Yes Yes
M-Mandatory M-Mandatory
4 Human resources
Doctors
Tech staff
Non Tech staff
Duty and salary roster
OTHER REQUIREMENT LIKE PERIODIC HEALTH CHECK UPS,vaccination of staff
MCh /DNB Plastic Surgery
MCh /DNB Plastic Surgery NURSE-1
Attendant-1
Yes
M-Mandatory D-Desirable D-Desirable M-Mandatory D-Desirable
5 Equipment
a.Stethoscope
b.Thermometer
c. BP Apparatus
d. Glucometer
e.Weigh machine
f. Emergency kit and medicine
g. Drugs,Medical devices and consumables
Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes* Yes*
M-Mandatory
M (Non Mercury)
M (Non Mercury)
M-Mandatory
M-Mandatory
Refer to Clinic/Polyclinic document *M-Mandatory
h. List of disposables
i. Annual Maintenance records of equip
Yes Yes
Yes* Yes*
*M-Mandatory *M-Mandatory
CLINIC WITH PLASTIC SURGEON
Female Attendent
Attendant-1 Yes
yes
yes
6 support services
a. sterlization/CSSD Yes Yes b. security Yes Yes c. BMW management Yes Yes d. Laundry Yes Yes
if required
D: Desirable
As per BMW Rules
D -Desirable;own/outsourced
7 Standard on basic processes
a. Receiving patients,privacy for patients Yes Yes
M-Mandatory
while examining especially females
b. Infection control practices Yes Yes soap and water Yes Yes facilities for hand washing and disinfection Yes Yes
M-Mandatory M-Mandatory M-Mandatory
Disinfection of work Area Yes Yes Use of disposable services Yes Yes small autoclave Yes Yes c. Policy on outsourced services Yes Yes
M-Mandatory M-Mandatory M-Mandatory D
Template for Minimum standards for Hospital
BASIC (General purpose) NON INVASIVE
INVASIVE
Remarks
1 Scope
providesresuscitationandshortterm cardiologyinterventions(eg. Cardio respiratory support including General Hospital with Single defibrillation: require to ventilate for Specialities/Multiple Specialities 24to48hrs.(eg.GeneralHospitalwith exampleCHCSDH,DH,Civil
invasiveproceduresrequiring ICU care with long term acute care of highest standard
Services Provided
1.1 General purpose 1.2 Single Speciality 1.3. Multispeciality 1.4. Superspeciality
yes
2 Human resources 2.1 Doctors
MD/DNB Medicine
DM /DNB Cardiology MD/DNB Medicine MBBS doctors to provide the clock Medical cover
DM/DNB Cardiology
M-Mandatory M-Mandatory
Duty Doctors
MBBS doctors to provide clock Medical cover
round
the
round
MBBS doctors to provide round the clock Medical cover
2.2 Nurses General nurses Trained Nurses for ICU/OT/HDU
yes
Yes
Nurse Station:one ECG lead from each patient and as well as relevant haemodynamic and respiratory data should continuouslybepresentoncentral screen
Yes
Nurse Station:one ECG lead from each patient and as well as relevant haemodynamic and respiratory data should continuouslybepresnton central screen
M-Mandatory M-Mandatory
2.3 Pharmacist
Yes Yes
Yes Yes
Yes Yes*
M-mandatory,part of hospital
2.4 Para Medical staff a. Lab Tech
*M-EmergencyLab; part of hopital
Single Specialities/Multiple Specialities exampleCHCSDH,DH,CivilHospital, Private Hospital, Nursing Home etc )
Hospital,Private Hospital,Nursing Home etc)
CARDIOLOGY SERVICES IN HOSPITAL
yes yes yes
yes yes yes
b. Xray Technician Yes
Yes Yes* *M-own for invasive cardiology; others D-
c.Technician
TrainedcathLabTechnician* *M-ownforinvasive cardiology
d. ECG Technician Yes e. Dietician Yes f. Physiotherapist Yes g. Medicosocial worker
Yes* Yes* *M-Mandatory Yes Yes* *M-Mandatory Yes Yes* *M-Mandatory
3 Equipment
a. Therapeutic
Patient monitoring unit,with 2 ECG channels,invasive pressure channel,non-invasive blood pressure monitor,Sao2 meter 50% beds -5 ECG channels,2 additional haemodyanamic channel,end tidal CO2,Non invasive cardiac output,thermometer.
Yes D-Desirable
Other equipment: Volumetric pump/automatic syringe,Mechanical respirators 1 machine/2 beds ,Intra aortic balloon pump,haemodialysis and haemofiltration machine, pacemaker, defibrillator,external pacemaker , temporary pacemaker ,mobile echocardiography,with TEE probe,blood clot meter,mechanical compressor device for groin and radial haemostatis
own/outsourced
b.Diagnostic
ECG machine TMT,Holter
Xray system for fluroscopy,digital cardiac mobile C arm,-A fully equipped Cardiac Cath Lab
Yes
M-Mandatory
c. Emergency
Yes Yes
Refer to Document on Hospital M-mandatory Refer to Document on Hospital M-mandatory M-mandatory
d. Sterlizing
e. Drugs,Medical devices and consumables
f. List of disposables
g. Annual Maintenance records of equip
Yes Yes Yes Yes
Yes Yes
5 Support Service
a. Laboratory
yes yes
Biochemical markers kits, for MI, Can be own or Glucose level measurement kit, Outsourced Blood gases and electrolyte
analyser
b. Imaging
yes yes
Yes* *M-own for invasive; others
c. sterlization/CSSD
d. Medical Gas/Manifold
Yes Yes Yes Yes Yes Yes
own/outsourced Yes M-own
e. Blood storage unit/ blood Bank
f. Amb service
Yes M-mandatory
Yes M-own/outsourced
Yes Yes Yes Yes
Yes Yes
Yes Yes
Yes* *M-CCU Ambulance for invasive/ non invasive cardiology
service centres
1 Definition
2 Scope
Specialist consultation services
Template for Minimum standards for Clinics/Polyclinics
Minimum Standards
Remarks
Services Provided
MD Medicine can provide consultation services but signage of Cardiology not allowed
3 Physical Infrastructure
a. Space requirement
i). Reception
ii). consultation/waiting area iii). OPD Area
Yes Yes Yes
M-Mandatory M-Mandatory M-Mandatory
4 Human resources
a. Doctors
(MD Medicine can provide Cardiology Services but signage not allowed)
b. Tech staff
c. Non Tech staff
d. Duty and salary roster
ECG Tech yes
Yes
Yes
D
M
D D-Desirable
e. OTHER REQUIREMENT LIKE PERIODIC HEALTH CHECK
UPS
5 Equipment
a. Stethoscope
b. Thermometer
c. BP Apparatus
d. Glucometer
e. Weighing machine f. Others
Yes
Yes
Yes
Yes
Yes
ECG Machine* ,ECHO,TMT Holter
M-Mandatory
CLINIC WITH CARDIOLOGY SERVICES
DM/ DNB Cardiolology
Yes (Non Mercury)
Yes (Non Mercury)
M-Mandatory
M-Mandatory
*M-Mandatory others are desirable and can be own/outsourced
g. Drugs,Medical devices and consumables clopid,Aspirin,others h. List of disposables M
i. Annual Maintenance records of equip Yes
Refer to document of Clinic/Polyclinic M
D-Desirable
6 support services
a. security Yes b. BMW management Yes c. Laundry Yes
D-Desirable;Own or outsourced M-Mandatory
D-Desirable;Own or outsourced
7 Standard on basic processes
a. Receiving patients,privacy for patients while Yes examining especially females
b. Infection control practices Yes soap and water Yes
M-Mandatory
facilities for hand washing and disinfection Yes Disinfection of work Area Yes Use of disposable services Yes small autoclave Yes facilities for sterlization Yes c. Policy on outsourced services Yes
M
M
M
M
M
M
If applicable D
DENTAL SET UP -STAND ALONE/HOSPITAL SET UP (Also refer Annexures for Dental CE)
MinimumStandardsforDentalSetup Stand alone Centre
Multispeciality
Hospital set up Remark
1 Each Category of Dental clinic will be defined on the basis of services provided and basic facilities available.
Dental Chair cum unit-1
3 Dental Chair cum unit
1-5 Dental Chair cum unit
2 Scope of Services
Examination, diagnosis and treatment of all the diseases of teeth and oral cavity
Yes
Yes
Yes
3 Physical Infrastructure
Name of the dental surgeon incharge with qualification and registration
BDS/MDS
MDS
BDS,MDS M
Timings of the Dental Consultation/Fee structure: To be
Yes Yes
Yes Yes
Yes M Yes M
displayed separately
Safety signages : fire safety and Biomedical Waste
Space requirement for waiting room, consulting room and treatment room, safe drinking water
Yes
Yes
Yes M Yes For every additional M
Furniture & Fixtures
Yes
Yes
Yes M
Yes (As per scope of service) Minimum 100 square feet
Yes For every additional chair the usable carpet area must be increased by 50 % Thereshouldbeadequate space between two dental units enough for patient privacy, ease of movement of staff and proper sanitization.
chair the usable carpet area must be increased by 50 % There should be adequate space between two dental units enough for patient privacy, ease of movement of staff and proper sanitization.
Communication system – Landline/ mobile number for appointment/ internet access
Electrical facilities
Yes Yes
Yes
M
Qualification of Incharge dental
Yes Yes BDS/MDS BDS/MDS
Yes BDS/MDS
M M
surgeon
4 Human Resource (Full time/Part time/Visiting)
Trained Chairside assistant, Dental Technician(Trained Academically/Clinically)
1Assistant/DentalNurseperChair1Assistant/DentalNurseper 1Assistant/DentalNurse
M M
Minimum Dental Equipments with accessories
Dental Chair Cum Unit,RVG/Dental Xray unit
Dental Chair Cum Unit,RVG/Dental Xray unit
Dental Chair Cum Unit,RVG/DentalXrayunit
Payment/Roster of salary of staff
Yes Yes
Yes Yes
Yes Yes
M M
Periodic health check up and vaccination against Habatatis B for doctor and staff
5 Equipment(/ instruments/ drugs
Please see annexure 3 D – Own/Outsour ced
Dental X-Ray Sterilization equipments
RVG Autoclave
RVG/OPG Autoclave
RVG/OPG Autoclave
M; Autoclave should be periodically calibrated
Chair
per Chair
List of Consumables and disposables required
Annual Maintenance protocol for equipment and its record of maintenance
Yes
Yes
Yes
M
Receptionist
Yes Yes
Yes Yes
Yes Yes
D M
6 Support Service
Registration with State pollution
control board for BMW 1998
7 Legal/Statutory Requirements
Out and In patient records with names, addresses, Diagnosis and treatments given Site, Space is as given in annexure 1 (for Dental Clinical Establishments), Location and environmental requirements to take into account local bye laws
Yes
Yes
Yes
M
Space : D
All restoration Materials, Endodontic material,all material for extraction of mobile and semi mobile teeth,all material for scaling and polishing fissure,sealant and fluoride
All restoration Materials, Endodontic material,all material for extraction of mobile and semi mobile teeth,allmaterialforscaling andpolishingfissure,sealant and fluoride All instrumentandmaterialsfor minorperiodontalsurgery, Allmaterialfororalsurgery, like impaction, apicoectomy, implant placement,reduction of simplefractures
All restoration Materials, Endodontic material,all material for extraction of mobile and semi mobile teeth,all material for scaling and polishing fissure, sealant and fluoride All instrument andmaterialsforminor periodontal surgery, All materialfororalsurgery, like impaction, apicoectomy ,implant placement, reduction of simple fractures
M
7 Record Maintenance and reporting
Yes M Medicolegal records, as applicable Yes Yes Yes
Confidentialty of Medical records Yes Yes
Record keeping of personnel working Yes Yes in dental clinic indicating their details
including qualification and training
Yes M
Duration of record maintenance: Yes Yes
Yes M
As per the Acts and Rules in force
8 Standards on basic processes
Infection Control practices including Yes Yes Biomedical Waste management
Safety considerations- Yes Yes
Yes M
Annual Maintenance protocol for Yes Yes equipment and its record of
maintenance
Patient Information and Education Yes Yes
Yes M Yes D
M-Mandatory D-Desirable
Yes M
MinimumstandardsforHospital
BASIC (General purpose)
ADVANCE (Non Teaching)
Remarks
1 Scope
Skin Diseases , Skin surgeries (Biopsy) , Nail Surgeries,Electrocautery/Radiofrequency),LASER TREATMENT
Skin Diseases , Skin surgeries, LASER TREATMENT;all advanced dermatology procedures
Services Provided
1.1 General purpose 1.2 Single Speciality 1.3. Multispeciality
Yes
2 Human resources 2.1 Doctors
Med person incharge
MD/DNB/DIPLOMA DERMATOLOGY
MD/DNB /DIPLOMA DERMATOLOGY
M ; indoor full time Dermatologist / on visiting basis
Duty Doctors
MBBS doctor for round the clock medical cover
also MBBS-1 (with 6 months house job in Dermatology)
M; part of Hospital
2.2 Nurses
General nurses
Trained Nurses for ICU/OT/HDU
Yes Yes
Yes Yes
M; part of Hospital M; part of Hospital
2.3 Pharmacist
Yes
Yes*
*M; in advance dermatology hospital
2.4 Para Medical staff a.Lab Tech
DMLT/SMEAR TECHNICIAN
DMLT/ SMEAR TECHNICIAN
M-Mandatory; part of Hospital
b.X-ray Technician c.Dietitician d.Physiotherapist
Yes Yes Yes
Yes Yes Yes
part of Hospital
D; part of Hospital D; part of Hospital
DERMATOLOGY SERVICES IN HOSPITAL
Yes Yes
M.D. Dermatology, D.V.D, D.N.B Dermatology. LASERSurgeriesincludingChemicalPeelscan be performed only by a registered M.D./ DNB/ Diploma holders in Dermatolgy with a certificate of training from recognised institution for 6 months duration (as part of MD Training )
Addtion of 6 months training in advanceDermatologyaspartofMD to be considered by MCI
e.Psychologist Yes
Yes Yes*
MIFPSYCHIATRIST;partofHospital *D; part of Hospital
f.Medicosocial worker No
3 Equipment
a. Therapeutic yes
Microdermabrader , Dermabrader, Phototherapy (Desirable), LASER Electrocautery/ Radiofrequency
as required for Biopsy procedures, Microscope, Dark Ground Microscope narrow band or phototherapy chamber facility for Autoclaving
D
b. Surgical yes c. Diagnostic yes
D M
d. Emergency yes e.Sterilizing yes f. Drugs, Medical devices and yes consumables
M M
g. List of disposables yes h. Annual Maintenance records yes of equipment
Biopsy punch PUVA therapy optional yes
M M
4 Support Services
4.1. Laboratory Yes 4.2. Imaging Yes 4.3. Pharmacy Yes 4.4. sterlization/CSSD Yes 4.6. Medical Gas/Manifold Yes 4.7. Blood storage unit/blood Yes Bank
Yes Yes Yes* Yes Yes* Yes
own / Outsourced own / Outsourced *M
M
4.8. Amb service Yes
Yes*
Yes*
M-Mandatory D-Desirable
Chemical Peels*, Stains for microbiological examination, CO2 laser*
Also refer to documents on
* D hospital
*M D
Template for Minimum standards for Clinics/Polyclinics
Dermatology Clinic
CosmetologycentrewithDermatologist
Remarks
1 Definition
2 Scope
Specialist Specialist
Services Provided
Consultation services, skin biopsy,warts ,
electrocautery, RFA, Nail biopsy,ingrowing Dermabrasion nail excision
3 Physical Infrastructure
a. Space requirement i.Reception
ii. consultation/waiting area
Yes Yes
Yes Yes
M-Mandatory M-Mandatory
4 Human resources
Doctors
MD/DNB/DIPLOMA DERMATOLOGY
MD/DNB/DIPLOMA DERMATOLOGY with 6 months training from a recognised centre
ATTENDANT
M-Mandatory
Non Tech staff
Duty and salary roster OTHER REQUIREMENT LIKE PERIODIC HEALTH CHECK UPS
ATTENDANT Yes
Yes
Yes Yes
M-Mandatory M-Mandatory M-Mandatory
5 Equipment
a. Stethoscope b. Thermometer c. BP Apparatus
No
M-Mandatory
Yes
Yes (Non Mercury) No Yes (Non Mercury) No
DERMATOLOGY CLINIC
Consultation, Laser treatment ,
Dermatologists providing Cosmetology services must have certificate from Govt. recognised centres. No chemical or laser permitted without dermatologist at beauty clinic. No liposuction/ lipolysis without plastic surgeon at beauty clinic.
d. Glucometer Yes
e. Weighing machine Yes
f. Other ELECTROCAUTERY/RFA-ESSENTIAL
No
No
LASER,CHEMICAL PEEL-DESIRABLE
D-Desirable M-Mandatory D-Desirable
DESIRABLE g.Emergency kit and medicine Yes
No
Refer to document on clinic/Polyclinic
h. Drugs,Medical devices and Yes* consumables
No
*M-Mandatory
i. List of disposables
j. Annual Maintenance records of equip
Yes Yes
Yes Yes
M-Mandatory M-Mandatory
6 support services
a. sterlization/CSSD b. security
c. BMW management d. Laundry
Autoclave Yes
Yes
Yes
Autoclave Yes
Yes
Yes
M
D-Desirable M-Mandatory
own or outsourced
7 Standard on basic processes a. Receiving patients,privacy for patients whileexamining especially females
Yes
Yes
M-Mandatory
b. Infection control practices soap and water
Yes Yes Yes
Yes Yes Yes
M-Mandatory M-Mandatory M
facilities for hand washing and disinfection
Disinfection of work Area
Yes Yes Yes Yes
Yes Yes Yes Yes
M
M
M D-Desirable
Use of disposable services small autoclave
c. Policy on outsourced services
PHOTOTHERAPY,LASER,CHEMICAL PEEL-
1 Definition
2 Scope
Specialist
5 Equipment
Minimum standards for Clinics/Polyclinics
Minimum Standards
Remarks
Services Provided
Consultation services/Councelling services
3 Physical Infrastructure
a. Space requirement
i. Reception
ii. consultation/waiting area
Yes Yes
M-Mandatory M-Mandatory
4 Human resources
Doctors
Non Tech staff
Duty and salary roster
OTHER REQUIREMENT LIKE PERIODIC HEALTH CHECK UPS,vaccination of staff
MD/DNB/DIPLOMA in Dermatology, Venerology and Leprosy ATTENDANT
Yes
Yes
M-Mandatory D-Desirable M-Mandatory M-Mandatory
a. Stethoscope
b. Thermometer
c. BP Apparatus
d. Glucometer
e. Weigh machine
f. Emergency kit and medicine
g. Drugs,Medical devices and consumables h. List of disposables
Yes Yes Yes Yes Yes Yes Yes Yes Yes
M
M(Mercury free)
M(Mercury free)
M
M
Refer to document on Clinic/Polyclinic M
M
M-Mandatory
i. Annual Maintenance records of equip
6 support services
a. sterlization/CSSD b. security
c. BMW management d. Laundry
Autoclave Yes
Yes
Yes
Autoclave
D
M-Mandatory
own or outsourced
7 Standard on basic processes
a. Receiving patients,privacy for patients while examining especially females
b. Infection control practices
Yes
M-Mandatory
c. soap and water
d. facilities for hand washing and disinfection e. Disinfection of work Area
Yes Yes Yes Yes Yes Yes Yes
M-Mandatory M-Mandatory M-Mandatory M-Mandatory M-Mandatory M-Mandatory D
f. Use of disposable services
g. small autoclave
h. Policy on outsourced services
STD CLINIC
1 Scope
only Gastroscopy and COLONOSCOPY Yes
all other advanced procedure of Gastroenterology also
MinimumstandardsforHospitalunderCEA
Basic (General Purpose)
Advance (Non Teaching )
Remarks
Services Provided
1.1 General purpose 1.2 Single Speciality 1.3. Multispeciality 1.4. Superspeciality
Yes Yes Yes
2 Human resources 2.1 Doctors
Med person incharge
MD /DNB (MEDICINE) / PAEDIATRICS with certified training of six months in endoscopy
MBBS Doctor for round the clock Medical cover
DM/DNB in Gastroenterology
M-Mandatory
Duty Doctors
MBBSDoctorforroundtheclock Medical cover
M-Mandatory in inpatient
part of hospital AS PER NURSING COUNCIL
2.2 Nurses Nursing head
Yes Yes Yes Yes Yes Yes
Yes
General nurses
Trained Nurses for ICU/OT/HDU
Yes
AS PER NURSING COUNCIL
AS PER NURSING COUNCIL D-Desirable
2.3 Pharmacist
2.4 Para Medical staff a.Lab Tech
Yes
b.Xray Technician
Yes
c.Technician d.ECG Technician
Any Trained Technician Yes
GE trained Technician Yes
D
GASTROENTEROLOGY SERVICES INHOSPITAL
Yes
Yes
M-Mandatory ;if own lab services M-Mandatory; if own services M-Mandatory
e.Dietician f.Physiotherapist g.Medicosocial worker
Yes* Yes* No
Yes** Yes** Yes
*Desirable **-Mandatory *-Desirable **-Mandatory D-Desirable; in advance
3 Equipment
a. Therapeutic b. Surgical
Gastroscope, colonoscope
equipment for advanced Gastroenterology, EU scope with digital fluoroscope
Cardiac monitor,defibrillator and accessories,sengstaken tube
M-Mandatory
c. Diagnostic d. Emergency
Yes Yes
Yes Yes
M-Mandatory
Refer to document on Hospital M-Mandatory
Refer to document on Hospital M-Mandatory M-Mandatory
e. Sterlizing
f. Drugs,Medical devices and consumables
Yes
Emergency Drugs, Terlipressin
Yes
Emergency Drugs, Terlipressin, Sengstaken tube
Yes
Yes
g. List of disposables
h. Annual Maintenance records of equip
Yes Yes
4 Support Services
4.1. Pharmacy
4.2. sterlization/CSSD
4.4. Medical Gas/Manifold
4.5. Blood storage unit/blood Bank 4.6. Amb service
Yes Yes Yes Yes Yes
Yes* Yes Yes Yes Yes
*M-IN ADVANCE M-Mandatory
M-IN ADVANCE D-Desirable
M-own /outsourced / TIE UP
M-Mandatory
Minimum standards for Clinics/Polyclinics
Minimum Standards
Remarks
1 Definition
2 Scope
Specialist
Services Provided
PROVIDING GASTROENTEROLOGY CONSULTATION SERVICES/BASIC PROCEDURES (Gastroscopy & Colonoscopy)
3 Physical Infrastructure
a. Space requirement
i. Reception
ii. consultation/waiting area iii. OPD Area
Yes Yes Yes
M-Mandatory M-Mandatory M-Mandatory
4 Human resources
Doctors
DM /DNB GASTROENTEROLOGY ;MD (Med/Paeds) with certified training of 6 mths in endoscopy
M-Mandatory
Tech staff
Non Tech staff
Duty and salary roster OTHERREQUIREMENTLIKEPERIODICHEALTH CHECK UPS,vaccination of staff
Nurses 3-4 Attendant Yes
Yes
M-Mandatory M-Mandatory M-Mandatory D- Desirable
5 Equipment
a. Stethoscope
b. Thermometer
c. BP Apparatus d. Glucometer
e. Weight machine
Yes
Yes
Yes
Yes
yes Gastroscope,Colonoscope
M-Mandatory
Yes (Non Mercury) Yes (Non Mercury) M-Mandatory M-Mandatory O-Optional
CLINICS WITH GASTROENTEROLOGY SERVICES
f. Emergency kit and medicine
cardiac monitor,defribrillator and accessories,
Also Refer to document on clinic/polyclinic
M
M
g. Drugs,Medical devices and consumables h. List of disposables
i. Annual Maintenance records of equip
Yes Yes Yes
M-Mandatory
6 support services
a. sterlization/CSSD b. security
c. BMW management d. Laundry
Autoclave Yes
Yes
Yes
M
D- Desirable M-Mandatory
own or outsourced
7 Standard on basic processes
a. Receiving patients,privacy for patients while examining especially females
b. Infection control practices
soap and water
facilities for hand washing and disinfection
Yes
M
Disinfection of work Area
Use of disposable services facilities for sterlization
c. Policy on outsourced services
Yes Yes Yes Yes
M
M
M-if applicable D
Yes Yes Yes
M M M
Minimum standards for Hospital
Minimum Standards (Non Teaching)
Remarks
1 Scope
All G I Surgeries; Also diagnostic gastroscopy, colonoscopy, sigmoidoscopy, Oesophageal stricture dilatation.
Services Provided
Superspeciality
2 Human resources
Yes
2.1 Doctors
Med person incharge
Surgeon should fulfil MCI/DNB guidelines or have one year full time training in GI surgery after getting General Surgery degree
Critical care specialist/Intensivist in ICU-1
Duty Doctors
2.2 Nurses
Trained Nurses for ICU/OT/HDU 2.3 Pharmacist
2.4 Para Medical staff
a.Lab Tech
b.Xray Technician
c.OT Technician
d.ECG Technician
e.Dietitician
f.Physiotherapist
g.Psychologist
h.Medicosocial worker
MBBS Doctors for round the clock medical cover
M-Mandatory M-Part of Hospital
3 Equipment
a. Therapeutic b. Surgical
ABG machine is must,no other special equipment Surgical Tray set
M-Mandatory M-Mandatory
GI SURGERY SERVICES IN HOSPITAL
Yes Yes
1per2beds M-Mandatory
Yes Yes Yes Yes Yes Yes Yes Yes
M- if own lab;part of hospital M- if own;part of hospital M-Mandatory
M-Mandatory
M-Mandatory M-Mandatory D-Desirable D-Desirable
c. Diagnostic
d. Emergency
e. Sterlizing
f. Drugs,Medical devices and consumables
Yes as applicable
Yes Refer document of hospital Yes M-Mandatory
Yes Refer document of hospital
g. List of disposables
h. Annual Maintenance records of equip
Yes M-Mandatory Yes D-Desirable
4 Support Services
a. Laboratory b.Imaging
Yes own or Outsourced PortableUSGmachinewithaqualifiedRadiologistavailable M-Mandatory
on call
Yes M-Mandatory
c.Pharmacy
d. sterlization/CSSD
e. Medical Gas/Manifold
f. Blood storage unit/blood Bank g. Amb service
Yes M-Mandatory
Yes M-Mandatory
Yes M-own/outsourced/TIE UP Yes M-own/outsourced/TIE UP
Template for Minimum standards for Clinics/ Polyclinics
Minimum Standards
Day Care
Remarks
1 Definition 2 Scope
Specialist
Specialist
Services Provided
Only consultation services;minor procedure
Day Care Procedures:
1. DiagnosticsBiopsies(US guided/
3 Physical Infrastructure
a. Space requirement
i. Reception
ii. consultation/waiting area
Yes Yes
Yes M Yes M
4 Human resources
Med person incharge
MCh/DNB(GISurgery)/MSGeneralSurgerywith3 years of experience in recognised GI Surg Department)
MCh/DNB(GISurgery)/MSGeneral M Surgery with 3 years of experience in recognised GI Surg Department)
Tech staff
Non Tech staff
Duty and salary roster
NURSE-1 Attendant Yes
yes
NURSE-1 M-Mandatory Attendant M
Yes M-Mandatory yes D-Desirable
OTHER REQUIREMENT LIKE PERIODIC HEALTH CHECK UPS,vaccination of staff
CLINIC FOR GI SURGERY
Endoscopic)
2. Endoscopic- Diagnostic/Therapeutic/UGI
Colonoscopy, UGI scopy with stricture
dilatation
3. Protoscopic procedures- Haemorrhoidal
band ligation/sclerotherapy,fistula threading/wiring underLA
5 Equipment
a. Stethoscope
b. Thermometer
c. BP Apparatus
d. Glucometer
e. Weigh machine
f. Emergency kit and medicine
Yes Yes Yes Yes Yes yes
Yes Yes Yes Yes Yes yes
Yes
g. Drugs,Medical devices and consumables
Yes–2 rigid proctoscope with single light source,Haemorrhoidal band applicator device,punchbiopsyforcep,dressingset, specimen vial. (short stay facility)
Yes–2 rigid proctoscope with singlelightsource,Haemorrhoidal band applicator device,punch biopsy forcep,dressing set,specimen vial.Sigmoidoscope-
M
h. List of disposables
Yes Yes
Yes Yes
M D-Desirable
i. Annual Maintenance records of equip
6 support services
a. sterlization/CSSD b. security
c. BMW management d. Laundry
Yes Yes Yes Yes
Yes Yes Yes Yes
M-Mandatory M-Mandatory M-Mandatory Own/outsourced
7 Standard on basic processes
a. Receiving patients,privacy for patients while
Yes
Yes
M-Mandatory
examining especially females b. Infection control practices
Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes
M
M
M
M
M
M
M D-Desirable
soap and water
facilities for hand washing and disinfection Disinfection of work Area
Use of disposable services
small autoclave
facilities for sterlization
c. Policy on outsourced services
Yes (Non Mercury)
Yes (Non Mercury)
M
M
Refer to document on clinic/Polyclinic
Minimum standards for Hospital
<30 beds
>30 beds
Remarks
1 Scope
General Surgery Services
Emergency OT-1 (dedicated); with round the clock service
Services Provided
1.1General purpose 1.2.Single Speciality 1.3.Multispeciality
Yes Yes Yes
Yes Yes
2 Human resources 2.1 Doctors
Med person incharge
MS/DNB GEN SURG-1/OT JUNIOR SURGEON-1 DESIRABLE
MS GEN /DNB SURG-3, SENIOR Surgeon -1*
JUNIOR SURGEON-1** DESIRABLE
Duty Doctors
MBBS1
MBBS Doctor for round the clock Medical Cover
MBBS1
MBBS Doctor for round the clock Medical Cover
M-Mandatory M-Mandatory;part of hospital
2.2 Nurses
Nursing head
General nurses
Trained Nurses for ICU/OT/HDU 2.3 Pharmacist
1
2 Yes
Yes Yes Yes
part of hospital part of hospital part of hospital part of hospital
2.4 Para Medical staff a.Lab Tech
b.Xray Technician c.OT Technician d.ECG Technician
Yes
Yes
Yes
Yes (own/outsource)
Yes Yes Yes Yes
M- if own lab M- if own
M D-desirable
GENERAL SURGERY IN HOSPITAL
*M-Mandatory **D
e.Dietician f.Physiotherapist g.Psychologist h.Medicosocial worker
Yes Yes Yes No
Yes* Yes* Yes Yes
*M
*M D-desirable D-desirable
3 Equipment
a. Therapeutic
Surgical tray
Surgical Tray
M-NUMBER AS REQUIRED
b. Emergency
Yes
Yes
Refer to document on Hospital M-Mandatory
Refer to document on Hospital M-Mandatory D-desirable
c. Sterlizing
d. Drugs,Medical devices and consumables
Yes Yes
Yes Yes
d. List of disposables
Yes Yes
Yes Yes
e. Annual Maintenance records of equip
4 Support Services
4.1. Laboratory
4.2. Imaging
4.3. Pharmacy
4.4. sterlization/CSSD 4.5. Medical Gas/Manifold
Yes Yes Yes Yes Yes
Yes Yes Yes* Yes Yes
own or Outsourced own or Outsourced *M
*M
4.6. Blood storage unit/blood Bank 4.7. Amb service
Yes Yes
Yes* Yes
M- own/ Outsourced/ Tie up
M- own/ Outsourced/ Tie up
M- own/ Outsourced/ Tie up
Minimum standards for Clinics/Polyclinics
ONLY CONSULTATION
With minor OT
Remarks
1 Definition 2 Scope
Specialist
Specialist
Services Provided
SURGICAL CONSULTATION, PROCTOSCOPY, DRESSING, needle aspiration, DRE
SUTURING, SUTURE REMOVAL, ABSCESS DRAIN, EXCISION LYMPH NODE BIOPSY, DEBRIDEMENT, BANDING, PARACENTESIS, CATHETERIZATION, NEEDLE ASPIRATION, FNAC, MINOR PROCEDURE WHERE NO GA IS REQUIRED
3 Physical Infrastructure
a. Space requirement
i. Reception
ii. consultation/waiting area iii. OPD Area
Yes Yes Yes
Yes Yes Yes
M-Mandatory M-Mandatory M-Mandatory
4 Human resources
Med person incharge Technician
Non Tech staff
MS /DNB GEN SURG Nurse*
Attendant-1*
MS /DNB GEN SURG TRAINED TECHNICIAN-1** Attendant-1**
M-Mandatory
**M;*D
**M;*D;in only consultation clinic either Nurse or Attendant D-
Duty and salary roster
OTHER REQUIREMENT LIKE PERIODIC HEALTH CHECK UPS,vaccination of staff
Yes Yes
Yes Yes
M-Mandatory D-Desirable
GENERAL SURGERY CLINIC
5 Equipment
a. Stethoscope
b. Thermometer
c. BP Apparatus
d. Glucometer
e. Weigh machine
f. Emergency kit and medicine
Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
M
Yes (Non Mercury) Yes (Non Mercury) M
M
g. Drugs,Medical devices and consumables
Yes
Yes
M-Mandatory
h. List of disposables
i. Annual Maintenance records of equip
Yes Yes
Yes Yes
M-Mandatory D
6 support services
a. sterlization/CSSD b. security
c. BMW management d. Laundry
Yes Yes Yes Yes
Yes Yes Yes Yes
M-Mandatory
D
M
Own/ outsourced
7 Standard on basic processes
a. Receiving patients,privacy for patients whileexaminingespeciallyfemales
Yes
Yes
M
b. Infection control practices soap and water
Yes Yes Yes
Yes Yes Yes
M
M M-Mandatory
facilities for hand washing and disinfection
Disinfection of work Area Use of disposable services
Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes
M-Mandatory M
M
M D-Desirable
small autoclave
facilities for sterlization
c. Policy on outsourced services
DRESSING TRAY, CATHETERISATION TRAY, PORTABLE LIGHT
DRESSING TRAY, CATHETERISATION Refer to document on
TRAY, PORTABLE LIGHT
clinic and Polyclinic
1 Scope
General Medicine Services FNAC, PLEURAL TAP, ASCITIC TAP
Services related to Geriartic Care
Minimum standards for Hospital
MEDICINE
GERIARTIC
Remarks
Services Provided
1.1 General purpose 1.2.Single Speciality 1.3.Multispeciality
Yes Yes yes
Yes Yes
2 Physical Infrastructure
ICU Beds
Distance between 2 beds Windows
Physiotherapy Unit
Toilet
20% of Medical and surgical ICU
M M M D M
3 Human resources 3.1 Doctors
Med person incharge
MD/DNB MEDICINE/MD/DNB Medicine
or MD/DNB
M
Duty Doctors
3.2 Nurses
Nursing head
General nurses
Trained Nurses for ICU/OT/HDU 3.3 Pharmacist
MBBS-2
MBBS Doctors for round the clock service
MDGERIARTICMEDICINE-1/ MEDICINE-1
MBBS-4 for 10 BEDS
MBBS Doctors for round the clock service
M
M
part of Hospital
3.4 Para Medical staff a.Lab Tech
b.Xray Technician c.ECG Technician
Yes Yes Yes
Yes Yes Yes
M- if own lab
M- if own M;own/outsourced service
d.Dietician e.Physiotherapist f.Psychologist g.Medicosocial worker
Yes Yes Yes yes
Yes Yes Yes Yes
M-in >30 beds D
D
D
MEDICINE AND GERIARTIC SERVICES IN HOSPITAL
Yes
1 per 2 beds Yes
Yes
1per 2 beds Yes
M
M
Part of Hospital
General Ward: 1.8 m, ICU Ward: 2.5 m
20% of room area (for lighting and ventilation) 100 sq. m
One closet for every 8 patients
4 Equipment
Emergency
Yes
Yes
Refer to document on hospital
Sterlizing
Drugs,Medical devices and consumables
Yes Yes
Yes Yes
M
Refer to document on hospital
List of disposables
Annual Maintenance records of equipment
yes Yes
yes Yes
M
M for major equipments
5 Support Services
5.1. Laboratory
5.2. Imaging
5.3. Pharmacy
5.4. Medical Gas/Manifold 5.5.Blood storage unit/blood Bank 5.6. Ambulance service
Yes Yes Yes Yes Yes Yes
Yes
Yes
Yes
Yes
Yes
Services related to Geriartic Care
own or Outsourced own or Outsourced M;own/outsourced M
M- Mandatory
D- Desirable
D
M-own/ outsourced/ TIE UP
Minimum standards for Clinics/ Polyclinics
MEDICINE
GERIARTIC
REMARK
1 Definition
2 Scope
Specialist
Specialist
Services Provided
CONSULTATION SERVICES; care of acute and chronic illnesses,referral services,basic preventive services
CONSULTATION SERVICES; care of acute and chronic illnesses,referral services,basic preventive services
3 Physical Infrastructure a. Space requirement
GROUND/ LIFT FACILITY*; adequate space for wheel chair bound or disabled patient
*M
i. Reception
ii. consultation/ waiting area
Yes Yes
Yes Yes
M M
4 Human resources
Med person incharge
MD/DNB MEDICINE
MD Geriatric Medicine/ MD/ DNB Medicine
ATTENDANT-1
Yes
M
Non Tech staff
Duty and salary roster OTHER REQUIREMENT LIKE PERIODIC HEALTH CHECK UPS, vaccination of staff
ATTENDANT-1 Yes
Yes
Yes
M M D
5 Equipment
a. Stethoscope
b. Thermometer
c. BP Apparatus d. Glucometer
e. Weight machine Portable X-ray
Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes
M
Yes (Non Mercury) Yes (Non Mercury) M
M
D
MEDICINE AND GERIARTIC CLINIC
Ultrasound Yes Yes
D
Refer document of clinic/polyclinic
M
f. Emergency kit and medicine
Yes Yes
g. Drugs,Medical devices and consumables
h. List of disposables
i. Annual Maintenance records of equip
Yes Yes
6 support services
a. sterlization/CSSD b. security
c. BMW management d. Laundry
Yes Yes Yes Yes Yes Yes Yes Yes
M
D
M D-Own/outsourced
7 Standard on basic processes a. Receiving patients,privacy for patients while examining especially females
Yes Yes
M
b. Infection control practices soap and water
Yes Yes Yes Yes Yes Yes
M M M
facilities for hand washing and disinfection
Disinfection of work Area Use of disposable services
Yes Yes D D Yes Yes Yes Yes
M M M D
small autoclave
c. Policy on outsourced services
Yes Yes Yes Yes
M D
M- Mandatory D- Desirable
Template for Minimum standards for Hospital under CEA
Endocrinology with Endocrinology Surgery
Remarks
1 Scope
Services Provided 1.1 Single Speciality 1.2. Multispeciality 1.3. Superspeciality
Related to Endocrine diseases
2 Human resources 2.1 Doctors
Med person incharge
DM /DNB Endocrinology Mandatory)
(M- M.Ch /DNB Endocrinology surgery (D- Desirable)
only very few institutes giving MCh Endocrinology surgery Neurosurgeon/ENT Surgeons/General surgeons can also do the endocrinal surgeries.
Full time consultant Part time consultant visiting consultant Duty Doctors
Yes Yes Yes Yes
Yes Yes Yes Yes
MBBS Doctors for round the clock Medical cover
2.2 Nurses General nurses
Yes Yes
Yes 1forOT
M-Mandatory M-Mandatory
Trained Nurses for ICU/OT/HDU
2.3 Pharmacist
Yes
Yes
M;part of Hospital
ENDOCRINOLOGY SERVICES IN HOSPITAL
yes ( Beds Optional ) yes
yes
yes
yes
yes (Min 2 beds)
2.4 Para Medical staff a.Lab Tech
b.Xray Technician c.OT Technician d.ECG Technician e.Dietician f.Physiotherapist g.Psychologist h.Medicosocial worker
Yes Yes
1 Yes Yes Yes yes yes Yes Yes
M- if own lab M- if own M-Mandatory M-Mandatory M-Mandatory D-Desirable D-Desirable D-Desirable
3 Equipment
Emergency
Yes
Yes
Refer to documents on Hospital
Sterlizing
Drugs,Medical devices and consumables
List of disposables
Annual Maintenance records of equip
Yes Yes
Yes Yes
M-Mandatory
Refer to documents on Hospital
4 Support Services
4.1. Laboratory
Hormonal estimation lab,Dexa lab, BMD-Tie up
Yes
Yes
Hormonal estimation lab,Dexa lab, BMD-Tie up
yes
Yes
own or Outsourced or Tie up
4.2. Imaging
4.3. Pharmacy
4.4. sterlization/CSSD 4.5. Medical Gas/Manifold
Yes Yes
Yes Yes
own or Outsourced M-Mandatory M-Mandatory M-Mandatory
Yes yes Yes Yes Yes
Yes Yes
Yes Yes
M-Mandatory M-Mandatory
Template for Minimum standards for Clinics/Polyclinics
Diabetology Clinic
Endocrinology clinic
Remarks
1 Definition 2 Scope
General/Specialist
Specialist
Services Provided
providing consultation services for Diabetes
consultation services
3 Physical Infrastructure
a. Space requirement
i. Reception
ii. consultation/waiting area iii. OPD Area
yes Yes yes
yes Yes yes
M-Mandatory M-Mandatory M-Mandatory
4 Human resources
Med person incharge
DM /DNB Endocrinology or MD/DNB Diploma / training in Diabetology, both
(M- DM/DNB
Non Tech staff
Duty and salary roster Others
Attendant
Yes Diabeticeducator/Nurseeducator
D-Desirable D-Desirable D-Desirable
OTHERREQUIREMENTLIKEPERIODIC HEALTH CHECK UPS,vaccination of staff
asrequired
asrequired
D-Desirable
ENDOCRINOLOGY CLINIC
MD/DNB Medicine Medicine/MBBSwithminimumoneyear Mandatory)
from recognised institution Mandatory)
Attendant
Yes Diabeticeducator/Nurseeducator
(M-
Endocrinology Desirable)
(D-
5 Equipment
a. Stethoscope
b. Thermometer
c. BP Apparatus
d. Glucometer
e. Weigh machine
f. Emergency kit and medicine
Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes
M
Yes (Non Mercury) Yes (Non Mercury)
M
M
Refer to documents on clinic/Polyclinic
M
M-Mandatory D-Desirable
g. Drugs,Medical devices and consum h. List of disposables
Yes Yes Yes
Yes Yes Yes
i. Annual Maintenance records of
equip
6 support services
a. sterlization/CSSD b. security
c. BMW management d. Laundry
Yes
Yes
as per policy laid down Yes
Yes
Yes
as per policy laid down Yes
M
D
M
D-Desirable own/outsourced
9 Standard on basic processes a.Receiving patients,privacy for patients while examining especially females
Yes
Yes
M
b. Infection control practices soap and water
Yes Yes Yes
Yes Yes Yes
M M M
facilities for hand washing and disinfection
Disinfection of work Area
Use of disposable services small autoclave
Yes Yes Yes Yes
Yes Yes Yes Yes
M M M D
c. Policy on outsourced services
Template for Minimum standards for Hospital
BASIC (General purpose)
ADVANCE(NonTeachingHospital) REMARK
1 Scope
Providing services for General Hospital with Single Specialities/ Multiple Specialities example SDH, District Hospital, Civil Hospital,Private Hospital,Nursing Home)etc
Providing services for Superspecialities example Civil Hospital, Regional Hospital,Nursing Home,Private Hospital etc.
Services Provided
1.1 General purpose 1.2 Single Speciality 1.3. Multispeciality 1.4. Superspeciality
Yes Yes Yes
2 Human resources 2.1 Doctors
Med person incharge
DM/ DNB NEUROLOGY or MD/DNB MEDICINE
Yes or
Yes or
DM /DNB NEUROLOGY
Full time consultant Part time consultant visiting consultant Duty Doctors
Yes Yes
Yes or
Yes or
Yes
Yes MBBS Doctors for round the
2.2 Nurses
Nursing head
General nurses
Trained Nurses for ICU/OT/HDU 2.3 Pharmacist
Yes Yes Yes
Yes part of Hospital Yes part of Hospital Yes part of Hospital
2.4 Para Medical staff a. Lab Tech
Yes
Yes M- if own lab
NEUROLOGY SERVICES IN HOSPITAL
Yes
clock cover M
yes, own/outsourced; part of Hospital
b. Xray Technician c.Technician
Yes
*EEG Technician-1 (BSc NEURODIAGNOSIS) Yes
Yes
Yes*
Yes
Yes
**EEG Technician-1 (BSc NEURODIAGNOSIS)
Yes
Yes
Yes**
Yes*
M- if own *D
**M
D
d. ECG Technician e. Dietician
f. Physiotherapist g. Psychologist
D
*D;**M D,*M-Mandatory if Psychiatrist
D
h. Medicosocial worker
Yes
Yes
3 Equipment
Therapeutic Diagnostic Emergency
EEG.EMG Yes
CT Scan
EEG.EMG Yes
CT Scan
M
M
Also Refer document on hospital
M
Refer document on Hospital
Sterlizing
Drugs,Medical devices and consumables
Yes Yes
Yes Yes
List of disposables
Yes Yes
Yes Yes
M D
Annual Maintenance records of equip
4 Support Services
4.1. Laboratory
4.2. Imaging
4.3. Pharmacy
4.4. sterlization/CSSD
4.5. Medical Gas/Manifold
4.6. Blood storage unit/blood Bank 4.7. Amb service
Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes
own or Outsourced own or Outsourced M-own/outsourced M
M-Mandatory
D- Desirable
M
M-own/outsourced/TIE UP M-own/outsourced/TIE UP
Template for Minimum standards for Clinics/ Polyclinics
Minimum Standards
Remarks
1 Definition
2 Scope
Specialist
Neurology OPD Consultation
Services Provided
3 Physical Infrastructure
a. Space requirement
i. Reception
ii. consultation/waiting area
Yes Yes
M M
4 Human Resources
Med person incharge
Tech staff
Non Tech staff
Duty and salary roster
OTHER REQUIREMENT LIKE PERIODIC HEALTH CHECK UPS
DM/DNB NEUROLOGY NURSE-1
Attendant-1
Yes
M D M M D
5 Equipment
a. Stethoscope
b. Thermometer c. BP Apparatus d. Glucometer
e. Weigh machine f. Others
Yes
Yes
Yes
Yes
Yes HAMMER Yes
M
Yes (Non Mercury)
Yes (Non Mercury)
M
M
M
Refer document of Clinic/Polyclinic; INCLUDE DIAZEPAM , LORAZEPAM M
g. Emergency kit and medicine
h. Drugs,Medical devices and consumables
Yes
i. List of disposables
j. Annual Maintenance records of equip
Yes Yes
M D
Yes
NEUROLOGY CLINIC
6 support services
a. sterlization/CSSD Yes b. security Yes c. BMW management Yes d. Laundry Yes
M
D
M own/outsourced
7 Standard on basic processes
a. Receiving patients,privacy for patients Yes while
M
examining especially females
b. Infection control practices Yes
M M M
soap and water Yes facilities for hand washing and disinfection Yes
Disinfection of work Area Yes Use of disposable services Yes small autoclave Yes c. Policy on outsourced services Yes
M M M D
M-Mandatory D- Desirable
Template for Minimum standards for Hospital
BASIC
ADVANCE
Remarks
1 Scope
Providing Basic Neurosurgery services (example SDH, District Hospital, Civil Hospital, Private Hospital, Nursing Home) etc
Providing Neurosurgery services (example Civil Hospital, Regional Hospital, Nursing Home, Private Hospital etc.)
Services Provided
1.1 General purpose 1.2 Single Speciality 1.3. Multispeciality 1.4. Superspeciality
Yes yes yes
2 Human resources
Med person incharge Duty Doctors
MCh/ DNB Neurosurgery-1
also MS General SURGEON-3
MBBS Doctors for round the clock cover
MCh/ DNB Neurosurgery-1/6 beds also MS General SURGEON-3
MBBS Doctors for round the clock cover
M M M
2.2 Nurses
Nursing head
General nurses
Trained Nurses for ICU/OT/HDU 2.3 Pharmacist
1 Yes
M
M
M
M- Inhouse pharmacy
2.4 Para Medical staff a. Lab Tech
b. Xray Technician
c. OT Technician
Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes*
M- if own lab M- if own
M
D
d. ECG Technician e. Dietician
f. Physiotherapist g. Psychologist
D D D *M
h. Medicosocial worker
Yes
NEUROSURGERY SERVICES IN HOSPITAL
2 2
1 per 3 bed
1 per 1 bed
1 per 50 beds
Yes
3 Equipment
a. Surgical
Basic Surgical Tray/ Open surgery tray /Laproscopy
Basic Surgical Tray/ Open surgery tray/ M Laproscopy/ Equipment for neuro surgery super speciality; C Arm Machine- 1(for intraoperative spinal neurosurgical operations)
b. Diagnostic
EEG,EMG,XRay machine-both portable and fixed-1 for 50 beds/CT Scan 64 Slice -1
EEG,EMG,XRay machine-both portable M andfixed-1for50beds/CTScan64Slice-
1
c. Emergency
Yes Yes
Refer document of Hospital
d. Sterlizing
d. Drugs, Medical devices and consumables
e. List of disposables
f. Annual Maintenance records of equip
Yes Yes Yes Yes
M
Refer document of Hospital
4 Support Services
4.1. Laboratory
4.2. Imaging
4.3. Pharmacy
4.4. sterlization/CSSD
4.5. Medical Gas/Manifold
4.6. Blood storage unit/blood Bank 4.7. Amb service
Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
own or Outsourced own or Outsourced M
M
Yes Yes Yes Yes
M D
M-Mandatory
D- Desirable
M
M-own/outsourced/TIE UP M-own/outsourced/TIE UP
Minimum standards for Clinics/Polyclinics
CONSULTATION SERVICES
REMARK
1 Definition
2 Scope
Specialist
Services Provided
Consultation Services
3 Physical Infrastructure
a. Space requirement
i. Reception
ii. consultation/waiting area
Yes Yes
M M
4 Human resources
Med person incharge
Tech staff
Non Tech staff
Duty and salary roster
OTHER REQUIREMENT LIKE PERIODIC HEALTH CHECK UPS
M.Ch/ DNB NEUROSURGERY NURSE-1
Attendant-1
Yes
M Optional M
M
D
5 Equipment
a. Stethoscope
b. Thermometer
c. BP Apparatus
d. Glucometer
e. Weigh machine
f. Emergency kit and medicine
g. Drugs,Medical devices and consumables h. List of disposables
Yes Yes Yes Yes Yes Yes Yes Yes Yes
M
Yes (Non Mercury)
Yes (Non Mercury)
M
M
Refer document clinic / Polyclinic M
M
D
i. Annual Maintenance records of equip
6 support services
a. sterlization/CSSD b. security
Yes Yes
M D
CLINIC WITH NEUROSURGERYSERVICES
Yes
c. BMW management Yes
M own/outsourced
d. Laundry Yes 7 Standard on basic processes
a. Receiving patients,privacy for patients while examining Yes especially females
b. Infection control practices Yes
M
soap and water Yes facilities for hand washing and disinfection Yes Disinfection of work Area Yes
M M M M M M M D
Use of disposable services M small autoclave Yes facilities for sterlization Yes c. Policy on outsourced services Yes
M-Mandatory D- Desirable
Minimum standards for Hospital
BASIC (General Purpose)
Advance
Remarks
1 Scope
Providing services ( example Primary Health Centre, Community Health Centre SDH,District Hospital, Private Hospital,Nursing Home etc)
Providing services (example Civil Hospital, regional Hospital,Nursing Home,Private Hospital of similar scope)
Services Provided
1.1 General purpose 1.2 Single Speciality 1.3. Multispeciality 1.4. Superspeciality
Yes
2 Human resources Med person incharge
MD/MS/DGO-1 OR MBBS WITH EMOC TRAINING
YES or
YES OR visiting consultant PAEDIATRICIAN
MD/MS/DGO GYNAE OBS
M
Full time consultant
YES or
YES OR visiting consultant PAEDIATRICIAN
Part time consultant
Full time/Part time/visiting consultant
Duty Doctors
MBBS Doctors for round the clock service
MBBS Doctors for round the clock service
2.2 Nurses
Nursing head
General nurses
Trained Nurses for ICU/OT/HDU 2.3 Pharmacist
2 Yes Yes
1 M 2 M
2.4 Para Medical staff a. Lab Tech
Yes
Yes
M- if own lab;lab can be own/outsourced/Tie up
GYNAECOLOGY AND OBSTETRICS SERVICES IN HOSPITAL
Yes Yes Yes
Yes Yes
As per ICU policy M-own/outsourced
b. Xray Technician
Yes
Yes
M- if own ;can be own/outsourced/Tie up
c. OT Technician
d. ECG Technician
e. Dietician
f. Physiotherapist
g. Psychologist
h. Medicosocial worker
yes Yes Yes Yes Yes Yes
Yes* Yes Yes Yes Yes Yes
*M D-Desirable D-Desirable D-Desirable D-Desirable D-Desirable
3 Equipment
Therapeutic Surgical Diagnostic Emergency
Yes
Yes
Yes
forceps, sims speculum, cusco’s, colposcope, pap smear, endometrial biopsy
Yes
Yes
Yes
for ECLAMPSIA, POST PARTUM HAEMORRHAGE MGT also
M-Mandatory M-Mandatory M-Mandatory
For others refer to document of hospital
Sterlizing
Drugs,Medical devices and consumables
List of disposables
Annual Maintenance records of equ
Yes Yes
Yes Yes
M
refer to document of
4 Support Services
4.1. Laboratory
4.2. Imaging
4.3. Pharmacy
4.4. sterlization/CSSD
4.5. Medical Gas/Manifold
4.6. Blood storage unit/blood Bank D
Yes
own or Outsourced own or Outsourced M-IN ADVANCE
M
4.7. Amb service Yes
Yes
own/ outsourced/ TIE UP
Yes Yes
Yes Yes
hospital
M D-Desirable
Yes
Yes Yes Yes
Yes Yes Yes Yes*
M-IN ADVANCE *M-Mandatory- own/outsourced/TIE UP
Minimum standards for Clinics/ Polyclinics
GYNAE OPD
GOVT RECOGNISED MTP CENTRES
Remarks
1 Definition 2 Scope
General/Gynaecologist
General/Gynaecologist
Services Provided
PAP SMEAR, VIA, VILI, CERVICAL BIOPSY, COLPOSCOPY, VULVOSCOPY,ANC, NORMAL DELIVERY, USG, ANC
PAP SMEAR, VIA, VILI, CERVICAL BIOPSY, COLPOSCOPY, VULVOSCOPY, DELIVERIES, MTP
3 Physical Infrastructure
a. Space requirement
i. Reception
ii. consultation/waiting area
Yes Yes
Yes Yes
M-Mandatory M-Mandatory
4 Human resources
Doctors
MBBS/MD/MS/DGO GYNAE OBS
MD/MS/DGO GYNAE OBS
Under MTP Act clause Subject to the provisions of sub- section (4), a pregnancy may be terminated by a registered medical practitioner, –
(a) Where the length of the pregnancy does not exceed twelve weeks if such medical practitioner is, or
(b) Wherethelengthofthepregnancyexceedstwelve weeks but does not exceed twenty weeks, if not less than two registered medical practitioner are, of opinion, formed in good faith, that –
(i) the continuance of the pregnancy would involve a risk to the life of the pregnant woman or of grave injury to her physical or mental health; or
Tech staff
Non Tech staff
Duty and salary roster OTHER REQUIREMENT LIKE PERIODIC HEALTH CHECK UPS,vaccination of staff
STAFF NURSE-1 ATTENDANT-1 Yes
Yes
STAFF NURSE-2 ATTENDANT-1 Yes
Yes
M
M
M D-Desirable
GYNAE AND OBS CLINIC
(ii) there is a substantial risk that if the child were born, it wouldsufferfromsuchphysicalormentalabnormalities to be seriouslyhandicapped.
5 Equipment
Stethoscope Thermometer BP Apparatus Glucometer Weigh machine
Yes
Yes
Yes
Yes
Yes
DELIVERY KIT
forceps,sims speculum, cusco’s, colposcope, pap smear,endometrial biopsy
Yes M-Mandatory Yes M
Yes M
Yes M
Emergency kit and medicine
Yes M
DELIVERY KIT M
ECLAMPSIA,POST PARTUM HAEMORRHAGE MGT alsorefertodocumenton
List of Disposables and Consumables
Yes Yes
Clinic/Polyclinic Yes M
Yes D
Annual maint of equipt
6 support services
a. sterlization/CSSD b. security
c. BMW management d. Laundry
Yes Yes Yes Yes
Yes M-Mandatory Yes D-Desirable
Yes M
Yes Own/outsourced
7 Standard on basic processes a. Receiving patients,privacy for patients while examining especially females
Yes
Yes M-Mandatory
b. Infection control practices soap and water
Yes Yes Yes
Yes M-Mandatory Yes M-Mandatory Yes M
facilities for hand washing and disinfection
Disinfection of work Area
Yes Yes Yes Yes Yes
Yes M
Yes M
Yes M
Yes M
Yes D-Desirable
Use of disposable services small autoclave
facilities for sterlization
c. Policy on outsourced services
1 Scope
Providing orthopaedics services ( example SDH, District Hospital, Private Hospital, Nursing Home etc)
Providing orthopaedics services (example Civil Hospital, regional Hospital, Nursing Home, Private Hospital of similar scope)
Minimum standards for Hospital
BASIC (General purpose)
ADVANCE
Remarks
Services Provided
1.1.General purpose 1.2.Single Speciality 1.3.Multispeciality
Yes Yes yes
yes Yes
2 Human resources
Medpersonincharge
MS/DNBGENERALSURGorMS/DNB/Diploma MS/DNB/DiplomaORTHOPAEDICS ORTHOPAEDICS
visiting Orthopaedic consultant Duty Doctors
or Yes
also GENERAL SURGEON-2 MBBS-2
or Yes
2.2 Nurses Nursing head General nurses Trained Nurses for ICU/OT/HDU
1
2 Yes
1
2 Yes
M M M
2.3 Pharmacist
Yes
Yes
Mandatory-in inhouse pharmacy
2.4 Para Medical staff a. Lab Tech
b. Xray Technician
Yes Yes
Yes Yes
M- if own lab M-ifown;
c. OT Technician
Yes
Yes
M
ORTHOPAEDIC SERVICES INHOSPITAL
MBBS DOCTORS for round the clock cover from hospital pool
MBBS DOCTORS for round the clock cover from hospital pool
part of Hospital
d. ECG Technician e. Dietitician
f. Physiotherapist g. Psychologist
Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes*
D-own/outsourced D
M
D
h. Medicosocial worker 2.5 others
*M M
a. Policy Manpower/ posting/ rotation/ of medical and ALLIED HEALTH PROFESSIONAL
Yes
Yes
b. STANDARD PERTAINING TO PERSONAL RECORD KEEPING AND TRAINING
c. PAYMENT/ROSTER OF STAFF
Yes
Yes
M
d. OTHER REQUIREMENT LIKE PERIODIC HEALTH CHECK UPS,vaccination of staff in lab,bld bank,TLD badges
Yes Yes
Yes Yes
M D
3 Equipment
Therapeutic Surgical Diagnostic Emergency
Yes
Yes
Yes
HAMMER, SPLINTS, KRAMMER WIRE,THOMAS SPLINT, PELVIC BINDER,SKIN TRACTION,CERVICAL COLLAR,SPINE BOARD
Yes
Yes
Yes
HAMMER,SPLINTS,KRAMMER WIRE, THOMAS SPLINT, PELVIC BINDER,SKIN TRACTION,CERVICAL COLLAR,SPINE BOARD
M
M
M
Also Refer documents on Hospital
Sterlizing
Yes
Yes
M
Drugs,Medical devices and Yes consumables
Yes Also Refer documents on
List of disposables Yes Annual Maintenance records of Yes equip
Hospital Yes M
4 Support Services
4.1. Laboratory Yes
Yes own or Outsourced
4.2. Imaging Yes
Yes Own/out sourced / Tie up
4.3. Pharmacy Yes
4.4. sterlization/CSSD Yes
4.5. Laundry/Kitchen Yes
4.6. Medical Gas/Manifold Yes
4.7. Bloodstorageunit/blood Yes
Bank outsourced / TIE UP
4.8. Amb service Yes
Yes M-own/ outsourced / TIE UP
M-Mandatory D- Desirable
Yes D
Yes M-IN ADVANCE Yes M
Yes own or Outsourced Yes M-IN ADVANCE Yes M-own/
1 Definition
2 Scope
Specialist
Minimum standards for Clinics/ Polyclinics
Minimum Standards
Remarks
Services Provided
CONSULTATION SERVICES, PLASTER APPLICATION AND REMOVAL, SUTURING AND DRESSING,SPLINT APPLICATION; local injection allowed but no intra- articular without asepticOT
3 Physical Infrastructure a. Space requirement
Room for consultation,minor OT,room for plaster application and removal
i. Reception
ii. consultation/waiting area iii. OPD Area
Yes Yes Yes
M M M
4 Human resources
Med person incharge
Tech staff
Non Tech staff
Duty and salary roster
OTHER REQUIREMENT LIKE PERIODIC HEALTH CHECK UPS,vaccination of staff in lab,bld bank,TLD badges
MS /DNB/Diploma ORTHOPAEDICS NURSE-1
attendant-1
yes
D M D D
5 Equipment
a. Stethoscope b. Thermometer c. BP Apparatus d. Glucometer
Yes Yes Yes Yes
M
M(Mercury free) M(Mercury free) M
CLINIC WITH ORTHOPAEDICSERVICES
Yes
e. Weigh machine f. other
Yes M HAMMER,SPLINTS,KRAMMER WIRE,THOMAS M
g. Emergency kit and medicine h. Drugs,Medical devices and consumables
i. List of disposables
SPLINT,PELVIC BINDER,SKIN TRACTION,CERVICAL COLLAR,SPINE BOARD
Yes
Yes
Refer document of Clinic/Polyclinic M
j. Annual Maintenance records of
Yes Yes
M D-Desirable
equip
6 support services
a. sterlization/CSSD b. security
c. BMW management d. Laundry
Yes Yes Yes Yes
M
D
M own/outsourced
7 Standard on basic processes
a. Receiving patients,privacy for patients while examining especially females
b. Infection control practices
Yes
M
soap and water
facilities for hand washing and disinfection
Disinfection of work Area
Yes Yes Yes
M M M
Use of disposable services
small autoclave
c. Policy on outsourced services
Yes Yes Yes Yes
M M M D
M- Mandatory
D-Desirable
1 Scope
Providing services ( example Primary Health Centre, Community Health Centre, SDH,District Hospital ,Private Hospital,Nursing Home etc)
Providing services (example Civil Hospital, regional Hospital,Nursing Home,Private Hospital of similar scope).
Template for Minimum
BASIC (General Purpose)
ADVANCE
Remarks
Services Provided
OPD ENT dianostics-Audiometry, tympanometry, Emergency ENT procedures, Stridor, Tracheostomy, Foreign Body removal(nasal and aural),nasal packing,incision and drainage of simple neckabscess
OPD ENT dianostics including endoscopy, Emergency ENT procedures, Stridor, Tracheostomy, Foreign Body removal(nasal and aural),nasal packing,incisionanddrainageofhead& neck abscess , bronchoscopy,Nasoendoscopic surgeries.Microscopic,endoscopic and open ENT surgeries,Skull base surgery
1.1.General purpose
1.2.Single Speciality
Yes Yes Yes
Yes Yes
1.3.Multispeciality 2 Human resources
2.1 Doctors
Med person
incharge Fulltimeconsultant Yes or
MS/DNB /DLO/ENT Surgeon-2 Yes or
Yes or
Yes
Part time Yes or consultant
visiting consultant Yes
OTORHINOLARYNGOLOGY SERVICES IN HOSPITAL
MS/DNB /DLO ENT Surgeon-1
M-Mandatory
Duty Doctors
MBBS Doctors
MBBS Doctors
MBBS Doctors for round the clock Medical Cover; part of hospital
2.2 Nurses General nurses Trained Nurses for ICU/OT/HDU
2.3 Pharmacist
1 Yes 1 Yes
Part of Hospital ICU norms
2.4 Para Medical staff
Yes
Yes
M-Mandatory in inhouse pharmacy
a.Tech
Audiometry technician/Assistant-1
Audiometry technician/Assistant-1; speech pathologist-1
Yes
Yes
M-Mandatory
b.Xray Technician c.OT Technician d.ECG Technician e.Dietician f.Physiotherapist g.Psychologist h.Medicosocial worker
Yes Yes Yes yes yes yes yes
Yes Yes Yes Yes Yes
M-own/outsourced M-own/outsourced D-own/outsourced D-Desirable D-Desirable D-Desirable D-Desirable
3 Equipment
Therapeutic
Tongue depressor,Thudicum nasal
speculum,Aural speculum,Tilleys forcep,Indirect laryngoscopymirrors,Posteriorrhinoscopymirror,
Wax probe,Alligator forceps,Eustachian Tube catheter,Spiritlamp,Suctiontipconnector,Suction probe,Alligatorforceps,EustachianTube
Surgical
Portable Light,Tracheostomy set,Minor set, general set.
Portable Light,Tracheostomy set,Thyroid set,MLS set,general set,minor set,direct larygoscopy set,bronchoscopy set,CWL set,FESS set,Endoscopes with monitor, surgical drill,mastoid set,shea set, myringoplasty set, surgical microscope, tonsillectomy set,microdebrider,CO2 laser machine,nerve monitor machine,vascular set.
M-Mandatory
tips
catheter,Spirit lamp,Suction tip connector,Suction tips
Tongue depressor,Thudicum nasal speculum,Aural speculum,Tilleys forcep,Indirectlaryngoscopy mirrors,Posterior rhinoscopy mirror,Wax
M
Diagnostic
ENT Tray,portable head light
ENT Tray, portable head, endoscopes, surgical microscope
M-mandatory; ENT Tray-Tongue depressor- 10,Thudiculum nasal speculum-10, Aural speculum- 10(different sizes),Tilley’s forcep, Indirect laryngoscopy mirror- 5, posterior rhinoscopy mirrors- 5,wax probe-2, Alligators forcep-5, Eustachian tube catheter-1, spirit lamp-1, suction tip connector-1, suction tips(different sizes)- 5
Emergency
For epistaxis-Killian’s nasal speculum,Tilley’s forcep,Tongue depressor,Bowl,Nasal packs- anterior/posterior.Emergency Set
For epistaxis-Killian’s nasal speculum,Tilley’s forcep,Tongue depressor,Bowl,Nasal packs- anterior/posterior.Emergency set- 1;Tracheostomy set-1;general set- 1;surgical microscope-1.
Emergency Kit- Killians Nasal speculum-1,Tilley’s Forcep-1,Tongue depressor-1,Bowl- 1,Nasal packs-
Sterlizing Drugs,Medical devices and consumables
List of disposables Annual
autoclave/boiler-1 Life saving drugs
autoclave
Life saving drugs
M-Mandatory Refer to Hospital documents
4 Support Services
4.1. Laboratory 4.2. Imaging 4.3. Pharmacy
Yes Yes
Yes Yes
M-if own lab M-if own
M-IN ADVANCE
gloves,sterile gauze,cotton,gown yes
gloves,sterile gauze,cotton,gown yes
M D-Desirable
4.4. Yes Yes sterlization/ CSSD
4.5. Medical Yes Yes Gas/Manifold
M
4.6. Blood storage Yes Yes unit/blood Bank
4.7. Amb service Yes Yes
M-own/ outsourced/ TIE UP
M-own/ outsourced/ TIE UP
M-own/outsourced
1 Definition
2 Scope
Specialist
Services Provided
OPD Diagnostics, syringing, wax, epistaxis management, laryngoscopy andsimple nasal and ear foreign body removal
3 Physical Infrastructure
a. Space requirement
i. Reception
ii. consultation/waiting area iii. OPD Area
Yes Yes Yes
M-Mandatory M-Mandatory M-Mandatory
4 Human resources
Med person incharge
Tech staff
Non Tech staff
Duty and salary roster
OTHER REQUIREMENT LIKE PERIODIC HEALTH CHECK UPS
MS/DNB/DLO ENT Nurse-1 Attendant-1
Yes
M
optional
M D-Desirable D
5 Equipment
Stethoscope Thermometer BP Apparatus Glucometer Weigh machine
Yes
Yes
Yes
Yes
Yes Speculum,ENTTray,Portablelight,suctionmachine-1
M
Yes (Non Mercury) Yes (Non Mercury) M
M
CLINIC WITH OTORHINOLARYNGOLOGY SERVICES
Template for Minimum standards for Clinics/ Polyclinics
Minimum Standards
Remarks
yes
M-mandatory; ENT Tray-Tongue depressor- 10,Thudiculum nasal speculum- 10 , Aural speculum- 10(different sizes),Tilley’s forcep, Indirect laryngoscopy mirror-5,posterior rhinoscopy
Emergency kit and medicine
EmergencyKit;medicinesalineandxylometazolidine nasal drops, antibiotic and anti -fungal ear drops,betadine gargle, antihistamine, 10% xylocaine spray,betadine solution. For epistaxis-Killian’s nasal speculum,Tilley’s forcep,Tongue depressor, Bowl, Nasal packs-anterior/posterior
Emergency Kit- Killians Nasal speculum-1, Tilley’s Forcep- 1,Tongue depressor-1, Bowl- 1,Nasal packs- anterior-2,
Drugs,Medical devices and consumables List of disposables
Annual Maintenance records of equip
sterile gauze pieces, gloves, dressing,adhesive Yes
Yes
M
M D-Desirable
6 support services
a.sterlization/CSSD b. security
c. BMW management d. Laundry
Table top/boiler-1 Yes
Yes
Yes
M
D
M own/outsourced
7 Standard on basic processes a.Receivingpatients,privacyforpatientswhileexaminingespeciallyfemales
Yes
M-Mandatory
b. Infection control practices
Yes Yes Yes Yes Yes Yes Yes
M M M M M M D
soap and water
facilities for hand washing and disinfection Disinfection of work Area
Use of disposable services
small autoclave
c. Policy on outsourced services
TemplateforMinimumstandardsforClinics/Polyclinics
Minimum Standards
Remarks
1 Definition
2 Scope
General/ Specialist
Services Provided
Clinical ENT evaluation, audiometry, (Optional Speech therapy)
3 Physical Infrastructure
a. Space requirement
i. Reception
ii. consultation/waiting area
Yes Yes
M-mandatory M-mandatory
4 Human resources
Doctors Tech staff
MS /DNB/DLO ENT provide cover AUDIOLOGIST/Speech Pathologist-1( BSc Audiology)
M D
Non Tech staff
Attendant-1 Yes
Yes
Duty and salary roster
D D
OTHER REQUIREMENT LIKE PERIODIC HEALTH CHECK UPS,vaccination of staff in lab,bld bank,TLD badges
5 Equipment
Stethoscope Thermometer BP Apparatus
Yes Yes Yes
M-mandatory
M-mandatory
M-mandatory
M-mandatory; ENT Tray-Tongue
DEAF AND DUMBCLINIC
Speculum,ENT Tray,Portable light-1,suction machine- 1,audiometry machine-1, Tympanometry machine-1(Optional)
depressor-10,Thudiculumnasal speculum-10,Aural speculum- 10(different sizes),Tilley’s forcep,Indirectlaryngoscopymirror- 5,posterior rhinoscopy mirrors- 5,wax probe-2,Alligators forcep- 5,Eustachian tube catheter-1,spirit lamp-1,suction tip connector- 1,suction tips(differentsizes)-5
Emergency kit and medicine
)Emergency Kit ; medicine saline and xylometazolidine nasal drops,antibioticandanti-fungaleardrops,betadinegargle, antihistamine, 10% xylocaine spray,betadine solution.
Emergency Kit-Killians Nasal speculum-1,Tilley’s Forcep- 1,Tongue depressor-1,Bowl-1,Nasal packs-anterior-2,posterior-2
List of Disposables
sterile gauze pieces, gloves, dressing, adhesive Yes
M D
Annual maint of equipt
6 support services
sterlization/CSSD security
BMW management Laundry
Table top boiler/Autoclave-1 Yes
Yes
Yes
M
M
M own/outsourced
7 Standard on basic processes
a.Receiving patients,privacy for patients while examining
Yes
M-mandatory
especially females b.Infection control practices
Yes Yes Yes Yes Yes Yes Yes Yes
M-mandatory M
M
M
soap and water
facilities for hand washing and disinfection Disinfection of work Area
Use of disposable services small autoclave
facilities for sterlization
c.Policy on outsourced services
M
M
M D-Desirable
Template for Minimum standards for Hospital under CEA
MINIMUM STANDARDS
Remarks
1 Scope
Services Provided 1.1.General purpose 1.2.Single Speciality 1.3.Multispeciality
Yes Yes Yes
2 Human resources
2.1 Doctors
Med person incharge
Other Doctors dedicated for psychiatry
Duty Doctors, as per case load of the hospital 2.2 Nurses
MD/DNB in PSYCHIATRY/DPM MBBS-1
MBBS for round the clock service
M
D
M (May be part of the hospital)
Nursing head
General nurses
Trained Nurses for ICU/OT/HDU 2.3 Pharmacist
2.4 Para Medical staff
a.Lab Tech
b.Xray Technician
c.ECG Technician
d.Dietician
e.Physiotherapist
f.Psychologist
g.Medicosocial worker
2.5 Support Staff
a. Receptionist & Billing Staff
b. MRD Office Staff
1 Yes
2
as per nursing council norms D
PSYCHIATRY SERVICES INHOSPITAL
Yes Yes
Yes Yes
M- part of the hospital M- part of the hospital
1 1 1
M-if own
M-if own M-own/outsourced D
D
1 1
D- own/ Outsourced D- own/ Outsourced
M- own/outsourced
c. Security closed circuit surveillance and sanitation
Yes
M- Sanitation and security D-
d. Transport facility including driver e. Data entry operators
f. Housekeeping
2.6 Rapid response team
closed circuit surveillance 1 M- own/outsourced
2.7 Others
a. Policy for Manpower/ posting /rotation/ of medical and Allied Health Professional
b. Standard Pertaining To Personal Record Keeping And Training
c. Payment/Roster OfStaff
d. Other Requirment Like Periodic Health Checkups,Vaccination of staff in lab, blood storage Unit,TLD badges
M
3 Equipment
3.1Therapeutic
Brief pulse ECT machine; Anaesthesia equipment for MECT; Computerised Biofeedback machine(Desirable)
D
3.2 Diagnostic 3.3 Emergency
Inj Haloperidol,Inj Promethazine,Inj Diazepam,Inj Lorazepam,Inj Naloxone,IV B Complex,Inj Flumazenil
M
3.4 Sterlizing
Yes Yes
Part of the hospital M
D
M M D
3.5 Drugs,Medical devices and consumables
Tab Chlorpromazine, Haloperidol, M Olanzepine, Tab Fluoxitine, Carbemazepine, Phenobarbitone,Tab Tramadol, Propanolol, Antacids, Analgesics
3.6 List of disposables
Yes Yes
M D
3.7 Annual Maintenance records of equipment
4 Support Services
4.1 Reception & Billing 4.2 MRD Services
4.3 Laboratory
4.4 Imaging
Yes Yes Yes yes Yes yes yes Yes Yes Yes
M- part of hospital M- part of hospital own or Outsourced own or Outsourced own or Outsourced D
4.5 Pharmacy
4.6 Sterlization/CSSD 4.7 Laundry/Kitchen
4.8. sterlization/CSSD 4.9.Medical Gas/Manifold 4.10. Ambulance service
own or Outsourced
D
D
M-own/outsourced /TIE UP
M-Mandatory
D – Desirable
Minimum standards for Clinics/ Polyclinics
Clinic with Psychiatrist
Psychology clinic
DAY CARE
REMARK
1 Definition
2 Scope
Specialist CONSULTATION SERVICES
Specialist
Services Provided
CONSULTATION SERVICES
CONSULTATION SERVICES, MECT
3 Physical Infrastructure a.Space requirement
i. Reception
ii. consultation/waiting area
Yes Yes
Yes Yes
Yes Yes
4 Human resources
Doctors
MD/DNB IN PSYCHIATRY/DPM
MD
M D/Outsourced
Tech staff
Non Tech staff
Duty and salary roster
ATTENDANT-1 Yes
RCI recognised MPhil in ClinicAnaesthetist on call ATTENDANT-1
OTHER REQUIREMENT LIKE PERIODIC HEALTH CHECK UPS, Vaccination of staff in lab, blood storage unit, TLD charges
5 Equipment Stethoscope
Yes Yes Yes Yes Yes
Not Required Not Required Not Required
Yes Yes Yes Yes Yes
M
Yes (Non Mercury) Yes (Non Mercury) D
M
Thermometer
BP Apparatus Glucometer Weighing machine
Yes
PSYCHIATRY CLINIC
Yes
D
other equipment
OPHTHALMOSCOPE, INSTRUMENT TRAY FOR NEUROLOGIGAL EXAMINATION
Computerised biofeedback machines (desirable)
Brief pulse ECT and Biofeedback : Mandatory Computerised brief pulse ECTmachine with EEG monitoring, Boyle’s apparatus for MECT, Computerised biofeedback machine- desirable
Emergency kit and medicine
Inj.Haloperidol, Promethazine, Diazepam, Lorazepam, Naloxone ,Thiamine, Flumazenil
Anti psychotic – Chlorpromazine,Haloperidol, Resperidone,Olanzapine,Halo peridol.
Anti depressant- Imipramine,Fluoxitine,Escital opram,
Mood Stabilizers-Sodium Valproate.
Anti epileptic- Phenobarbitone Diphenylhydation. Inj promethazine, triphenidylpropranolol, antacids.
No
Inj.Haloperidol, M Promethazine,Diazepam, Lorazepam, Naloxone ,Thiamine, Flumazenil
Brief pulse ECT and Biofeedback
Anti psychotic – Chlorpromazine,Haloperid ol,Resperidone,Olanzapin e,Haloperidol.
Anti depressant- Imipramine,Fluoxitine,Esci talopram,
Mood Stabilizers-Sodium Valproate.
Anti epileptic- Phenobarbitone Diphenylhydation. Inj promethazine, triphenidylpropranolol, antacids.
Drugs,Medical devices and consumables
Yes no Yes
M-Refer to documents on Clinic/Polyclinic M
List of disposables
Annual Maintenance records of equip
Yes no Yes Yes no Yes
D-Desirable
6 support services
sterlization/CSSD security
BMW management Laundry
Yes no Yes Yes Yes Yes Yes no Yes Yes Yes Yes
D
D
M own/outsourced
7 Standard on basic processes a. Receiving patients,privacy for patients while examining especially females
Yes Yes Yes
M
b. Infection control practices soap and water
Yes Yes Yes Yes Yes Yes Yes Yes Yes
M M M
facilities for hand washing and disinfection
Disinfection of work Area Use of disposable services small autoclave
Yes no Yes Yes no Yes Yes no Yes Yes Yes Yes
M M D D
c. Policy on outsourced services
M- Mandatory D – Desirable
MinimumstandardsforHospitalunderCEA
MINIMUM STANDARDS
Remarks
1 Definition 2 Scope
Drug Dependence Treatment Centre
Services Provided
1.1.General purpose
Yes Yes
1.2.Single Speciality 3 Human resources
Med person incharge
Duty Doctors
1.2 Nurses
Nursing head
General nurses
Trained Nurses for ICU/OT/HDU 1.4 Para Medical staff
MD/DPM/DNB PSYCHIATRY for 24 HRS COVER MBBS Doctors
M M
Lab Tech
Xray Technician
ECG Technician
Dietitician
Physiotherapist
Psychologist/Medico-social worker /Counsellor
yes yes yes yes Yes 1
M-if own M-if own D
D
Medicosocial worker
1.5 Support Staff
a.Receptionist & Billing
b.MRDOffice
c.Securityclosed circuit surveillance and sanitation
COUNCELLOR-2
M
d.Transport facility including driver
Yes
Sanitation and Security; Must Closed circuit surveillance M-own/outsourced
DEADDICTION CENTRE
1 yes 2
D
M- as required M
Yes Yes Yes
M
D
M -Full time/Part time/ Visiting
M
e.Data entry operators 1.7 others
Yes Yes
M M
Policy Manpower/ posting/ rotation/ of medical and Allied Health Professional
Standard Pertaining To Personal Record Keeping And Training
Yes
M
PAYMENT/ROSTER OF STAFF
OTHER REQUIREMENT LIKE PERIODIC HEALTH CHECK UPS
Yes Yes
M D
4 Equipment
Emergency
Sterlizing
Drugs,Medical devices and consumables List of disposables
Annual Maintenance records of equip
Yes Yes Yes Yes Yes
Refer Hospital Document M-if own
Refer Hospital Document M
5 Support SERVICE
Reception &Billing
Laboratory
Imaging
Pharmacy
sterlization/CSSD Laundry/Kitchen
Medical Gas/Manifold
Blood storage unit/blood Bank
Yes Yes Yes Yes Yes Yes Yes
M D-own/outsourced D-own/outsourced D-own/outsourced M-Mandatory M-own/Outsourced M
referral
Amb service
Yes
M
M- Mandatory
D- Desirable
M
Minimum standards for Hospital
BASIC (General purpose)
ADVANCE
Remarks
1 Scope
Providing services ( example Primary Health Centre, Community Health Centre, SDH, District Hospital, Private Hospital,Nursing Home etc)
Providing services (example Civil Hospital, regional Hospital,Nursing Home,Private Hospital etc of similar scope)
ServicesProvided
BASICOPHTHALMICCARESERVICES
Surgicalproceduresincludingbutnotlimitedto anythefollowinglikecataractsurgery,todiagnose andtreat-superficialanddeepinjuries,refractive error, glaucoma, injuries, eye problems due to systemic diseases, squint & amblyopia, retinal disease, paediatric ophthalmology, oculoplasty , retinasurgeries,lasers,keratoplasty,refractive lasers and refractive surgeries etc.
Itisnotnecessaryfora hospitaltohaveallthe facilities in-house.A planned referral policy or arrangement for facilities not available should be available
1.1.General purpose 1.2.Single Speciality 1.3.Multispeciality
Yes
2 Human resources Med person incharge
MD/MS Ophthalmology/DO/DNB-1
Upto 20 beds
20-40 EYE BEDS-2 SENIOR MS/DNB /DO OPHTHALMOLOGY
Yes
Yes or
Yes
MBBS DOCTORS FOR ROUND THE CLOCK COVER
M-Mandatory
Full time consultant Part time consultant visiting consultant Duty Doctors
Yes or
Yes or
Yes
MBBS DOCTORS FOR ROUND THE CLOCK COVER
M-Part of Hospital
OPHTHALMOLOGY SERVICES IN HOSPITAL
Yes Yes
2.2 Nurses
General nurses
Trained Nurses for ICU/OT/HDU 2.3 Pharmacist
2.4 Para Medical staff
a.Tech
b.Xray Technician
c.OT Technician
d.ECG Technician
e.Dietitician
f.Physiotherapist
Yes
yes 2 yes
As per norms of Nursing Council
ICU Norms own/outsource
g. Psychologist
h. Medicosocial worker
Yes
Yes Yes
D
D-part of Hospital
3 Equipment
Therapeutic
Illuminated Snellen’s vision drum/charts,Near vision chart,Retinoscope,Trial set, Ophthalmoscope & Slit Lamp.
Snellens chart,Trial Set,Colour vision,Near Vision, Ophthlmoscope, and retinoscope,Bright focus torch,slit lamp, tonometer, indirect ophthalmoscope, Gonioscope-Mandatory Optional-Auto Refractor,Non contact Tonometer,Nd YAG laser,Visual Field Analyzer,Fundus camera,instrument for removal of Stye,Chalazion,corneal foreign body removal
M
Surgical Emergency
M-Mandatory Yes M-Mandatory
Sterlizing
Yes
Yes
Optometrist/Ophthalmic technician Yes
Yes
Yes
Optometrist/Ophthalmic technician Yes
Yes
Yes
M
Mifown
M
D-own/outsource D-own/outsource D-own/outsource (ocular exercise)
Yes Yes
Yes Yes
ResuscitationEquipmentadult,Ambubag/ Airway/ Oxygen cylinder
Ophthalmology Tray
ResuscitationEquipmentadult,Ambubag/Airway/ Refertodocumenton Oxygen cylinder Hospital
Drugs,Medical devices and consumables
0.5%Tropicamide drops, 0.5% Tropicamide+5% phenylephrine drops, 2% Homatropine drops/ointment, Sterile Fluoresin stick. Ciprofloxacin eye drops 0.3%,ciprofloxacin 0.3% ointment,Sulphacetamide eye 20%Moxifloxacin 0.5%, Tobramyc in 0.3% Anti inflammatory Flubiprofeneyedrops,Predaetateeyedrop1%Anti GlaucomaDrugsTimololeyedrops-5%Pilocarpine eyedrops2%, Tab Acetazolamide 250 mgSyrup Glycerol, Inj mannitol Lubricating eye
Sterile pads,bandage Annual Maintenance records of Yes
Sterile pads,bandage Yes
M-Mandatory D-Desirable
List of disposables
equip
4 Support Services
4.1. Laboratory Yes 4.2. Imaging yes 4.3. Pharmacy Yes 4.4 Medical Gas/Manifold Yes 4.5. Blood storage unit/blood Bank Yes
Yes Yes Yes Yes Yes
own or Outsourced own or Outsourced M-Mandatory M-Mandatory
4.6. Amb service Yes
Yes
D M-own/outsourced/TIE
0.5%Tropicamide drops, 0.5%
Tropicamide+5%phenylephrinedrops,2%
Homatropine drops/ointment, Sterile
Fluoresin stick. Ciprofloxacin eye
drops.3%,ciprofloxacin 0.3%
ointment,Sulphacetamide eye
20%Moxifloxacin0.5%,Tobramycin0.3%Anti
inflammatory Flubiprofen eye
drops,Predaetate eye drop1% Anti Glaucoma
Drugs Timolol eye drops-5% Pilocarpine
eyedrops2%,TabAcetazolamide250mgSyrup drops:preservativefreeHPmcorSodiumCMC0.3- Glycerol,Injmannitol Lubricating eye 05%
M-Mandatory
drops:preservative free HPmcor Sodium CMC 0.3-05%
M-Mandatory D- Desirable
Minimum standards for Clinics/Polyclinics
NON SURGICAL CLINICS
SURGICAL CLINICS
Remark
1 Definition
2 Scope
Specialist
Specialist
Services Provided
CONSULTATION, REFRACTIVE ERROR, DETECTION OF CATARACT, SQUINT, CORNEAL ULCER, GLUCOMA(basicOpthalmicdisorder/IOP Measurement)
REFRACTION- MANUAL/ AUTOREFRACTOR, SYRINGING, FB REMOVAL, EPILATION, SUTURE REMOVAL SUBCONJUNCTIVALS INJECTIONS, WART & STYE EXCISION, CORNEAL SCRAPING, I&D OF LID ABSCESS IOP Measurement: AT (Applantaion Tonometry) / NCT (Non-contact tonometry)
3 Physical Infrastructure b. Space requirement i. Reception
Yes
Yes
M
ii. consultation/waiting area
Yes Yes
Yes Yes
M M
iii. OPD Area
4 Human resources
Med person incharge Tech staff
Non Tech staff
Duty and salary roster OTHER REQUIREMENT LIKE PERIODIC HEALTH CHECK UPS,vaccination of staff
MS/DNB/DIPLOMA OPHTHALMOLOGY NURSE-1
Attendant-1
Yes
MS/DNB/DIPLOMA OPHTHALMOLOGY OT TECH-1-M
Attendant-1
Yes
M
5 Equipment
a. Stethoscope
b. Thermometer c. BP Apparatus d. Glucometer
e. Weigh machine
Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes
M
Yes (Non Mercury) Yes (Non Mercury) M
M
Yes
Yes
M M D
CLINIC WITH OPHTHALMOLOGY SERVICES
f. Others
AT (Applantaion Tonometry) / NCT (Non-contact tonometry)
ILLUMINATED SNELLENS VISION M DRUM/CHARTS,RETINOSCOPE,TRIAL
SETprism bar maddox rod synatophore(d)
red green glasses.wf dot test
g. Emergency kit and medicine
Tab. Acetazolamide,Xylocain 2%, Paracaine 4%
.5%TROPICAMIDE, .5%TROPICAMIDE+5%PHENYLEPHRINE, 2%HOMATROPINE, STERILE FLUORESIN
STICK, .3%CIPROFLOXACIN DROP
yes M
h. Drugs,Medical devices and
yes
consumables
6 support services
sterlization/CSSD security
BMW management Laundry
yes Yes Yes Yes
yes M
Yes D
Yes M
Yes Own/outsourced
7 Standardonbasicprocesses a. Receiving patients,privacy for patients while examining especially females
Yes
Yes D
b. Infection control practices
Yes Yes
Yes M Yes M
soap and water
facilities for hand washing and disinfection Disinfection of work Area
Yes Yes Yes Yes Yes
Yes M Yes M Yes M Yes M Yes M
Use of disposable services small autoclave
facilities for sterlization
c. Policy on outsourced services
Yes
Yes D
M- Mandatory
D- Desirable
Minimum standards for Clinics/Polyclinics
Minimum standards
REMARKS
1 Scope
Services Provided
REFRACTIVE ERROR,DETECTION OF CATARACT,SQUINT,CORNEAL ULCER
2 Physical Infrastructure
b. Space requirement
i. Reception
ii. consultation/waiting area iii. OPD Area
10’*15′,DARK ROOM
3 Human resources
Doctors
Tech staff
Non Tech staff
Duty and salary roster
ophthalmologist BSC OPTOMETRICS Attendant
Yes
M-Mandatory D-Desirable M
4 Equipment
other
STREAK RETINOSCOPE,VISION CHART,NEAR VISION, AUTO REFRACTOR,AUTO KERATOFACTOR (OPTIONAL) .5%TROPICAMIDE,.5%TROPICAMIDE+5%PHENYLEPH RINE,2%HOMATROPINE, STERILE FLUORESIN STICK, .3%CIPROFLOXACIN DROP
M
Emergency kit and medicine
M-Mandatory
Annual Maintenance records of equip
Yes
D
5 support services
a security
b. BMW management c. Laundry
Yes Yes Yes
D
M own/outsourced
OPTOMETRIST SERVICES
Yes Yes Yes
M-Mandatory M-Mandatory M-Mandatory
6 Standard on basic processes a.Receivingpatients,privacyforpatientswhile examining especially females
b. Infection control practices
Yes
D
soap and water
facilities for hand washing and disinfection Disinfection of work Area
Yes
Yes
Yes
Yes
yes
Yes
Yes
Yes
M- Mandatory
M M M M M D M D
Use of disposable services
small autoclave
facilities for sterlization
c. Policy on outsourced services
D- Desirable
Minimum standards for Hospital
BASIC (General Purpose)
ADVANCED
Remarks
1 Scope
Providing services (examplePrimaryHealthCentre, Community Health Centre, SDH, District Hospital, Private Hospital,Nursing Homeetc)
Providing services (example Civil Hospital, regional Hospital, Nursing Home,Private Hospital etc of similar scope)
Services Provided
OPEN SURGERY,OTHER SURGERIES EXCLUDING ADVANCED RECONSTRUCTIVE SURGERIES LIKE RADICAL PROSTECTOMIES, AND ONCOLOGY SURGERIES.SIMPLE LAPROSCOPIC SURGERIES E.G., NEPHRECTOMY, URETERLITHOTOMY, NO ENDOSCOPIC SURGERIES ALLOWED.
OPEN SURGERIES, ENDO UROLOGY, LAPROSCOPIC UROLOGICAL PROCEDURES , ESWL, URODYNAMICS FACILITIES (PREFERRED) RECONSTRUCTIVE SURGERY
1.1 General purpose 1.2 Single Speciality 1.3. Multispeciality 1.4. Superspeciality
Yes
2 Human resources Med person incharge Full time consultant Part time consultant visiting consultant Duty Doctors
MS GENERAL SURG/MCh /DNB UROLOGY Yes or
Yes or
Yes or
M.Ch /DNB UROLOGY-1
also GENERAL SURGEON-2
Yes or
Yes or
MBBS doctor for round the Clock medical cover
M M M M M
2.2 Nurses
General nurses
Trained Nurses forICU/OT 2.3 Pharmacist
MBBS Doctor for round the Clock medical cover 2
Yes
1
Yes 2 yes
As per ICU morms M-for inhouse pharmacy
UROLOGY
Yes Yes Yes
2.4 Para Medical staff a.Lab Tech
b.Xray Technician c.OT Technician d.ECG Technician e.Dietitician
Yes Yes 1/OT Yes Yes Yes Yes Yes
Yes Yes 1/OT Yes Yes Yes Yes Yes
M-if own
M-if own M-Mandatory D-own/outsource on call
D
D
D
f. Physiotherapist
g. Psychologist
h. Medicosocial worker
3 Equipment
Therapeutic
LAPROSCOPY SET, OPEN SURGERY EQUIPMENT
LAPROSCOPY SET, OPEN SURGERIES INSTRUMENT, UPPER AND LOWER TRACT ENDOSCOPY , emergency electrocauery, laser /pneumatic lithtripter(D) laproscopy.open sugery set for Gynae, gen surg and urology -Mandatory
M -lithotripsy stand alone not permitted
Emergency Sterlizing
yes yes Yes
yes yes yes
Refer to hospital document M-MANDATORY
Refer to hospital document
Drugs,Medical devices and consumables
List of disposables Annual Maintenance records of equip
Yes Yes
Yes Yes
M D
4 Support Services
4.1. Laboratory
4.2. Imaging
4.3. Pharmacy
4.4. sterlization/CSSD 4.5. Medical Gas/Manifold
Yes Yes Yes Yes Yes
Yes
M-own/outsourced M-own/outsourced M-IN ADVANCE M
4.6. Blood storage unit/blood Bank 4.7. Amb service
Yes Yes
Yes Yes
Yes Yes Yes
M
M-own /outsourced / TIE UP M-own/outsourced / TIE UP
1 Definition
2 Scope
Specialist
Specialist
Minimum standards for Clinics/ Polyclinics
CONSULTATION SERVICES
DAY CARE PROCEDURE
REMARK
Services Provided
CONSULTATION SERVICES, DRESSING, FOLEY’s CATHETERISATION, FOLEY’S REMOVAL, USG GUIDED PROCEDURE:PCN, PROSTATE BIOPSY, UROFLOWMETRY, URO DYNAMICS (OPTIONAL)
PROCEDURES UNDER LA , SUPRAPUBIC CATHETERIZATION, PCN, URETHRAL DILATATION, MEATOPLASTY, LOWER TRACT ENDOSCOPY TEST
M
3 Physical Infrastructure
a. Space requirement
i. Reception
ii. consultation/waiting area iii. OPD Area
Yes Yes Yes
Yes Yes Yes
M-Mandatory M-Mandatory M-Mandatory;
Minor OT mandatory in Day care
4 Human resources
Doctors
Tech staff
Non Tech staff
Duty and salary roster OTHERREQUIREMENTLIKEPERIODIC HEALTH CHECK UPS,vaccination of staff in lab,bld bank,TLD badges
MS GENERAL SURGEON NURSE-1
Attendant-1
Yes
M.Ch UROLOGY
OT TECHNICIAN-1/ NURSE-1 Attendant-1
Yes
Yes
M
M M-Mandatory M-Mandatory D
5 Equipment
Yes
CLINIC WITH UROLOGY SERVICES
MINOR OPEN PROCEDURES ORCHIDECTOMY, MEATOPLASTY, TESTICULAR BIOPSY
a. Stethoscope
b. Thermometer
c. BP Apparatus
d. Glucometer
e. Weigh machine
f. Emergency kit and medicine
Yes
Yes
Yes
Yes
Yes
DRESSING TRAY, CATHETERISATION TRAY, PORTABLE LIGHT
Yes
Yes
Yes
Yes
Yes
ENDOSCOPY FOR LOWER TRACT ONLY(OPTIONAL) OPENSURGERY SET
M
M
M
M
M
Also refer to Clinic/ Polyclinic document
g. Drugs,Medical devices and consumables
h. List of disposables
i. Annual Maintenance records of equip
Yes
Yes
M
6 support services
sterlization/CSSD security
BMW management Laundry
Autoclave Yes
Yes
Yes
Autoclave Yes
Yes
Yes
M
D
M own/outsourced
7 Standard on basic processes
a. Receiving patients,privacy for patients while examining especially females
b. Infection control practices
Yes
Yes
M
soap and water
facilities for hand washing and disinfection
Disinfection of work Area
Yes Yes Yes
Yes Yes Yes
M M M
Use of disposable services
small autoclave
facilities for sterlization
c. Policy on outsourced services
Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes
M M M M D
Yes Yes
Yes Yes
M D
Minimum standards for Hospital
BASIC (General Purpose) ADVANCE(Non Teaching Hospital)
Remarks
1 Scope
Providingservices(examplePrimaryHealth Providingservices(exampleCivilHospital,
Services Provided
1.1 General purpose 1.2 Single Speciality 1.3. Multispeciality 1.4. Superspeciality
Yes
2 Human resources 2.1. Doctor
Med person incharge Full time consultant
MD/DNB NEPHROLOGY
MD/DNB NEPHROLOGY MD -1
M
Duty Doctors 2.2 Nurses
cover
M
part of hospital
As per norms of Nursing Council
As per paramedics council norms
Nursing head
Dialysis Nurse/Technical
Yes Yes
Yes Yes
NEPHROLOGY SERVICES INHOSPITAL
Centre, Community Health Centre, SDH, District Hospital, Private Hospital,Nursing Home etc)
regional Hospital,Nursing Home,Private Hospital etc of similar scope)
KIDNEYBIOPSY,MINOROT,CENTRALVEIN ALLBASICSERVICES,CAPD,
,CATHETERISATION, ACUTE PERITONEAL DIALYSIS
CATHETERISATION, AV FISTULA, PERMA CATH, RENAL TRANSPLANT
MD WITH EXPERIENCE IN NEPHROLOGY from a recognised hospital
MBBS Doctors for round the clock medical cover
M MBBS Doctors for round the clock medical
Yes Yes Yes
General nurses
Trained Nurses for ICU/OT 2.3 Pharmacist
2.4 Para Medical staff a. Lab Tech
b. Xray Technician
c. OT Technician
Yes Yes Yes Yes Yes Yes
As per norms of Nursing Council
ICU norms
M-inhouse pharmacy
d. ECG Technician e. Dietitician
f. Physiotherapist g. Psychologist
DIALYSIS MACHINE (MAN POWER AS PER GUIDELINES-NURSE-1,TECHNICIAN-1) Yes Yes Yes Yes Yes* Yes Yes Yes Yes Yes Yes
M-own/outsourced *M
D
M IF PSYCHIATRIST D
h. Medicosocial worker
3 Equipment
Therapeutic
DIALYSISMACHINE(MANPOWERASPER DIALYSISMACHINE(MANPOWERASPER GUIDELINES- minimum NURSE-1, GUIDELINES-minimum NURSE-1, TECHNICIAN-1) TECHNICIAN-1)
Yes Yes
M;Refer Dialysis Centre
Diagnostic
Emergency
Sterlizing Drugs,Medical devices and consumables
Yes Yes Yes Yes
M
Refer to documents of Hospital M
List of disposables Annual Maintenance records of equip
Yes Yes Yes yes Yes Yes
Refer to documents of Hospital M
M
4 Support Services
4.1. Laboratory
Yes Yes
Basic Laboratory facilities must be available in the hospital and advance can be Outsourced
Yes Yes Yes Yes
M-if own
M-if own
M (Refer Dialysis Centre)
4.2. Imaging
Basic Imaging facilities must be available in the hospital and advance can be Outsourced
4.3. Pharmacy Yes Yes 4.4. sterlization/CSSD Yes Yes 4.5. Medical Yes Yes Gas/Manifold
M-IN ADVANCE M
M-IN ADVANCE
4.6. Blood storage Yes Yes unit/blood Bank
4.7. Amb service Yes Yes
M for advance set-up, otherwise D M-own/outsourced/TIE UP
M-Mandatory D- Desirable
Minimum standards for Clinics/Polyclinics
Minimum Standards
Remarks
1 Definition
Nephrology services
2 Scope
Services Provided
1. CONSULTATION (M)
2. ACCESS TO DIALYSIS(D) 3. LAB SERVICES (O)
infrastructure and Staff according to scope of services
3 Physical Infrastructure a. Space requirement i. Reception
ii. Consultation
Yes Yes Yes
M M M
iii. waiting area
4 Human resources
Med person incharge
Technical staff
Non Technical staff
Duty and salary roster
OTHER REQUIREMENT LIKE PERIODIC HEALTH CHECK UPS,vaccination of staff
DM/DNB NEPHROLOGY Yes
Attendant-1
Yes
M M M M D
5 Equipment
a. Stethoscope
b. Thermometer
c. BP Apparatus
d. Glucometer
e. Weigh machine
f. Emergency kit and medicine
g. Drugs,Medical devices and consumables
Yes Yes Yes Yes Yes Yes Yes
M
Yes (Non Mercury)
Yes (Aneroid)
M
M
Refer documents on clinic /polyclinic M
NEPHROLOGY CLINIC
yes
h. List of disposables Yes i. Annual Maintenance records of equip Yes j. O2 cylinder for emergency Yes
M D D
6 support services
a. sterlization/CSSD Yes b. security Yes c. BMW management Yes d. Laundry Yes
M
D
M
Own/ outsourced
7 Standard on basic processes
a. Receiving patients,privacy for patients while Yes examining especially females
b. Infection control practices Yes
M
soap and water Yes facilities for hand washing and disinfection Yes Disinfection of work Area Yes
M M M M M M D D
Use of disposable services Yes small autoclave Yes facilities for sterlization Yes c. Policy on outsourced services Yes
M-Mandatory D- Desirable O- Optional
Minimum standards for Clinics/Polyclinics
Minimum Standards
Remarks
1 Definition
2 Scope
Dialysis services
Services Provided
CONSULTATION SERVICES,DIALYSIS
3 Physical Infrastructure Space requirement
i. Reception
ii. consultation/waiting area iii.OPD Area
10*10 SQ FT Yes
Yes
Yes
(for 1 machine) M
M
M
4 Human resources
Doctors
DM/DNB NEPHROLOGY/MD MEDICINE TRAINED IN DIALYSIS 6 MTHS
Techician-1 Nurse-1
Attendant-1
Tech staff
Non Tech staff
Duty and salary roster
OTHER REQUIREMENT LIKE PERIODIC HEALTH CHECK UPS,vaccination of staff in lab
Yes Yes
M M M D
5 Equipment
Stethoscope Thermometer BP Apparatus Glucometer Weigh machine
Yes
Yes
Yes
Yes
Yes
4 DIALYSIS MACHINE (MAN POWER AS PER GUIDELINES- NURSE-1,TECHNICIAN-1); (MINIMUM 2 MACHINES in any Dialysis Centre)
M
Yes (Non Mercury) Yes (Non Mercury) M
M
M
DIALYSIS CENTRE
Emergency kit and medicine Yes Drugs,Medical devices and consumables Yes List of disposables Yes Annual Maintenance records of equip Yes
Refer to Hospital Document Refer to Hospital Document M
D
6 support services
sterlization/CSSD Yes security Yes BMW management Yes Laundry Yes
M
D
M own/outsourced
9 Standard on basic processes
a. Receiving patients,privacy for patients while Yes examining especially females
b. Infection control practices Yes
M-Mandatory
soap and water Yes facilities for hand washing and disinfection Yes Disinfection of work Area Yes
M M M M M M M D
Use of disposable services Yes small autoclave Yes facilities for sterlization Yes c. Policy on outsourced services Yes
M-Mandatory D- Desirable
Minimum standards for Hospital
Single Superspeciality
Multi Superspeciality
Remarks
1 Scope
Providing CTVS services (example Civil Hospital, regional Hospital,Nursing Home,Private
Providing services (example District Hospital, regional Hospital,Nursing Home,Private Hospital,etc
Services Provided
Services relating to cardiothoracic and vascular speciality
Services relating to cardiothoracic and vascular specialities in Multispeciality set up
1.1 General purpose 1.2 Single Speciality 1.3. Multispeciality 1.4. Superspeciality
Yes yes
yes Yes
2 Human resources 2.1 Doctors
Med person incharge Full time consultant Duty Doctors
MCh/DNB-1per OT
Gen Surgeon/MBBS-1 MBBSDoctorsforroundtheclock service
MCh/DNB-1per OT M Gen Surgeon -1 , MBBS-1 M MBBSDoctorsforroundtheclockservice M
2.2 Nurses
General nurses
Trained Nurses for ICU/OT/HDU 2.3 Pharmacist
2.4 Para Medical staff
a.Lab Tech
b.Xray Technician
c.OT Technician
d. ECG Technician
e.Dietitician
f.Physiotherapist
g.Psychologist
yes yes M-Mandatory 2 2 ICU Norms
h.Medicosocial worker
psychiatrist Yes Yes D
CTVS IN HOSPITAL
Perfusionist-1 M Yes Yes M Yes Yes M Yes Yes M Yes Yes M
Yes Yes D-Desirable Yes Yes D-Desirable Yes Yes compulsory if
3 Equipment
Therapeutic
OpenHeartTray,GaspipelinesLung Machine with TCM,3 invasive pressure monitor at Anaesthesia work station,suction, defibrillator, ABGMachine,ACTMachine,Single chambered pacemaker, Hypothermiamachine,IABP,temp monitoring module, cautery
Open Heart Tray, Gas pipelines Heart Lung Machine with TCM,3 invasive pressure monitor at Anaesthsia work station, suction, defibrillator,ABG Machine, ACT Machine, Single chambered pacemaker, Hypothermia machine ,IABP, temp monitoring module, Cautery
M-Mandatory
Surgical Diagnostic
2 sets of operating equipment Yes
2 sets of operating equipment Yes
M-Mandatory M-Mandatory
Emergency
Sterlizing
Drugs,Medical devices and consumables
Y
Yes
Inotropes, protamines, heparin, isopronaline,antiarrhythmic,life saving drugs
yes
yes
Inotropes, protamines, heparin, isopronaline, anti arrhythmic, life saving drugs ,anaesthetic drug.
Refer to document on Hospital
M-Mandatory Alsorefertodocuments on hospital
List of disposables
Yes Yes
Yes Yes
M M
Annual Maintenance records of equip
4 Support Services
4.1. Laboratory
Yes
Yes
own or Outsourced
4.2. Imaging
yes
Yes
own or Outsourced
4.3. Pharmacy
Yes
Yes
M-own/outsourced
4.4. Medical Gas/Manifold
4.5. Blood storage unit/blood Bank
Yes Yes
Yes Yes
M-IN ADVANCE M-own/outsourced/TIE UP M-own/outsourced/TIE UP
4.6. Amb service
CCU AMB
CCU AMB
Minimum standards for Clinics/ Polyclinics
Minimum Standards
Remarks
1 Definition
2 Scope
Specialist
Services Provided
Consultation Services
3 Physical Infrastructure
a. Space requirement
i. Reception
ii. consultation/waiting area
Yes Yes
M-Mandatory M-Mandatory
4 Human resources
Med person incharge
Tech staff
Non Tech staff
Duty and salary roster OTHERREQUIREMENTLIKEPERIODICHEALTHCHECK UPS,vaccination of staff
M.Ch./DNB CTVS ECG Tech
Yes
Yes
M M M M D
5 Equipment
a. Stethoscope
b. Thermometer c. BP Apparatus d. Glucometer
e. Weigh machine f. Others
Yes
Yes
Yes
Yes
Yes
ECG Machine clopid,Aspirin
M
Yes (Non Mercury)
Yes (Non Mercury)
M
M
M
Refer to document on clinic/Polyclinic
M
M
D
g. Emergency kit and medicine
h. Drugs,Medical devices and consumables i. List of disposables
j. Annual Maintenance records of equip
Yes Yes Yes
6 support services
a. security
Yes
M
CLINIC with CTVS SERVICES
Yes
b. BMW management Yes
M D-own/outsourced
c. Laundry Yes 7 Standard on basic processes
a. Receiving patients,privacy for patients while Yes examining especially females
b. Infection control practices Yes soap and water Yes facilities for hand washing and disinfection Yes Disinfection of work Area Yes Use of disposable services Yes small autoclave Yes facilities for sterlization Yes c. Policy on outsourced services Yes
M-Mandatory
M
M
M
M
M
D-if applicable D-if applicable D
Minimum standards for Hospital
Minimum Standards
Remarks
1 Scope
Services Provided 1.1.Single Speciality 1.2.Multispeciality
Treatment of Cancer patients by Radiotherapy Yes
Yes
2 Physical Infrastructure a.Location
No Department should be below Radiotherapy Department in a building. Basement or Ground floor is a good option.
b.Space requirement
Space requirement varies from one machine to another, & one manufacturer to other. Any Radiotherapy equipment shall be located in the hospital at a place where occupancy is minimum. Should permit easy installation, source loading,commissioning, patient treatment, maintenance & decommissioning. Approximately 2500 sq. feet
As per AERB
3 Human resources 3.1 Doctor
Med person incharge Full time consultant Part time consultant 3.2 Nurses Generalnurses
RADIOTHERAPIST-1/500 NEW CASES Annually 1
RESIDENT-2
M -Mandatory M-Mandatory M-Mandatory
Trained Nurses for ICU/OT/HDU 3.3 Pharmacist
2 for minor OT/Brachytherapy Yes
ICU norms M-Mandatory,part of Hospital
RADIOTHERAPY SERVICES
OneOncologyNursefor300patientsannually,additionalonefor every 300 more number of patients. Besides, more number needed for Brachytherapy, Simulator and Day Care Chemotherapy.
M-Mandatory
3.4 Para Medical staff Lab Tech
MSCMEDICALPHYSICIST-1RSOEXAMCERTIFIEDORMSCGEN PHYSICISTWITHPGDiPlomaRADIOLOGICALPROTECTION(DRP)
M-Mandatory
Xray Technician ECG Technician Dietitician Physiotherapist Psychologist Medicosocial worker 3.5 others
RADIOTHERAPY TECHNICIAN Yes
Yes
Yes
M-Mandatory
D- part of hospital M- part of hospital D-Desirable D-Desirable M-Mandatory
a. PolicyManpower/ posting/ rotation/ of medical and ALLIED HEALTH PROFESSIONAL
b. STANDARD PERTAINING TO PERSONAL RECORD KEEPING AND TRAINING
Yes
M-Mandatory
c. PAYMENT/ROSTER OF STAFF
Yes
For any radiation generating equipment,type/approval/ NOC is must by AERB.Approval of room layout plan of Radiotherapy installation is must before any start of construction and any modification thereof.Procurement of personal monitors and measuring and monitoring instruments as per AERB guidelines is must.These include personal monitors and measuring and monitoring badges,Pocket dosimeter,Ionisation chambers, Electrometer, Radiation field analyser,Survey meter, Gamma zone monitor, suitable air conditioning, and fire fighting measures
M-Mandatory D-Desirable
d. OTHER REQUIREMENT LIKE PERIODIC HEALTH CHECK UPS,vaccination of staff in lab,bld bank,TLD badges
Yes Yes
Yes
M-Mandatory
4 Equipment
Therapeutic
Onelowenergylinearaccelerator/Cobaltteletherapymachine, M-Mandatory One simulator,one TPS (if not part of machine),One HDR BRACHYTHERAPY , immobilization devices,Medical phycists lab
investgation for calibration,Dosimetry and radiationprotection.
Diagnostic Emergency
Yes Yes
M -Mandatory
Refer to documents on Hospital
M-Mandatory Alsorefertodocumentson Hospital
Sterlizing
Drugs,Medical devices and consumables
Yes
Cisplatin, Carboplatin, 5FU, Doxorubicin, cyclophosphamide, Methotrexate,Vincristine, Vinblastine, Bleomycin , Paclitaxel,Gemcitabine, Folinic acid/Leukovorin, Ondansetron, Tab Temazolamide
List of disposables
Yes Yes
M-Mandatory D-Desirable
Annual Maintenance records of equip
5 Support Services
5.1 Laboratory
5.2 Imaging
5.3 Pharmacy
5.4 Medical Gas/Manifold
5.5 Blood storage unit/blood Bank 5.6 Amb service
Yes Yes Yes Yes Yes Yes
own or Outsourced
own or Outsourced
own or Outsourced
M part of hospital M-own/outsourced/TIE UP M-own/outsourced/TIE UP
Template I Definition
Basic Composite *
Medium
Advanced
Remarks
II Scope of Services
upto 30 samples
These test can be performed in mobile lab at field centres also
30-100 samples
Apart from the test performed in Basic Composite lab additional tests mentioned as under.
>100 samples
Apart from the test performed in Medium lab additional tests mentioned as under.
a) Biochemistry
Routine Biochemistry Test like Blood Sugar,KFT,LFT,Amylase,lipase,lipid profile, CSF & other biological fluid (glucose and protein), OGTT, Electrolytes, Ca/PO4, HbA1c.Any dry chemistry based rapid test.
a) Routine Biochemistry, b)HormoneBioassay,Tumormarkers, plasma protein electrophoresis
a) Routine Biochemistry, b)HormoneBioassay,Tumor
b) Hematology
Haemogram,BT,CT,PT, APTT, Blood grouping
Haemogram,BT,CT, PT, APTT,Blood grouping, Coagulation Assay
All other Haematology test also
c) Histopathology
d) Molecular Genetics
e) Cytopathogy
NIL NIL NIL
May/ May not do
May/ May not do
PAP smear , FNAC , sputum & CSF cytology
Histopathology Examination
f) Immunohistopathology
NIL
NIL
Immunohistopathology
as per scope of lab
g) Medical Microbiology & Immunology
Basic test like Rapid Test (point of care) tests for infection,Urine routineandmicroscopy,Hanging dropforVcholerae,Stoolforova ,cyst.AllHIVpositiverapidassays need to be confirmed from the next level diagnostic laboratory.
a) Basic Test as in composite lab
b) Serological tests for viruses , bacteria, fungi,parasites c) Culture Sensitivitytests,Bacterial/fungal) d)OtherspecialstainsbesidesGram’s
a) Basic Test as in composite lab
b) Serological tests for viruses , bacteria, fungi, parasites c)CultureSensitivitytests,Bacterial/ fungal/viruses)Genebasedtests (Nucliec acid tests for infections like Real time PCR tests). Histopathlogy of Infectious diseases. and Desirable: Immunocytochemistry
Medical Diagnostic Laboratories
markers, plasma protein electrophoresis, coagulationprofile,Drugmonitoringand toxicology assay, c) Molecular genetics,Inborn errors of metabolism
molecular genetics
PAP smear, FNAC, sputum cytology and other biological fluidcytology,
D; Ultrasound and CT Guided FNAC
III Infrastructure
1. Signage
Basic signage- A signage Yes Yes within or outside the facility
should be made available
containing the following
information.
Yes M
a) Name of the incharge with Yes Yes qualification and registration
number,
Yes M Yes M
b) Broad Services provided Yes Yes i.e.Hematology,Biochemistry,
Clinical Pathology , Histology,
Cytology Molecular Genetics-
Whichever is applicable
c)Timingsofthedifferent Yes Yes consultants
Yes M Yes D
d) Internet facility/ Telephone Yes Yes and mobile number for
appointment
Fee structure: To be displayed Yes Yes separately including type of
investigation and charges i.e.
Special and routine tests.
Yes M
Safety Signage’s (wherever applicable)
Safety Hazard and Caution Yes Yes signs – Biomedical waste
segreted in colored bins and
bags as per Biomedical waste
Yes M
ManagementandHandling Rules 1998 including Radioactive materials, toxic chemicals, Microbial agents, Infected biologicalmaterial.
AppropriateFireexitsignage’s Yes* Yes* Yes** – Minimum one fire
extinguisher
As per norms*- Desirable **Mandatory
2. Space requirement-
A. Registration and waiting Yes* Yes** Yes** room, Public Utilities, Safe
drinking water etc.
B. Sample collection area Yes Yes Yes C. Laboratory with adequate Yes Yes Yes diffuse and spot lighting
* D **M
D. Toilet Yes Yes Yes E. Reporting and billing area Yes Yes Yes
M M *M
F. Staff room and doctor’s Desirable Desirable Yes* duty room – Male and female
different where 24 hours
services available
G. Washing room Yes Yes Yes
M M
H. Preservation of the Yes Yes Yes specimens and slides
I. Electrical facilities Yes Yes Yes J. Temperature control for Yes Yes Yes specilized equipments like
M M
flow cytometry and chemiluminescence equipments ELISA test equipment etc.
K. Counselling room for HIV yes yes yes L. FNAC room for all patients yes Yes Yes for samplecollection
if applicable D
M. Dark room for No No Yes Immunofluorescence
N. Frozen Section facilities No Yes Yes
if applicable if applicable
M M
4. Furniture & Fixtures
5. Communication system – Telephone and mobile number for appointment 6. Wash – Basins
Yes Yes
Yes Yes
Yes M Yes D
IV Human resource
Designation, minimum qualificationofTechnical Head of Lab / Specialist/ Signatories.
MBBS from a recognised institution(withatleastoneyear experience in laboratory work- Desirable
Incharge can be MD/DNB in Pathology/Biochemistry/Medical Microbiology /Lab Medicine/ Diploma in Clinical Pathology (DCP) with one year post diploma experience / MBBS with PhD in any of the 3 subjects/ Apart from incharge, if any special test of other speciality is done, it is desirable that specialist of that subject need be there on full time/part time or outsourced (Special tests means any other apart from routine basic biochemistry, haematology,or medical microbiology tests as listed in basic composite lab)
Medicine/Biochemistry/Medical Microbiology/ DCP with one year post diploma experience / MBBS with PhD in any of the 3 subjects/ Apart from incharge, if any special test of other speciality is done, it is desirable that specialist of that subject need be there on full time/part time or outsourced (Special tests means any other apart from routine basic biochemistry, haematology, or microbiology tests as listed above)
Number of laboratory technicians with DMLT / MLT/BSc in lab sciences/ MSc in lab sciences/PhD in lab sciences qualification (govt / university)
1
2 LT
4 LT
M
Support staff (Lab Assistant / Lab Attendant) Roster of salary of staff Periodic health check up and vaccination of staff
1
1
2 M
Yes
Yes
Yes M Incharge can be MD/DNB Pathology/Lab M
V Equipment / Instruments/ drugs
List of minimum medical diagnostics lab Equipments with quantity
List of minimum medical diagnostics lab Instruments with quantity
Sterilization such Hot air Yes Yes oven or Autoclave
List of reagents and Yes Yes Consumables required
Yes M Yes M
List of Disposables Yes Yes
Yes M
Policy of Annual Yes Yes Maintenance Contract /
Comprehensive
maintenance contract and
Yes D
records for equipment (Log books)
VI Legal/ Statutory Requirements
Legal/ statutory Yes Yes requirements such as
registration for Biomedical
Waste Management Act
Yes M
with state /UTs pollution control board with registration number and date of expiry Site, Space, Location and environmental requirements to be as per local bye laws
VII Record Maintenance and reporting
Reports of all patients Yes Yes Yes datewise and specialty wise
for ex Histopathology,
Cytology, Hematology and
M-mandatory (All Clinical Establishment to maintain information and statistics as provided)
Laboratory Medicine.
Medicolegal records if Yes Yes Yes applicable (as per law)
Record keeping of technicians Yes Yes Yes working in laboratory
M M
indicating their details of qualification training and others
Availability of reference library Yes Yes Yes including books/periodicals/e-
journals/CDs
D
Duration of preservation of Yes Yes Yes record (as applicable from
time to time)
M
VIII Standards on basic processes
Infection Control practices – As Yes Yes Yes per BMW Rules 1998
Safety considerations- use of Yes Yes Yes disposable needles etc
M M
Patient Information and Yes Yes Yes Education
Process of calibration of Yes Yes Yes equipments and reagents
M M M M
Booklet of SOPs of all Yes Yes Yes procedures available
Grievance Registration and Yes Yes Yes Disposal mechanism
Process of calibration of equipments and reagents Booklet of SOPs of all procedures available Grievance Registration and Disposal mechanism QUALITY CONTROL in the form of EQAS/ILC as the case may be
Yes Yes Yes M Yes Yes Yes M Yes Yes Yes M Yes Yes Yes D
policy of PROFICIENCY TESTING of tests performed.
Yes Yes Yes D
M- Mandatory D- Desirable
1 Definition
Definition of X-Ray Clinic
X-RayClinic/Cathlab/DSA/OPGandDental/DEXAScan examination and diagnosis
3 Physical Infrastructure 3a Informative signages
Imaging Centers – X-Ray Clinic / Cathlab / DSA / OPG and Dental / DEXA Scan
Template
Minimum Standards Radiological examination and diagnosis
Remarks
2 Scope of Services
Enlist the investigations which can be carried out by X- Ray machine
Portable/ Mobile Xray,Installed X Ray, Fluoroscopy
The scope should match the scanner specification
Name of the Radiologist with qualification and AERB certification of safety and installation with registration number
Yes
M-Mandatory
Display of model of equipment
Broad Services provided
Timings of the facility
Fee structure of different investigations : To be displayed
Yes Yes Yes Yes
M-Mandatory M-Mandatory M-Mandatory M-Mandatory
Safety signage’s (wherever applicable)
Yes
M-Mandatory
3b Safety Hazard and Caution signs Appropriate Fire exit signages
Measures / Devices for radiation protection and monitoring of staff
Yes Yes
M-Mandatory M-Mandatory
4 Space Requirement Reception and waiting area Space for keeping machine Reporting room
Yes Yes Yes Yes Yes
AERB guidelines M-Mandatory M-Mandatory M-Mandatory M-Mandatory
Toilet
includingCathLab,Others Xray-IOPA, OPG,CBCT, Others. Others
Absorptiometry (DEXA)
Dental Mammography,
Dual EnergyXray
Patient preparation area
Electrical facilities
Space for keeping patient monitoring apparatus, Resuscitatory appliances and Anesthesia machine for specialized procedures
Yes Yes Yes
M-Mandatory M-Mandatory M-Mandatory
Furniture & Fixtures
Communication system – Telephone, Fax, internet facility and mobile number for appointment and emergency helpline number of manufacturing company
Yes Yes
D-Desirable
Water and Electricity
Toilet (male and female wherever applicable)
Yes Yes
M-Mandatory M-Mandatory
5 Human Resource
(Full time/Part time/Visiting)
Number of Qualified and registered Radiologists Full time/Parttime/Visiting
MD/DMRD Radiology
M
Number of qualified and registered Nurses Full time/Parttime/Visiting
Number of Radiography technicians with training status and support staff Full time/Part-time/Visiting
Yes
D-DESIRABLE M-Mandatory
Number of scavenging and support staff
Policy for engagement, posting and rotation of staff Roster of payment and salary of staff
Yes Yes Yes
M-Mandatory M-Mandatory M-Mandatory
Periodic health check-up and vaccination of staff
M-Mandatory
1.RSO-degree recognised by MCI/NBE 2.Radiographers passed from recognised institution
6 Equipment/instruments/drugs
Yes
M
List of equipments required and tools for radiation safety
List of small instruments required
As per scope of service
M
List of consumables and disposables
BP app, Pulse oximeter, Monitoring Anaesthesia equipment—if imaging under sedation is in scope
M-Mandatory
Annual Maintenance protocol for equipment and its record maintenance
Films, envelops for reports, CDs/ DVDs for soft copies of report’
M-Mandatory M-Mandatory
List of Drugs and resuscitation equipments
Injector syringes, tubing, i/caths, etc
7 Support Service If applicable
provision for appropriate patient transfer in case of adverse event
8 Legal/Statutory Requirements
Status of registration under Atomic Energy Act
AERB
preferably linked to patient UID
M-Mandatory M-Mandatory
9 Record Maintenance and reporting
Proforma of list of names of patients along with diagnosis and name of referral hospital and date wise record of reports
Availability of reference library including books/periodicals/e-journals/CDs
Yes
D-DESIRABLE
Medicolegal records
Record keeping of technicians and support staff working in X-Ray clinic indicating their details including qualification, registration and training
MLCs; consents for contrast/sedation etc. Yes
M-Mandatory
Duration of record maintenance: As per the Acts and Rules in force
Record of payment of wager and perks
Yes Yes
M-Mandatory M-Mandatory
As per the scope of services
10 Standards on basic processes
Infection Control and waste management practices Yes
M-Mandatory M-Mandatory
Safety considerations – (i) Fire safety (ii) Patient safety Yes
Patient Information and Education Yes
M-Mandatory
Schedule of preparation and dispatch of reports Yes Trolleys for patient transport Yes Calibration of Equipment Yes Grievance Registration and Disposal mechanism Yes
M-Mandatory M-Mandatory M-Mandatory M-Mandatory
Air-conditioning System Yes
D-Desirable
Minimum standards for Imaging Centers – Sonography (Color Doppler) Clinic
1 Definition
Definition of Sonography (Color Doppler) Clinic
USG/ Doppler examination and diagnosis
2 Scope of Services
Enlist the investigations which can be carried out by Sonography (Color Doppler) machine
USG/ Doppler examination of Regions/ parts of body with capabilities of advanced vascular/ cardiac imaging as per the capabilities of the equipment
The Scope should match the Scanner specifications.
3 Physical Infrastructure
Template
Minimum standards
Remark
3a Informative signages
Name of the Radiologist with qualification and PCPNDTcertification and with registration number Display of model of equipment
Broad Services provided
Timings of the facility
Fee structure of different investigations : To be displayed
Yes
M-Mandatory
Safety signage’s (wherever applicable) 3b Safety Hazard and Caution signs
Yes
M-Mandatory
Appropriate Fire exit signages
Yes Yes Yes Yes Yes Yes Yes
M-Mandatory M-Mandatory M-Mandatory M-Mandatory M-Mandatory M-Mandatory M-Mandatory
Reception and waiting area 4 Space for keeping machine
Reporting room
Toilet
Patient preparation area Electrical facilities
Yes Yes Yes Yes
M-Mandatory M-Mandatory M-Mandatory M-Mandatory
Space for keeping patient monitoring apparatus, Recovery area, Resuscitatory appliances for specialized procedures
Yes
M-Mandatory
Furniture & Fixtures
Communication system – Telephone, Fax, internet facility and mobile number for appointment and emergency helpline number of manufacturing company
Water and Electricity
Toilet (male and female wherever applicable)
Yes Yes
M-Mandatory D-Desirable
5 Human Resource
(Full time/Part time/Visiting)
Number of Qualified and registered Radiologists Number of qualified and registered Nurses Number of scavenging and support staff
MD/DMRD Radiology yes
Yes
M-Mandatory
M-Mandatory(as per workload) M-Mandatory
Policy for engagement, posting and rotation of staff Roster of payment and salary of staff
Periodic health check-up and vaccination of staff
Yes Yes Yes
M M D
6 Equipment/instruments/drugs
List of equipments required
List of small instruments required
Annual Maintenance protocol for equipment and its record maintenance
List of consumables, disposables
List of Drugs and resuscitation equipments
Yes Yes Yes
M-Mandatory M-Mandatory M-Mandatory
7 Support Service If applicable
Yes Yes
8 Legal/Statutory Requirements
To be registered under Atomic Energy Act
M;PCPNDT act also
9 Record Maintenance and reporting
Yes Yes Yes
M-Mandatory M-Mandatory
Yes Yes
M-Mandatory
M-Mandatory,Refer to ANNEXURE of Hospital
Proforma of list of names of patients along with diagnosis Yes and name referral hospital
Availability of reference books Yes Medicolegal records, as applicable Yes Record keeping of technicians and support staff working in Yes Sonographycenter indicating their details including qualification, registration and training
M-Mandatory D-DESIRABLE M-Mandatory
Duration of record maintenance: As per the Acts and Rules Yes in force
Statistics to be collected – If felt necessary yes
M-Mandatory M-Mandatory
10 Standards on basic processes Yes Infection Control and waste management practices Yes Safety considerations – Fire safety act
Patient Information and Education Yes Timely preparation and dispatch of reports Yes Trolleys for patient transport Yes Regular calibration of Equipment Yes Grievance Registration and Disposal mechanism Yes Appropriate Air-conditioning Yes
M-Mandatory M-Mandatory M-Mandatory M-Mandatory M-Mandatory M-Mandatory M-Mandatory M-Mandatory
Template 1 Definition
Minimum Standards
Remark
Definition of CT center
Type of scanner (Slices /Detectors /Energy sources)
Minimum standards for Imaging Centers – CT Scan center / PET CT Scan
2 Scope of Services
Enlist the investigations to be carried out by CT Scanner
CT Scan of Regions/ parts of body with capabilities of advanced vascular/ cardiac/ neurological etc. imaging as per the capabilities of the scanner.
The Scope should match the Scanner specifications
3 Physical Infrastructure 3a Informative signages
Name of the Radiologist with qualification and AERB certification of safety and installation with registration number
Display of model of equipment
Yes
M-Mandatory
Broad Services provided Timings of the facility
Yes Yes Yes
M-Mandatory M-Mandatory M-Mandatory
Fee structure of different investigations : To be displayed
Safety signage’s (wherever applicable)
Yes Yes
M-Mandatory M-Mandatory
3b Safety Hazard and Caution signs
Radiation ÓN’ signage linked with the exposure Radiation signage and symbol as per AERB
Yes Yes
M-Mandatory M-Mandatory
Appropriate Fire exit signages 4 Radiation Safety Measures
Yes
M-Mandatory
RSO level 1
Measures/Devices for radiation protection of staff Measures/Devices for radiation monitoring of staff QC of all equipment, devices and protocols as per AERB guidelines
Yes Yes Yes Yes
M-Mandatory M-Mandatory M-Mandatory M-Mandatory
5 Space requirement
Space for keeping machine as per AERB guidelines Space for supplementary equipment like printer, film processor, injector etc
Yes Yes
M-Mandatory M-Mandatory-can be
shared
Reporting room
Reception, report dispatch and waiting area
Toilet
Patient preparation area, change room
Electrical facilities with backup like UPS, Generator Space for keeping patient monitoring apparatus, Resuscitatory appliances and Anesthesia machine Furniture & Fixtures
Communication system – Telephone, Fax, internet facility and mobile number for appointment and emergency helpline number of manufacturing company
Yes yes Yes Yes Yes Yes
M-Mandatory-can be M-Mandatory-can be M-Mandatory-can be M-Mandatory-can be M-Mandatory-can be M-Mandatory-can be
shared shared shared shared shared shared
Water and Electricity
Toilet (male and female wherever applicable)
Yes Yes
M-Mandatory M-Mandatory
6 Human Resource
(Full time/Part time/Visiting)
Number of Qualified and registered Radiologists Number of qualified and registered Nurses Number of CT technicians with training status and support staff
Number of scavenging and support staff
MD/DMRD /DNB Radiology
One/more per center D
One/more per center
Roster of payment and salary of staff
Periodic health check up and vaccination of staff
yes yes
M-Mandatory M-Mandatory
Yes Yes
M-Mandatory M-Mandatory
yes
Qualified with recognised course in Radiology technology, or equivalent
yes
M-Mandatory-can be
shared
7 Equipment/instruments/drugs
List of equipments required
List of small instruments required
As per the scope of services
BP appratus, Pulse oximeter, Monitoring Anaesthesia equipment-if CT under sedation is in scope Films,envelopsforreports,CDs/DVDsforsoftcopiesofreport Injector syringes, tubing, i/caths, etc
List can be provided List can be provided
Listofconsumables
Listcanbeprovided
Annual Maintenance protocol for equipment and its record maintenance
Yes
M-mandatory
Also refer to documents on hospital
List of Drugs and resuscitation equipments
1. Contrast agents;
2. Medication for preparation (e.g. Beta blockers, buscopan etc);
3. Medication for sedation;
4. Medication for resuscitation
8 Support Service
If applicable
Provisionforappropriatepatienttransferincaseofadverse event
Radiation safety Officer
9 Legal/Statutory Requirements
To be registered under Atomic Energy Regulatory Board
M-Mandatory
(AERB)
10 Record Maintenance and reporting
Proforma of list of names of patients along with diagnosis and name referral hospital Availability of reference books
Medicolegal records, as applicable
Preferrably linked to patient UID
D-Desirable
Record keeping of technicians and support staff working in CT Center indicating their details including qualification, registration and training
Yes
MLCs; Consents for contrast/sedation etc. Yes
D-Desirable M-Mandatory M-Mandatory
Duration of record maintenance: As per the Acts and Rules in force
Statistics to be collected – If felt necessary
Yes Yes
M-Mandatory M-Mandatory
11 Standards on basic processes
Radiation Safety Measures and protocols as per AERB Yes requirements
Infection Control and waste management practices Yes Safety considerations – Fire safety act Yes Patient Information and Education and consent
M-Mandatory
Timely preparation and dispatch of reports Yes Trolleys for patient transport Yes Regular calibration of Equipment Yes Appropriate Air-conditioning Yes
M-Mandatory M-Mandatory M-Mandatory
Yes M-Mandatory
M-Mandatory M-Mandatory
1 Definition
Definition of MRI center
MRI examination and diagnosis According to the type of scanner
Template
Minimum standards
Remarks
Fee structure of different investigations : To be displayed
Safety signage’s (wherever applicable)
Yes
M-Mandatory
3b Safety Hazard and Caution signs
Appropriate Fire exit signages
Yes Yes
M-Mandatory M-Mandatory
Metal detector available
4 Space requirement
Reception and waiting area Space for keeping machine Reporting room
Toilet
Yes Yes Yes Yes Yes Yes Yes
M-Mandatory M-Mandatory M-Mandatory M-Mandatory M-Mandatory M-Mandatory M-Mandatory
Patient preparation area
Electrical facilities
Space for keeping MRI compatible patient monitoring apparatus, Resuscitatory appliances and Anesthesia machine
Minimum standards for Imaging Centers – MRI
2 Scope of Services
Enlist the investigations to be carried out by MRI MRI Scan of Regions/ parts of body with capabilities
The Scope should match the Scanner specifications
3 Physical Infrastructure 3a Informative signages
Name of the Radiologist with qualification Display of model of equipment
Broad Services provided
Timings of the facility
Yes Yes Yes Yes Yes
M-Mandatory M-Mandatory M-Mandatory M-Mandatory M-Mandatory
of advanced vascular/ cardiac/ neurological / functional etc. imaging as per the capabilities of the scanner
Furniture & Fixtures
Communication system – Telephone, Fax, internet facility and mobile number for appointment and emergency helpline number of manufacturing company
Water and Electricity
Toilet (male and female wherever applicable) Yes
M-Mandatory M-Mandatory
5 Human Resource
(Full time/Part time/Visiting)
Number of Qualified and registered Radiologists MD/DMRD Radiology
M-Mandatory(as per workload) M-Mandatory(as per workload) M-Mandatory(as per workload)
Number of qualified and registered Nurses Number of MRI technicians with training status and support staff
Number of scavenging and support staff
Roster of payment and salary of staff
Periodic health check up and vaccination of staff
Yes
Qualified with recognised technology,or equivalent. Yes
Yes
Yes
6 Equipment/instruments/drugs List of equipments required
List of small instruments required
As per scope of service
BP apparatus,pulse oximeter,Monitoring anaesthesia equipment-if MRI under sedation is in scope.
M M
Listofconsumables
Films,envelopesforreports,CDs/DVDsforsoftcopies of report .Injector syringes,tubing,i/cath,etc
M-Mandatory
List of Drugs and resuscitation equipments Sterilization equipments
Yes Yes
ANNEXURE on clinic/polyclinic M-Mandatory
M-Mandatory
Annual Maintenance protocol for equipment and its record maintenance
Yes Yes
Yes
M-Mandatory
course
in
Radiology/MRI
M
M Advisory
7 Support Service
If applicable
provisionforappropriatetransferincaseofadverse event
Radiation safety Officer
8 Legal/Statutory Requirements
To be registered under PCPNDT Act
AERB
M-Mandatory M-Mandatory D-DESIRABLE M-Mandatory
9 Record Maintenance and reporting
Proforma of list of names of patients along with diagnosis and name referral hospital Availability of reference books
Medicolegal records, as applicable
preferably linked to patient UID
Record keeping of technicians and support staff working in MRI Center indicating their details including qualification, registration and training
Yes
MLCs; consents for contrast/sedation etc Yes
Duration of record maintenance: As per the Acts and Rules in force
Yes Yes
M-Mandatory M-Mandatory
Statistics to be collected – If felt necessary
10 Standards on basic processes
Infection Control and waste management practices
Yes Yes
M-Mandatory M-Mandatory
Safety considerations – Fire safety act and preventing access of steel near the machine.
Patient Information and Education
Timely preparation and dispatch of reports Trolleys for patient transport
Yes Yes Yes Yes Yes
M-Mandatory M-Mandatory M-Mandatory M-Mandatory M-Mandatory
Regular calibration of Equipment Appropriate Air-conditioning
Minimum standards for Hospital
ADVANCE ( Non Teaching )
REMARK
1 Scope
Rheumatology services Yes
Services Provided
Superspeciality
2 Human resources
2.1 Doctors
Med person incharge
DM/DNBINRHEUMATOLOGYORTwoYearsStructured Post Doctoral Training in Clinical Immunology and Rheumatology OR MD/DNB MEDICINE WITH 5 YEARS EXPERIENCE OF WORKING IN GOVT RECOGNISED HOSPITAL WITH RHEUMATOLOGYCENTRE.
M
Full time consultant Part time consultant visiting consultant Duty Doctors
Yes or Yes or Yes
2.2 Nurses
Nursing head
General nurses TrainedNursesforICU/OT/HDU
part of hospital
2.3 Pharmacist Yes 2.4 Para Medical staff
a. Lab Tech Yes b. Xray Technician Yes
yes in inhouse pharmacy
RHEUMATOLOGY SERVICES IN HOSPITAL
FOR PAEDIATRIC RHEUMATOLOGY- DM/DNB/rheumatology or MD/DNB paediatrics WITH 5 YEARS POST MD/DNB EXPERIENCE OF WORKING IN GOVTRECOGNISEDHOSPITALWITH RHEUMATOLOGY. (SPECIAL BEDS IN PAEDIATRICS DESIRABLE)
MBBS Doctor (Mandatory)
MD Med Or MD Pediatrics (Desirable) for round the clock cover
yes
Yes Yeswith6monthsTrainingfromaRheumatologyCenter D
part of hospital
M- if own lab M- if own
c. Technician
e. Dietician
f. Physiotherapist/Occupational Therapist g. Psychologist
h. Medicosocial worker
yes Yes Yes Yes Yes
M-Mandatory(for Minor OT) D
D
part of hospital
3 Equipment
Diagnostic
USG, RHEUMATOLOGY- MONITORS, INFUSION PUMP, COLOUR DOPPLER (Mandatory)
Emergency
Sterlizing Drugs,Medicaldevicesandconsumables
Yes
Refer to documents on Hospital M-Mandatory
DGCI DMAARDS & IMMUNOSUPPRESSANTS List of disposables Yes
Annual Maintenance records of equip Yes
4 Support Services
4.1. Laboratory Yes 4.2. Imaging Yes 4.3. Pharmacy Yes
own or Outsourced own or Outsourced own or Outsourced
OTOSCOPE, Polarising Microscope, USG with Probe for facilitating Intra Articular Injections, Immunofluorescence Microscope and Video Capillaroscope (Desirable)
Yes
Yes-BIOLOGICALSFORRHEUMATOLOGYrecognisedby
EMERGENCYDRUGS-Alsorefertohospital documents
M
D
M-Mandatory
D-Desirable
part of Hospital
Minimum standards for Clinics/ Polyclinics
PAEDIATRIC RHEUMATOLOGY
ADULT RHEUMATOLOGY
Remarks
1 Definition
2 Scope
Specialist
Specialist
Services Provided
PAEDIATRIC RHEUMATOLOGY OPD Consultation
ADULT RHEUMATOLOGY OPD Consultation
3 Physical Infrastructure
a. Space requirement
i. Reception
ii. consultation/waiting area
Yes Yes
Yes Yes
M-Mandatory M-Mandatory
4 Human resources
Doctors
DM/DNB RHEUMATOLOGY or MD/ DNB/PAEDIATRICS WITH 5 YEARS POST MD/DNB EXPERIENCE OF WORKING IN GOVT RECOGNISED HOSPITAL WITH RHEUMATOLOGY .(SPECIAL BEDS IN PAEDIATRICS DESIRABLE)
DM/DNB RHEUMATOLOGY OR MD/DNBMEDICINE WITH5YEARS EXPERIENCEOFWORKINGIN GOVT RECOGNISED HOSPITAL WITH RHEUMATOLOGY CENTRE
Tech staff
NURSE-1
NURSE-1
EITHER NURSE/ ATTENDANT-M
Non Tech staff
Duty and salary roster
OTHER REQUIREMENT LIKE PERIODIC HEALTH CHECK UPS
ATTENDANT-1 Yes
Yes
ATTENDANT-1 Yes
Yes
M-Mandatory D-Desirable
5 Equipment
Stethoscope Thermometer BP Apparatus Glucometer
Yes Yes Yes Yes
Yes Yes Yes Yes
M
Yes (Non Mercury) Yes (Non Mercury) M
RHEUMATOLOGY CLINIC/POLYCLINIC
Weighing machine Others
Yes Yes ophthalmoscope, otoscope(Desirable) ophthalmoscope,
M M-Mandatory
Emergency kit and medicine
otoscope(Desirable) Yes Yes
Refer document on Clinic/Polyclinic
M
Drugs, Medical devices and consumables
List of disposables
Annual Maintenance records of
Yes Yes
6 support services
sterlization/CSSD security
BMW management Laundry
Yes Yes Yes Yes Yes Yes Yes Yes
M
M
M own/outsourced
7 Standard on basic processes a. Receiving patients,privacy for patients while examining especially females
Yes Yes
M
b. Infection control practices soap and water
Yes Yes Yes Yes Yes Yes
M M M
facilities for hand washing and disinfection
Disinfection of work Area
Use of disposable services small autoclave
Yes Yes Yes Yes Yes Yes Yes Yes
M Yes M D
c. Policy on outsourced services
Yes Yes Yes Yes
M M
Minimum standards for Hospital
BASIC (General purpose)
ADVANCE ( Non Teaching )
REMARK
1 Scope
Providing services ( example Primary Health Centre, Community Health Centre, SDH, District Hospital, Private Hospital,Nursing Homeetc)
Providing services (example Civil Hospital, regional Hospital,Nursing Home,Private Hospital etc of similar scope)
Services Provided
Lung Function Test-spirometry , simple Bronchoscopy – non intervention, Blood Gas
PFT with advance spirometry test including diffusion, Bronchoscopy with advance procedures,CT guided FNAC, Medical thoracoscopy
1.1 General purpose 1.2 Single Speciality 1.3. Multispeciality 1.4. Superspeciality
Yes Yes
Yes Yes Yes
2 Human resources 2.1 Doctors
Med person incharge
MD/DNB MEDICINE
with at least 2 mth training in recognized centre in Pulmonology Yes or
Yes or
Yes
MBBS Doctors for round the clock
DM /DNB /MD/Diploma Pulmonology /DiplomainChestDiseasesand Tuberculosis(DCDT)
Yes or
M-Mandatory
Full time consultant Part time consultant visiting consultant Duty Doctors
Yes or
Yes
MBBS Doctors for round the clock
M-Mandatory
2.2 Nurses
Nursing head
General nurses
Trained Nurses for ICU/OT/HDU 2.3 Pharmacist
Yes Yes Yes
Yes Yes Yes Yes
part of hospital
part of hospital
part of hospital
yes-if Inhouse pharmacy
PULMONOLOGY SERVICES IN HOSPITAL
2.4 Para Medical staff Lab Tech
Xray Technician Technician
Yes
Yes
PFT Technician Yes
1
Yes
Yes
PFT Technician Yes
1
1
Yes
Yes
M- if own lab; M- if own M-Mandatory D-Desirable D-Desirable M-Mandatory D-Desirable D-Desirable
ECG Technician Dietician Physiotherapist Psychologist Medicosocial worker
yes yes
3 Equipment
a. Therapeutic
Chest tube,Bipap Machine, Nebuliser, Oxygen, Resuscitation Tray
Chest tube,Bipap Machine, Nebuliser, Oxygen, Resuscitation Tray,Access to ICU
M-Mandatory
b. Diagnostic c. Emergency
Pulse oximeter, PFT
Pulse oximeter, PFT, Tracheostomy set
Yes
M-Mandatory
d. Drugs,Medical devices and consumables
e. List of disposables
f. Annual Maintenance records of equip
Yes (steroids,Nebuliser bronchodilators)
Yes
Yes
Yes (steroids, Nebuliser bronchodilators), central line, USG Yes
Yes
M-Mandatory D
4 Support Services
4.1. Laboratory
4.2. Imaging
4.3. Pharmacy
4.4. sterlization/CSSD
4.5. Medical Gas/Manifold
4.6. Blood storage unit/blood Bank
Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes
own or Outsourced own or Outsourced M-IN ADVANCE
M
Yes
refer to documents on hospital
refer to documents on hospital
M-IN ADVANCE D
Minimum standards for Clinics/Polyclinics
Minimum Standards
Remarks
1 Definition
2 Scope
Specialist
PULMONOLOGY OPD Consultation/nebulisation
Specialist
Services Provided
3 Physical Infrastructure
a. Space requirement
i. Reception
ii. consultation/waiting area
Yes Yes
M-Mandatory M-Mandatory
4 Human resources
Med person incharge
DM /DNB /MD/Diploma Pulmonology /Diploma in Chest Diseases and Tuberculosis(DCDT) Attendant-1
Yes
M-Mandatory
Non Tech staff
Duty and salary roster
OTHER REQUIREMENT LIKE PERIODIC HEALTH CHECK UPS
Yes
Either Nurse/Attendant M-Mandatory D-Desirable
5 Equipment
a. Stethoscope
b. Thermometer c. BP Apparatus d. Glucometer
e. Weigh machine f. Others
Yes
Yes
Yes
Yes
Yes
Peak flowmeter,pulse oximeter,heightometer,tape yes
M
g. Emergency kit and medicine
Refer to document on clinic / polyclinic
M
M
h. Drugs,Medical devices and consumables i. List of disposables
j. Annual Maintenance records of equip
Yes Yes Yes
M
PULMONOLOGY CLINIC
Yes (Non Mercury)
Yes (Non Mercury)
M
M
M-Mandatory
6 support services
a. sterlization/CSSD b. security
c. BMW management d. Laundry
Yes Yes Yes Yes
if required M
M
if required
7 Standard on basic processes
a. Receiving patients,privacy for patients while examining especially females
b. Infection control practices
Yes
M
soap and water
facilities for hand washing and disinfection Disinfection of work Area
Use of disposable services
small autoclave
c. Policy on outsourced services
Yes
Yes
Yes
Yes
Yes
if required if required
M M M M Yes M D
Minimum standards for Hospital
MEDICAL ONCOLOGY
CLINICAL HAEMATOLOGY
Remarks
1 Scope
Solid Tumors, Haematology
Haematology
Procedures-Bone Marrow Test,Lumbar puncture,Pleural/Ascitic Tap,PICC line insertion,PICC line maintenance, Blood transfusion Services
Services Provided 1.1. Multispeciality 1.2. Superspeciality
yes yes
yes yes
2 Human resources 2.1 Doctors
Med person incharge
DM /DNB Medical Oncology
DM/ DNB Clinical Haematology
M M
Duty Doctors 2.2 Nurses General nurses
MBBSforroundtheclockcover Yes
MBBS for round the clock cover Yes
M ,part of Hospital
Trained Nurses for ICU/OT/HDU
2.3 Pharmacist
Yes Yes
Yes Yes
1 nurse per 2 beds
MEDICAL ONCOLOGY/CLINICALHAEMATOLOGY
1. DM Haematopathology
2. MD Pathology with 03 experience in Haematopathology in recognised institutions can work in Haematology Lab.
For Bone Marrow Transplant-HEPA Filter room,Irradiation of Blood products,Stem cell collection facility,Stem cell cryo preservation facility,Inhouse Blood Bank
30% nurses should have 2 years experience of Oncology from tertiary care centres.
M-Mandatory,with one year training in Oncology, Pharmacology.
2.4 Para Medical staff a.Lab Tech
b. Xray Technician
c. ECG Technician
Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
M- if own lab,part of Hospital M- part of Hospital
M- part of Hospital
M- part of Hospital
d. Dietician
e. Physiotherapist f.Psychologist
g. Medicosocial worker
D- part of Hospital D- part of Hospital D- part of Hospital
3 Equipment
a. Therapeutic b. Diagnostic
yes yes
*M–Automated Haematology
M
c. Emergency d. Sterlizing
Yes Yes Yes Yes Yes Yes
Refer to documents of Hospital M
Refer to documents of Hospital
e. Drugs,Medical devices and consumables
f. List of disposables
g. Annual Maintenance records of equip
Yes Yes Yes Yes
M M
4 Support Services
4.1. Laboratory
Yes Yes
own or Outsourced ( lab with basic facility
4.2. Imaging
4.3.. sterlization/CSSD 4.4. Medical Gas/Manifold
Yes yes Yes Yes Yes Yes
own or Outsourced M
M
Analyser,Microscope,Haematology Cell counter,Flowcytometer, D-Autopipettes, Cytochemistry stains, Immunohistochemistry, Immunocytochemistry
M-Mandatory D- Desirable
mandatory)
1 Definition
2 Scope
Specialist
Services Provided
ONLY CONSULTATION
3 Physical Infrastructure
a. Space requirement
i. Reception
ii. consultation/waiting area
Yes M Yes M
4 Human resources
MEDICAL ONCOLOGY/CLINICAL HAEMATOLOGY CLINIC/POLYCLINIC
Minimum standards for Clinics/Polyclinics
ONLY CONSULTATION
Remarks
Med person incharge 1.DM/DNBMEDICALONCOLOGY
CLINICAL HAEMATOLOGY a.DM/DNB
2. M
Technical staff NURSE-1 or Non Tech staff Attendant-1 Duty and salary roster Yes
OTHER REQUIREMENT LIKE PERIODIC Yes HEALTH CHECK UPS,vaccination of staff
D
5 Equipment
Stethoscope Yes Thermometer Yes BP Apparatus Yes Glucometer Yes Weigh machine Yes Emergency kit and medicine Yes
M
Yes (Non Mercury)
Yes (Non Mercury)
M
M
Refer to document on clinic and polyclinic
Medical Oncology b. DM Haematopathology
c. MD Pathology with 03 experience in Haematopathology in recognised institutions can work in Haematology Lab.
Drugs,Medical devices and consumables Yes
Refer to document on clinic and polyclinic
M-Mandatory
D
List of disposables Yes
Annual Maintenance records of equip Yes
6 support services
sterlization/CSSD Yes security Yes BMW management Yes Laundry Yes
if applicable
D
M Own/outsourced
7 Standard on basic processes
a. Receiving patients,privacy for patients Yes while examining especially females
b. Infection control practices Yes
M
soap and water Yes facilities for hand washing and disinfection Yes
M M M
Disinfection of work Area Yes Use of disposable services Yes small autoclave Yes facilities for sterlization Yes c. Policy on outsourced services Yes
M M M M D
M-Mandatory
D- Desirable
Minimum standards for Hospital
Basic( General Purpose)
Advance (Non Teaching)
Remarks
1 Scope
eg., Civil Hospital, Regional Hospital,Nursing Home,Private Hospital
Services Provided 1.1 General purpose 1.2 Single Speciality 1.3. Multispeciality 1.4. Superspeciality
Yes
2 Human resources 1.1 Doctors
Med person incharge
Mch Gynaecological oncology from a recognised centre or MD/MS/DNB Gynaecology and Obstetrics with 02 years experience in Gynaecological oncology in a recognised centre
MCh Gynaecological Oncology specialist- Trained in Colposcopy
Duty Doctors
Yes
Yes
MBBS Doctors,round the clock cover
2.2 Nurses
Nursing head
General nurses
Trained Nurses for ICU/OT/HDU 2.3 Pharmacist
Yes
1Nurse per 2 patients Yes
yes1forOT
Yes
1Nurse per 2 patients Yes
M M M M
2.4 Para Medical staff Lab Tech
Yes
yes
M- if own lab, part of Hospital(lab with frozen section -M mandatory
yes yes
yes yes
GYNAECOLOGICAL ONCOLOGY
eg. (General Hospital with Single
Specialities/Multiple Specialities example
Community Health Centre Sub Divisional etc. Of similar scope Hospital ,District Hospital,Civil
Hospital,Private Hospital,Nursing Home) etc
2
desired
Xray Technician
Yes
Yes
M- if own, part of Hospital
M- if own, part of Hospital
OT Technician
yes
Yes
ECG Technician Dietician Physiotherapist Psychologist Medicosocial worker
Yes yes Yes Yes Yes
Yes yes Yes Yes Yes
M-part of Hospital M-part of Hospital D-part of Hospital D-part of Hospital D-part of Hospital
3 Equipment
a. Therapeutic b. Surgical
Basic Surgical Equipment,
DRESSING TRAY, CATHETERISATION TRAY, PORTABLE LIGHT
Basic Surgical Equipment DRESSING TRAY, CATHETERISATION TRAY, PORTABLE LIGHT
M M
c. Emergency
Yes
Yes
Refer to Documents on Hospital
M
Refer to Documents on Hospital
d. Sterlizing
e. Drugs,Medical devices and consumables
f. List of disposables
g. Annual Maintenance records of equip
Yes Yes
Yes Yes
4 Support Services
b. Laboratory
c. Imaging
d. Pharmacy
g. Medical Gas/Manifold i. Amb service
Yes Yes Yes Yes Yes
Yes yes Yes* Yes* Yes
own or Outsourced own or Outsourced
*M
*M M-own/outsourced/TIE UP
Yes Yes
Yes Yes
M M
M-Mandatory
D- Desirable
Minimum standards for Clinics/ Polyclinics
ONLY CONSULTATION
Remarks
1 Definition
2 Scope
Specialist
Services Provided
ONLY CONSULTATION
3 Physical Infrastructure a.Space requirement
i. Reception
ii. consultation/waiting area iii. OPD Area
Yes Yes Yes
M-Mandatory M-Mandatory M-Mandatory
4 Human resources
Med person incharge
MchGynaecologicaloncologyfromarecognised centre or MD/MS/DNB Gynaecology and Obstetrics with 02 years experience in Gynaecological oncology in a recognised centre
Technician
Non Tech staff
Duty and salary roster
OTHER REQUIREMENT LIKE PERIODIC HEALTH CHECK UPS,vaccination of staff
NURSE-1 or Attendant-1 Yes
Yes
M
5 Equipment
Stethoscope
Thermometer
BP Apparatus
Glucometer
Weigh machine
Emergency kit and medicine
Yes
Yes
Yes
Yes
Yes
DRESSING TRAY, CATHETERISATION TRAY, PORTABLE LIGHT
M
Yes (Non Mercury) Yes (Non Mercury)
M
M
Refer to document on clinic/Polyclinic M-Mandatory M-Mandatory
Drugs,Medical devices and consumables List of disposables
Yes Yes
GYNAECOLOGICAL ONCOLOGY CLINIC/POLYCLINIC
M-Mandatory D-Desirable
Annual Maintenance records of equip Yes
D
6 support services
sterlization/CSSD Yes security Yes BMW management Yes Laundry Yes
M-MANDATORY D
M Own/outsourced
7 Standard on basic processes
a. Receiving patients,privacy for patients while Yes examining especially females
b. Infection control practices Yes
M
soap and water Yes facilities for hand washing and disinfection Yes Disinfection of work Area Yes Use of disposable services Yes small autoclave Yes facilities for sterlization Yes c. Policy on outsourced services Yes
M
M M-MANDATORY M-MANDATORY M
M
M
D
M-Mandatory D- Desirable
Minimum standards for Hospital under CEA
Minimum Standards
Remarks
1 Scope
Services Provided i. Multispeciality
ii. Superspeciality
yes yes
2 Human resources 2.1 Doctors
Duty Doctors
MCh/DNB Surgical Oncology or
MS General Surgery/MS ENT/MS Orthopaedics with 05 years experience in Surgical Oncology in Recognised Centres by MCI,Government Medical College having this course,RCCs.
Yes MBBS Doctors as and when required for round the clock cover
2.2 Nurses
General nurses
Trained Nurses for ICU/OT/HDU 2.3 Pharmacist
2.4 Para Medical staff
a. Lab Tech
b. Xray Technician
c. OT Technician
d. ECG Technician
e. Dietician
f. Physiotherapist
g. Psychologist
h. Medicosocial worker
Yes Yes Yes
M M M
SURGICAL ONCOLOGY
Yes Yes Yes Yes 1 Yes Yes Yes
M- if own lab,part of Hospital M- if own ,part of Hospital M-Part of Hospital
M-Part of Hospital
M-Part of Hospital M-Part of Hospital D-part of Hospital D-part of Hospital
3 Equipment
Therapeutic
Surgical
Diagnostic
Emergency
Sterlizing
Drugs,Medical devices and consumables List of disposables
Surgical Tray Yes
yes
Yes
M
M ;as applicable
M-Mandatory
Refer to document on Hospital M
Refer to document on Hospital M-Mandatory
M
Annual Maintenance records of equip
Yes Yes Yes Yes
4 Support Services
4.1. Laboratory
4.2. Imaging
4.3. Pharmacy
4.4.Medical Gas/Manifold
4.5. Blood storage unit/blood Bank 4.6. Amb service
Yes
Yes
Yes
Yes
Yes
Yes M-Mandatory
own or Outsourced
own or Outsourced
*M
*M
M-own/outsourced/TIE UP M-own/outsourced/TIE UP
D- Desirable
Minimum standards for Clinics/Polyclinics
With minor OT
Remarks
1 Definition
2 Scope
Specialist
Services Provided
CONSULTATIONSERVICES;SUTURING,SUTURE REMOVAL, ABSCESS DRAIN, EXCISION LN BIOPSY, DEBRIDEMENT, BANDING, PARACENTESIS, CATHETERIZATION, NEEDLE ASPIRATION, FNAC, MINOR PROCEDURE WHERE NO GA IS REQUIRED
3 Physical Infrastructure
a. Space requirement
i. Reception
ii. consultation/waiting area iii. OPD Area
Yes Yes Yes
M M M
4 Human resources
Doctors
MCh/DNB Surgical Oncology or MS General Surgery/MS ENT/MS Orthopaedics with 05 years experience in Surgical Oncology in Recognised Centres by MCI,Government Medical College having this course,RCCs.
M
Technician
Non Tech staff
Tech
Duty and salary roster
OTHER REQUIREMENT LIKE PERIODIC HEALTH CHECK UPS,vaccination of staff
Yes Attendant-1 NURSE-1 Yes
Yes
D D D D D
5 Equipment
Stethoscope Thermometer BP Apparatus
Yes Yes Yes
M
Yes (Non Mercury) Yes (Non Mercury)
SURGICAL ONCOLOGY CLINIC/POLYCLINIC
Glucometer
Weigh machine
Emergency kit and medicine
Yes M Yes M
Drugs,Medical devices and consumables List of disposables
Annual Maintenance records of equip
DRESSING TRAY, CATHETERISATION TRAY, PORTABLE LIGHT
Yes
Yes
Refer to documents on Clinic /polyclinic
M
M
6 support services
a. sterlization/CSSD b. security
c. BMW management d. Laundry
Yes Yes Yes Yes
M
D
M Own/outsourced
7 Standard on basic processes
a. Receiving patients,privacy for patients while examining especially females
b. Infection control practices
Yes
M
soap and water
facilities for hand washing and disinfection Disinfection of work Area
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes M-Mandatory
M M M M M M M D
Use of disposable services
small autoclave
facilities for sterlization
c. Policy on outsourced services
Yes
D
D- Desirable
Minimum standards for Hospital
BASIC(General purpose)
ADVANCE (Non Teaching Hospital )
REMARK
1 Scope
Providing services for eg. (General Hospital with Single Specialities / Multiple Specialities example Sub Divisional Hospital, District Hospital, Civil Hospital,Private Hospital, Nursing Home) etc For post delivery Newborn care, prevention of Hypothermia , management of low birth weight baby, jaundice
Providing services for Superspecialities example Civil Hospital, Regional Hospital,Nursing Home,Private Hospital etc.
Treatment of babies with respiratory failure,c pap,ventilator,seizure disorder,septicemia,jaundice, LBW and VLBW babies
Services Provided
1.1 General purpose 1.2 Single Speciality 1.3. Multispeciality 1.4. Superspeciality
Yes Yes Yes
2 Human resources 1.1 Doctors
Med person incharge
MD/DNB/DIPLOMA/ PAEDIATRICS /MATERNAL AND CHILD HEALTH FROM RECOG INSTITUTION WITH 03 YRS EXPERIENCE IN NEONATOLOGY – Desirable
MD/DNB/DIPLOMA/ PAEDIATRICS FROM RECOG INSTITUTION WITH 03 YRS EXPERIENCE IN NEONATOLOGY – Mandatory
DM/DNB NEONATOLOGY or equivalent foreign qualification: desirable
OpOphthalmology, ENT experts for follow-up of high-risk neonates Duty Doctors
Yes
D
1.2 Nurses General nurses
1 per 5 beds 1 per 5 beds
1 per 3 beds 1 per2 beds
M M
Trained Nurses for ICU/OT/HDU
Hospital Infection Control 1.3 Pharmacist
1 D
1.4 Para Medical and other staff
a. Lab Tech
b. Xray Technician
Yes Yes Yes Yes
Yes Yes Yes M
M- if own lab
M-if own
M
M-(Trained in Breast Feeding and KMC)
c. ECG Technician
d. Dietician(Lactational Councellor)
MBBS Doctors for round the clock cover
MBBS Doctors for round the clock cover
M
Yes
Yes
yes, if inhouse pharmacy; part of Hospital
NEONATOLOGY
Yes
e. Physiotherapist
f. Psychologist
g. Medicosocial worker h. Cleaner
yes Yes Yes Yes
yes Yes Yes Yes
D D D
i. Attendant
Yes
3 Equipment
Therapeutic
1. Open care system: radiant warmer, fixed height, servo- controlled with trolley, drawers, O2-bottles , 2) Phototherapy unit 3)Resuscitator(siliconeresuscitationbagandmask withreservoir)hand-operated,neonate,500ml,750 ml, 4) Electronic Weighing Scale,
1. Open care system: radiant warmer, fixed height, servo- controlled with trolley, drawers, O2-bottles ,
2) Phototherapyunit 3)Resuscitator(siliconeresuscitationbagand mask with reservoir) hand-operated, neonate, 500 ml, 750 ml,
M
21-29: Desirable
Diagnostic Surgical Emergency Sterlizing
ABG machine, glucometer
Chest tube drainage,dressing tray Yes
Yes
Yes
M-Mandatory M
5) Electric suction machine /central suction system
4) Electronic Weighing Scale,
5) Electricsuctionmachine/centralsuction system
6) Manual suction machine
7) Thermometer, clinical, digital,
8) Examination Light, mobile
9) Laryngoscope with 0, 1size blade, 10)Washbasin
11) Hub Cutter, syringe
12) Oxygen cylinder/Central oxygen supply 13)fire safety equipment as per requirement 14) ABG machine
15) Pulse oximeter
16) Portable X Ray
17) CPAP machine
18) minimum 3 para monitor(SpO2,HR,ECG) 19) Infusion pumps
20) Ventilator
21) Compressedairlineorstandalone compressors for ventilators
22) Ultrasound machine; Echo optional
Yes
6) Manual suction machine
7) Thermometer, clinical, digital,
8) Examination Light, mobile
9) Laryngoscope with 0, 1size blade, 10)Washbasin
11) Hub Cutter, syringe
12) Oxygencylinder/Centraloxygensupply 13)fire safety equipment as per requirement 14) ABG machine
15) Pulse oximeter
16) Portable X Ray
17) CPAP machine
18) minimum 3 para monitor(SpO2,HR,ECG) 19) Infusion pumps
Appropriate Manpower to ensure adequate disinfection
One per shift: Desirable
Drugs, Medical devices and 10% dextrose,25% dextrose,Calcium 10% dextrose,25% dextrose,Calcium
consumables
gluconate,dopamine,dobutamine,adrenaline,midazo gluconate,dopamine,dobutamine,adrenaline,mid lam,salbutamol,antibiotic as per institutional azolam,salbutamol,antibioticasperinstitutional
Listofdisposables
ETTube,Infusionset,burrete,Disposablesyringe- (1ml,2ml,5ml,10ml,10ml,20ml,50ml ),Umbilical catheter,infant feeding tube(6,8),Oxygen catheter,Sterile glove of various sizes,measuring tap,gown,NIBP,Glucometer
ETTube,Infusionset,burrete,Disposablesyringe- M (1ml,2ml,5ml,10ml,10ml,20ml,50ml
),Umbilical catheter,infant feeding tube(6,8),Oxygen catheter,Sterile glove of
Annual Maintenance
yes Yes
yes
D
records of equip
4 Support Services
4.1. Laboratory
Hb,TLC,DLC,PS examination/Serum bilirubin/CSF examination/CRP/Blood sugar/Blood calcium estimation.
Yes
own or Outsourced
4.2. Imaging
4.3. Pharmacy
4.4. sterlization/CSSD
4.5 biomedical waste management,
4.5. Medical Gas/Manifold 4.6. Blood storage unit/blood Bank
4.7. Amb service
Yes Yes Yes Yes
Yes Yes Yes
own or Outsourced M-own/outsourced M
M
5 Process
Protocols and Policies
written protocols in the unit (should cover common neonatal problems, follow-up care, infection control policies, daily ICU routines, etc
D
protocol,a hand sanitizer,liquid soap,phenytoin,phenobarbitone,Intra Venous Cannula 24g,26g Mucus Extractor, 20 ml, sterile, Oxygen Cylinder,Sterile Gloves,Hand Sanitizer Measuring tape, all I V Fluid.
protocol,a hand sanitizer,liquid soap,phenytoin,phenobarbitone,Intra Venous Cannula 24g,26g Mucus Extractor, 20 ml, sterile, Oxygen Cylinder,Sterile Gloves,Hand Sanitizer Measuring tape, all I V Fluid. Intravenous lipid and amino acid solutions for parenteral nutrition
Yes Yes
Yes Yes
M
M-own /outsourced / TIE UP
M-own / outsourced/ TIE UP
Yes
Yes
M- Mandatory
D- Desirable
various sizes,measuring tap,gown,NIBP,Glucometer
Minimum standards for Clinics/Polyclinics
Minimum Standards
Remarks
1 Definition
2 Scope
Specialist
Services Provided
Consultation services,Immunisation Services,upper respiratory tract infection not requiring admission
3 Physical Infrastructure
a. Space requirement
i. Reception
ii. consultation/waiting area
Yes Yes
M-Mandatory M-Mandatory
4 Human resources
Med person incharge
MD/DNB/DIPLOMA PAEDIATRICS/MATERNAL AND CHILD HEALTH FROM RECOG INSTITUTION WITH 03 YRS EXPERIENCE IN NEONATOLOGY,DM/DNB NEONATOLOGY
Tech staff
Non Tech staff
Duty and salary roster OTHERREQUIREMENTLIKEPERIODICHEALTH CHECK UPS,vaccination of staff in lab,bld bank,TLD badges
NURSE-1 or attendant-1 Yes
Yes
M M-Mandatory D-Desirable
5 Equipment
Stethoscope
Thermometer
BP Apparatus
Glucometer
Weigh machine(Electronic-Desirable) Emergency kit and medicine
with small chest piece
Yes
small calf for neonate /NIBP
Yes
Yes Midazolam,phenytoin,adrenaline,dopamine,dobutami ne, calcium gluconate, 10% ,25% dextrose,IV fluid
M
Yes (Non Mercury)
Yes (Non Mercury)
M
M M;Alsorefertodocumenton clinic/Polyclinic
NEONATOLOGY CLINIC
Drugs,Medical devices and consumables
disposable gloves,sterile syringe,liquid soap,hand M;Alsorefertodocumenton sanitizer,infant feeding tube,iv cannula(24g,26g) clinic/Polyclinic
List of disposables
Yes M Yes D
Annual Maintenance records of equipment
6 support services
sterlization/CSSD security
BMW management Laundry
Yes M
Yes D
Yes M
Yes own/outsourced
7 Standard on basic processes
a. Receiving patients,privacy for patients while examining especially females
b. Infection control practices
Yes M
soap and water
facilities for hand washing and disinfection Disinfection of work Area
Yes M Yes M Yes M Yes M Yes M Yes M Yes M Yes D
Use of disposable services
small autoclave
facilities for sterlization
c. Policy on outsourced services
Minimum standards for Hospital under CEA
BASIC ADVANCE (General purpose) (Non Teaching Hospital )
Remarks
1 Scope
Providingservices(examplePrimary Providingservices(exampleCivil
Services Provided
1.1. General purpose 1.2. Multispeciality 1.3. Superspeciality
yes
2 Human resources Med person incharge
MS General Surgeon with 03 years experience in Paediatric Surgery from a recognised DNB/MCh centre
MCh/DNB Paediatric Surgery or MS General Surgeon with 03 years experience in Paediatric Surgery from a recognised DNB/MCh centre
Duty Doctors
YesMBBSDoctorsasandwhen requiredforroundtheclockcover
Yes MBBS Doctors as and when required for round the clock
2.2 Nurses
General nurses
Trained Nurses for ICU/OT/HDU
1 nurse per 5 beds 1 nurse per 2 beds
1 nurse per 5 beds
1 nurse per 2 beds;ICU-1:1 on level III bed
Yes
D-Desirable D-Desirable
2.3 Pharmacist
2.4 Para Medical staff Lab Tech
M-part of Hospital
Xray Technician
Yes Yes
Yes Yes
M- if own lab,part of Hospital
M- if own ,part of Hospital
PAEDIATRIC SURGERY
Health Centre, Community Health Centre, SDH, District Hospital, Private Hospital,Nursing Home etc)
Hospital, regional Hospital,Nursing Home,Private Hospital etc of similar scope)
yes yes
OT Technician
ECG Technician Dietician Physiotherapist Psychologist Medicosocial worker
Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes
M-Part of Hospital M-Part of Hospital M-Part of Hospital M-Part of Hospital D-part of Hospital D-part of Hospital
3 Equipment
Therapeutic
Surgical Tray
Surgical Tray, Cystoscope ,resectoscope,
M-Mandatory
Surgical Diagnostic
Yes
Upper and lower GI Endoscope/Bronchoscope
Yes
complete CSSD with indicators of all types
Yes
M-Mandatory D
Emergency Sterlizing
Yes Yes
M-ANNEXURE-2 M
Drugs,Medical devices and consumables
List of disposables
Annual Maintenance records of equip
Yes
M-ANNEXURE-3
4 Support Services
4.1. Laboratory
4.2. Imaging
4.3. Pharmacy
4.4. Medical Gas/Manifold
4.5. Blood storage unit/blood Bank
Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes
own or Outsourced
own or Outsourced
M
M
M-own/outsourced/TIE UP
4.6. Amb service
Yes
Yes
M-own/outsourced/TIE UP
Yes Yes
Yes Yes
M-Mandatory M
Minimum standards for Clinics/Polyclinics
With minor OT
Remarks
1 Definition
2 Scope
PAEDIATRIC SURGERY
Services Provided
CONSULTATION,SUTURING AND SUTURE REMOVAL,INJECTIONS
(No Surgical procedure)
3 Physical Infrastructure
a. Space requirement
i. Reception
ii. consultation/waiting area
Yes Yes
M-Mandatory M-Mandatory
4 Human resources
Med person incharge
Technician
Non Tech staff
Duty and salary roster OTHERREQUIREMENTLIKEPERIODICHEALTH CHECK UPS,vaccination of staff
MCh /DNB Paediatric Surgery NURSE-1 or
Attendant-1
Yes
M-Mandatory
5 Equipment
Stethoscope
Thermometer
BP Apparatus
Glucometer
Weigh machine(electronic) Emergency kit and medicine
with small chest piece Yes
Yes
Yes
M
Yes (Non Mercury)
Yes (Non Mercury)
M
M
Refer to document on clinic/ Polyclinic
M-Mandatory
M-Mandatory
Drugs,Medical devices and consumables List of disposables
Yes
disposable gloves,sterile syringe,liquid soap,hand sanitizer,infant feeding tube,iv cannula(24g,26g)
Annual Maintenance records of equip
Yes
D
PAEDIATRIC SURGERY CLINIC/POLYCLINIC
Yes
M-Mandatory D
Yes Yes
6 support services
sterlization/CSSD Yes M-MANDATORY security Yes D
BMW management Yes M
Laundry Yes Own/outsourced
7 Standard on basic processes
a. Receiving patients,privacy for patients while Yes M
examining especiallyfemales
b. Infection control practices Yes M soap and water Yes M
facilities for hand washing and disinfection Yes M-MANDATORY
Disinfection of work Area Yes M-MANDATORY Use of disposable services Yes M
small autoclave Yes M
facilities for sterlization Yes M
c. Policy on outsourced services Yes D
Minimum standards for Clinics/Polyclinics
Minimum Standards
Remarks
1 Definition 2 Scope
Specialist
Services Provided
Consultation Services
3 Physical Infrastructure
a. Space requirement
i. Reception
ii. consultation/waiting area iii. OPD Area
Yes Yes Yes
M-Mandatory M-Mandatory M-Mandatory
4 Human resources
Doctors Tech staff
PG Diploma DPMR, DNB PMR,MD PMR, MS Ortho with training, MD Sports Med with training
M-Mandatory
Non Tech staff
Duty and salary roster
OTHER REQUIREMENT LIKE PERIODIC HEALTH CHECK UPS
Attendant-1 Yes
Yes
M-Mandatory M
as applicable
5 Equipment
a. Stethoscope
b. Thermometer c. BP Apparatus d. Glucometer
e. Weigh machine f. Others
Yes
Yes
Yes
Yes
Yes
Exercise Table, Cycling, Weight Dumbbells, Barbells, Cuff Bar
M
Yes (Non Mercury) Yes (Non Mercury)
g. Emergency kit and medicine
h. Consumables
i. List of Disposables Annual maint of equipt
yes Yes Yes
refer to documents on hospital M-Mandatory (as applicable) D
PMR CLINIC
Occuaptional Therapist, Physiotherapist, Prosthetic ,Clinical Psycologist, Speech Therapist
M-Mandatory (as applicable)
M M M
6 support services
sterlization/ CSSD Yes M
security Yes D
BMW management Yes M
Laundry Yes D-Desirable;own/outsourced
9 Standard on basic processes
a. Receiving patients,privacy for patients Yes M while examining especially females
b. Infection control practices Yes M soap and water Yes M facilities for hand washing and disinfection Yes M Disinfection of work Area Yes M
Use of disposable services Yes M c. Policy on outsourced services Yes D
Minimum standards for Hospital under CEA
Minimum Standards
Remarks
1 Scope
Multispeciality palliative care primarily for oncology, Neurology and HIV patients.This palliative centre can be part of General Hospital or stand alone centre
Services Provided
i. Multispeciality
yes yes
ii. Superspeciality 2 Human resources
Doctors
visiting consultant Duty Doctors
MBBS Doctor and MD Anaesthesia Oncologist,Neurophysician,DoctorstrainedinHIV
2.2 Nurses
General nurses
Trained Nurses for ICU/OT/HDU 2.3 Pharmacist
2.4 Para Medical staff
a. Lab Tech
b. Xray Technician
c. OT Technician
d. ECG Technician
e. Dietician
f. Physiotherapist
g. Psychologist
h. Medicosocial worker
Yes Yes Yes
M-Mandatory M-Mandatory M
PALLIATIVE CARE
MBBS Doctors as and when required for round the clock cover
Yes Yes Yes Yes yes Yes Yes Yes
M- if own lab,part of Hospital M- if own ,part of Hospital M-Part of Hospital
M-Part of Hospital
M-Part of Hospital M-Part of Hospital D-part of Hospital D-part of Hospital
3 Equipment
Therapeutic Yes Surgical Yes Diagnostic Yes Emergency Yes Sterlizing Yes Drugs,Medical devices and consumables Yes List of disposables Yes Annual Maintenance records of equip Yes
as per requirement M-Mandatory (as Applicable) M-Mandatory (as Applicable) Refer documents on Hospital M
Refer documents on Hospital M-Mandatory
M
4 Support Services
4.1. Laboratory Yes 4.2. Imaging Yes 4.3. Pharmacy Yes 4.4. Medical Gas/Manifold Yes 4.5. Blood storage unit/blood Bank Yes 4.6. Amb service Yes
own or Outsourced
own or Outsourced
M
M-Mandatory M-own/outsourced/ TIE UP M-own/outsourced/ TIE UP
1. Examination Table
2. Writing tables
3. Chairs
4. Almirah
5. Waiting Benches
6. Medical/Surgical Beds
7. Labour Table- if applicable
8. Wheel Chair/Stretcher
9. Medicine Trolley, Instrument Trolley
10. Screens/curtains
11. Foot Step
12. Bed Side Table
ANNEXURE FOR HOSPITAL ANNEXURE 1
FURNITURE AND FIXTURES S.N ITEMS
13. Baby Cot- if applicable
14. Stool
15. Medicine Chest
16. Examination Lamp
17. View box
18. Fans
19. Tube Light/ lighting fixtures
20. Wash Basin
21. IV Stand
22. Colour coded bins for BMW
*this is an indicative list and the items shall be provided as per the size of the hospital and scope of service.
EMERGENCY EQUIPMENT
Sr No
Name of Emergency Equipment
1
Resuscitation equipment including Laryngoscope, endotracheal tubes, suction equipment, xylocaine spray, oropharyngeal and nasopharyngeal airways, Ambu Bag- Adult &Paediatric (neonatal if indicated)
2
Oxygen cylinders with flow meter/ tubing/catheter/face mask/nasal prongs
3
Suction Apparatus
4 5 6
Defibrillator with accessories
Equipment for dressing/bandaging/suturing
Basic diagnostic equipment- Blood Pressure Apparatus, Stethoscope,, weighing machine, thermometer
ECG Machine
Pulse Oximeter
Nebulizer with accessories
7 8 9
ANNEXURE 2 EQUIPMENTS
Sl. No.
Name of the Drug
ANNEXURE 3
DRUGS, MEDICAL DEVICES AND CONSUMABLES
List of Emergency Drugs and consumables (Essential in all hospitals)
INJECTIONS
1. INJ. DIAZEPAM 10 MG
2. INJ. FRUSEMIDE 20 MG
3. INJ. ONDANSETRON 8 MG/4ML
4. INJ. RANITIDINE
5. INJ NOR ADRENALINE 4 MG
6. INJ. PHENYTOIN 50 MG
7. INJ DICLOFENAC 75 MG
8. INJ. DERIPHYLLINE
9. INJ CHLORPHENIRAMINE MALEATE
10. INJ. HYDROCORTISONE 100 MG
11. INJ. ATROPINE 0.6 MG
12. INJ. ADRENALINE 1 MG
13. INJ. KCL
14. STERILE WATER
15. INJ. SODA BICARBONATE
16. INJ. DOPAMINE
17. INJ. NALAXONE 400 MCG
18. INJ. LIGNOCAINE 50 ML
19. TAB. SORBITRATE
20. TAB. ASPIRIN
21. INJ. TETANUS
OTHER
22. NEB. SALBUTAMOL2.5 ML
23. NEB. BUDESONIDE
24. LIGNOCAINE JELLY 2%
25. ACTIVATED CHARCOAL
26. CALCIUM (INJ or TAB)
FLUIDS
27. RL 500 ML
28. NS 500 ML
29. NS 250 ML
30. NS 100 ML
31. DNS 500 ML
32. DEXTROSE 5% 500 ML
33. DEXTROSE 10% 500 ML
34. PEDIATRIC IV INFUSION SOLUTION 500 ML
The other drugs and consumables shall be available as per the scope of services, bed strength and patient turnover.
1. Registration under Nursing Home Act/ Medical
Establishment Act 2. Bio-medical Waste
Management Licenses Authorization of HCO by PCB
MOU with Vendor
3. AERB Licenses
4. NOC from Fire Department
5. Ambulance
Commercial Vehicle Permit Commercial Driver License Pollution Control Licenses
6. Building Completion Licenses
7. Lift license for each lift
8. DG Set Approval for Commissioning
9. Diesel Storage Licenses
10. Retail and bulk drug
license (pharmacy) 11. Food Safety Licenses
ANNEXURE 4
LIST OF LEGAL REQUIREMENTS
Below is the list of legal requirements to be complied with by a hospital a applicable by the local/state health authority (all may not be applicable):
Sl. Name of Document No.
Valid From
Valid Till
Send for
Remark
renewal by
(Expired/ valid/NA)
12. Narcotic Drug Licenses
13. Medical Gases Licenses/ Explosives Act
14. Clinical Establishments and Registration (if
applicable)
15. Blood Bank Licenses
16. Boilers Licenses
17. MoU / agreement with
outsourced human resource agencies as per labor laws
18. Spirit Licence
19. Electricity rules
20. Provident fund/ESI Act
21. MTP Act
22. PNDT Act
23. Salex Tax registration
24. PAN
25. No objection certificate
under Pollution Control
Act (Air/Water)
26. Arms Act, 1950 (if
guards have weapons)
S.N. Articles
1. Table
2. Chairs
3. Examination Table/couch
4. Screens
5. Foot Step
6. Stools
7. Storage Cabinet for records etc.
8. BMW storage area
ANNEXURE FOR CLINICS
Annexure 1 C Furniture/fixtures
S. No. 1
Name of the equipment
Minimum Specifications – Adult
No. of equipment
2 3
Oxygen Concentrator/ Cylinder (Portable)
Fire Extinguisher
– Pediatric –
1 1
ResuscitationEquipment Ambu Bag/Air Way
1 1
Annexure 2 C Emergency Equipment
S. No. 1
Name of the Drug
Minimum Quantity
2 3 5 6 7 8
Inj Adrenaline
Inj Hydrocortisone Inj Atropine
InjAvil InjPhenargan
Inj. Deryphyline Inj. Frusemide
2 A
1 vial
1 Ampoule 1 Ampoule 1 Ampoule 1 Ampoule 1 Ampoule
9 10 11 12 13 14
Inj. Metoclopramide
Inj. Dexamethasone
Inj. Diazepam
Inj. Dicyclomine Hydrochloride Inj. 5% dextrose infusion
1 Ampoule 1 Ampoule 1 Ampoule 1 Ampoule 1 Vac
Inj. Normal saline
1 Vac
Annexure3 C Emergency Drugs
Annexures to Minimum Standards for Dental Clinical Establishments Annexure 1
Indicative minimum space requirements for a dental hospital/centre shall be as follows (These are indicative minimum figures, actual size will depend on scope of services of the hospital):
Space Area for one dental Chair
Includes Common and Operatory Areas
100 Sq ft/single chair Dental unit
Common area
Space for reception, waiting area, toilets etc.
35 sq ft
Operatory
Dental Chair unit including washing area and bio medical waste
60 sq ft carpet area for 1 dental chair
Ancillary area/space for sterilization, dark room, storage, provision of compressed air and suction sterilization
30% of the carpet area for 1 dental chair
For every additional chair 50% additional area required.
There should be adequate space between two dental units enough for patient privacy, ease of movement of staff and proper sanitization.
Annexure 2
Following furniture and fixtures shall be available however the quantity shall be as per size of the hospital/centre and workload so as to provide safe and secure patient care:
S.No. ARTICLES
1. Basic Computer and Printer
2. Writing tables
3. Chairs
4. Almirah
5. Waiting Benches/chairs
6. Stretcher
7. Instrument Trolley
8. Screens/curtains
9. Fans
10. Tube Lights / CFL / Bulbs
11. Wash Basin
12.
Colour coded bins for BMW as per state regulations
13.
Small Refrigerator : 1
Note: Stretcher and Screens/curtains are mandatory only for dental hospitals, trauma care centers, those where gen.anesthesia is administered, and where critically challenged patients are admitted.
Annexure 3
Indicative list of minimum Equipment/Instruments /Drugs requirement in a Dental Hospital however the quantity shall be as per size of the hospital and workload so as to provide safe and secure patient care:
I. ESSENTIAL EQUIPMENT LIST FOR PRIMARY ORAL HEALTH DELIVERY and Checking Vital Parameters:
Sl.no.
Equipment
1.
Dental chair with attachments like air motor/air rotor/micro motor
2.
Autoclave
3.
Compressor
4.
Stethoscope
5.
Sphygmomanometer
6.
Suction Unit
7.
Oxygen cylinder with Ambu bag
II. ESSENTIAL INSTRUMENT LIST:
Sl. No.
Function
Instrument
1.
Essential Instrument
Mouth mirror Tweezer Probe Instrument tray
2.
Periodontology
Periodontal probe Scalers
Curettes
3.
Oral Medicine and Radiology
X-ray equipment Lead apron
4.
Oral surgery
Elevators (various) Forceps
Needle Holder Scissors –surgical BP blade and handle
5.
Conservative Dentistry
Filling instruments
Cement spatula (metal/plastic) Waste receiver
Dental hand pieces Excavators
Explorers
Glass slab/paper mixing pad Matrix retainer
Protective glasses
Cellophane strip
6.
Endodontic
Endo root canal explorer Endo root canal plugger Endo root canal spreader
Endo root canal ruler
Spirit lamp or similar instrument for heating purpose
7.
Prosthodontics
Impression trays Rubber bowl Ruler scale Spatula
Carver
Shade guide
Finishing and polishing instruments (e.g Acrylic trimmer, etc)
Wax Knife
Wax Spatula
Cement spatula (metal/plastic)
Waste receiver
Dental hand pieces
Pliers
Glass slab/paper mixing pad
Spirit lamp or similar instrument for heating purpose
8.
Orthodontics
Pliers
Applicable armamentarium
9.
Pedodontics
Relevant instruments as per procedures listed under various specialties.
10.
Implant Dentistry
Implants with surgical kit. Physio dispenser
Other surgical instruments
11.
First Stage Trauma care
Splinting material as per requirement.
III. Essential Drugs list
IV. Essential Emergency Drugs
Sl. No.
Drugs
1.
Local anesthetic with vasoconstrictor
2.
Local anesthetic without vasoconstrictor
3.
Alternate local anesthetics
Sl. No.
Name of Drug
1.
Oxygen
2.
Epinehrine
3.
Atropine
4.
Ephedrine
5.
Hydrocortisone
6.
Nitroglycerine
7.
Antihistamine (diphenhydramine or chlorphenramine)
8.
Albuterol/Salbutamol
9. 10. 11. 12.
V.
Lorazepam
Ethamsylate
Hemostat sponge
Glucose / dextrose-25% ampoule
LIST OF CONSUMABLES
This includes the minimum quantity of the commonly used consumables in the facility which should be made available.
Sl. No.
Category
Item
1.
Common Essential
BP blade
Cotton
Suture
Hypodermic needles – disposable
Saline solution
Burs
Gloves
Masks
Potable water
Disinfectant (general cleaning )
Disinfectant (Instruments) Lubricating oil for hand pieces Soap
Surgical spirit
2.
Periodontology
as per procedural requirements
3.
Oral Medicine and Radiology (Please refer to Annexure 6)
X-ray films
X-ray film developer – manual/automatic processing X-ray film fixer – manual/automatic processing (If digital radiography available in the clinic, the above are optional)
4.
Oral surgery
as per procedural requirements
5.
Conservative Dentistry
Matrix Band Filling Materials Articulating Paper Wedges
6.
Endodontic
Chelating agent paste for root canal preparation
Irrigation solutions Endodontic sealer
Temperory filling materials
GuttaPercha cones –various Files and reamers.
Paper points- absorbent calcium hydroxide
7.
Prosthodontics
Wax Sheet
Green Stick Impression Material Luting Cement
8.
Orthodontics
Wires
Brackets
Adhesive/bonding Materials
9.
Peadodontic
Flouride
Pit and fissure sealant
zinc oxide and eugenol calcium hydroxide
Also relevant consumables as per procedures already listed above
10.
Implant Dentistry
Implants and abutments
11.
Emergency Services
All emergency drugs shall be checked periodically for expiry dates.
Annexure 4
Minimum Human Resource for Dental Hospitals shall be as follows h:
Sl. no.
Category
Strength
Registration with the concerned council (If applicable)
1.
Dentist
1
State Dental council
2.
Dental Hygienist
Depending on the work load
State Dental council
3.
Dental Assistant / Auxillary
Depending on the work load
–
4.
Dental technician
Depending on the work load
State Dental council
5.
Multipurpose worker
1
10th Pass
6.
Others
There should be provision of an on call-Anesthetist, General Physician, General Surgeon as and when required.
Annexure 5
LIST OF LEGAL REQUIREMENTS
Below is the list of legal requirements to be complied with by a Dental hospital as applicable by the local/state health authority (all may not be applicable):
Sl. Name of Document Valid Valid Till Send for From renewal
by
Remark (Expired/ valid/NA)
1. Registration under Nursing Home Act/Clinical
Establishment Act
2. Bio-medical Waste Management Licenses
Authorization of HCO by PCB
MOU with Vendor
3. AERB License for Xray/OPG etc.
4. NOC from Fire Department
5. Lift license (if available)
6. DG Set Approval for Commissioning (if
available)
9. Diesel Storage Licenses
12. Narcotic Drug Licenses
13. Medical Gases Licenses/ Explosives Act
17. MoU / agreement with outsourced human
resource agencies as per labor laws
18. Spirit License
19. Electricity rules
20. Provident fund/ESI Act
25. PAN
27. Wireless operation certificate from Indian P&T
Annexure 6
AERB requirement for OPG/Dental/Mobile Radiography
Please refer to Radiological Safety Division (RSD) DIAGNOSTIC RADIOLOGY SECTION Revised Guidelines for obtaining regulatory consents from AERB for medical diagnostic X-ray equipment
1) Applications for Registration (Radiography/R &F/Mammography/OPG/BMD/ Dental/ Mobile Radiography/ C-Arm) (details given in TABLE-A):
• Completely filled duly signed and stamped application form (AERB/RSD/MDX/REG).
• Layout shall be prepared as per the AERB guidelines for layout and shielding of x-ray equipment.
2) Application for License (Computed Tomography(CT)/ Interventional Radiology (IR) installations) (Details given in TABLE-B)
• Completely filled, duly signed and stamped application form (AERB/RSD/MDX-CT-CATH/LCO & RSO)
• Layout shall be prepared as per the AERB guidelines for layout and shielding of x-ray equipment
3) RSO Approval
• Completely filled, duly signed and stamped application form (AERB/RSD/MDX-RSO)
• Copy of certificates of qualifications (Refer Prescribed qualifications for personnel in DR practice)
• Availability of Personnel monitoring badge (TLD) for which he/she is nominated to become RSO.
MINIMUM STANDARDS FOR
CLINICAL ESTABLISHMENTS OF
AYURVEDA
BY
NATIONAL INSTITUTE OF AYURVEDA, JAIPUR
1
CONTENTS
Sn
Title
Page No
1.
Introduction
3
2.
Clinic
4
3.
Dispensary
5
4.
Therapy Centre
6
5.
Hospital with minimum of 10 beds
7
6.
Hospital with minimum of 11-25 beds
8
7.
Hospital with minimum of 26-50 beds
9
8.
Hospital with minimum of 51-100 beds
10
9.
Hospital with more than 100 beds
11
10.
Teaching Hospitals
12
11.
General Specifications of OPD
13
12.
General Specifications of IPD
15
13.
Support Services
18
14.
Legal & Statutory Requirements
21
15.
Records Maintenance & Reporting
21
16.
Human Resource
24
17.
Bibliography
28
18.
Annexures
I. Instruments for the IPD (100 beds)
29
II. Pathology Laboratory (Central)
31
III. X- Ray Department
32
IV. Panchkarma
33
V. Records to be maintained
37
VI. Signages
38
VII. Furniture/fixture requirements for In-Patient Department (IPD)
39
2
Introduction
From its gradual evolution through the 18th and 19th centuries, the hospital has come of age only recently during the past 50 years or so, the concept of today’s hospital contrasting fundamentally from the old idea of a hospital as no more than a place for the treatment of the sick. With the wide coverage of every aspect of human welfare as part of health care- like physical, mental and social wellbeing, a reach out to the community, training of health workers, biosocial researches, etc- the health care services have undergone a steady metamorphosis.
A hospital is an integral part of a social and medical organization, the function of which is to provide for the population complete health care, both curative and preventive, and whose out-patient services reach out to the family and its home environment; the hospital is also a center for the training of health workers and for biosocial research.
The society’s health is influenced by the accessibility, affordability, quality, availability and utilization of health services.
Personal health services –
Personal health services are the services provided by the hospitals, health centers, clinics. The care provided has been traditionally classified into –
1. Promotion of health
2. Prevention of disease
3. Early diagnosis & treatment
4. Rehabilitation
The ayurvedic system is the very ancient life science which deals with the prevention and cure of the disease with pronature approach. Today is the era of life style disorders and Ayurveda have a unique approach towards these ailments. So the scope of the Ayurvedic hospital in today’s’ scenario is crucial.
The methodology adopted for this draft is based on the CCIM norms, IPHS guidelines and MSR for Ayurvedic hospitals in Gujarat.
3
CLINIC
Sn
Requirement
1
Physical infrastructure
Space–100 sq. ft (Minimum)
2
Human resource
One doctor (Minimum)
One multipurpose worker (Minimum)
3
Equipment
Stethoscope – 1
B.P. apparatus – 1
Torch – 1
Thermometer – 1
Tongue depressor – 1
Weighing machine – 1
X –Ray view box – 1
Hammer – 1
Others as required
4
Furniture requirement
Doctor’s table – 1
Doctor’s chair – 1
Chairs for attendants – 2
Examination table – 1
Patient’s stool – 1
Foot step – 1
5
Others
Display the name of doctor with the degree.
Registration number of the doctor
Fee
Timing of the clinic
Experience of the doctor
4
DISPENSARY
Sn
Requirement
1
Physical infrastructure
Space–100 sq. ft (Minimum)
Dispensing Counter: as per requirement.
2
Human resource
One doctor (Minimum)
One Pharmacist (Minimum)
One multipurpose worker (Minimum)
3
Equipment
Stethoscope – 1
B.P. apparatus – 1
Torch – 1
Thermometer – 1
Tongue depressor – 1
Weighing machine – 1
X –Ray view box – 1
Hammer – 1
Kharala -1
Others as required
4
Furniture requirement
Doctor’s table – 1
Doctor’s chair – 1
Chairs for attendants – 2
Examination table – 1
Patient’s stool – 1
Foot step – 1
5
Others –
Display the name of doctor with the degree.
Registration number of the doctor
Fee
Timing of the clinic
Experience of the doctor
Dispensing counter with signage
Name of the pharmacist with degree and experience
5
THERAPY CENTER
Sn
Requirement
1
Physical infrastructure
Space–150 sq. ft (Minimum) Therapy Room
2
Human resource
One doctor (Minimum)
One Pharmacist cum Panchakarma Therapist (Minimum)
One multipurpose worker (Minimum)
3
Equipment
Stethoscope – 1
B.P. apparatus – 1
Torch – 1
Thermometer – 1
Tongue depressor – 1
Weighing machine – 1
X –Ray view box – 1
Hammer – 1
Kharala -1
Others as required
4
Furniture requirement
Doctor’s table – 1
Doctor’s chair – 1
Chairs for attendants – 2
Examination table – 1
Patient’s stool – 1
Foot step – 1
Panchakarma droni and others as per requirement
5
Others –
Display the name of doctor with the degree.
Registration number of the doctor
Fee
Timing of the clinic
Experience of the doctor
Display of the therapy performed in the center
Fee structure for various procedures on daily as well as package system.
6
Sn Requirement
1 Physical infrastructure
2 Human resource
3 Equipment for OPD:
Equipment for IPD:
4 Furniture requirement
5 Others –
Space–
OPD: 100 sq. ft
IPD: 500 sq. ft.
Doctor – 1
Pharmacist/nurse – 1
Attendant – 1
Multipurpose worker – 1
Stethoscope – 1
B.P. apparatus – 1
Torch – 1
Thermometer – 1
Tongue depressor – 1
Weighing machine – 1
X –Ray view box – 1
Hammer – 1
Others as required
Stethoscope – 1
B.P. apparatus – 1
Torch – 1
Thermometer – 1
Tongue depressor – 1
Weighing machine – 1
Enema pot– 1
Tray – 1
Others as required
Iron beds – 10
Beside lockers – 10
Stretcher – 1
Display the name of doctor with the degree. Registration number of the doctor
Fee (both OPD & IPD – daily IPD charges)
Timing of the clinic
Experience of the doctor
Facilities provided
Signage in IPD
Separate toilets and bathrooms for male & females.
HOSPITAL WITH MINIMUM OF 10 BEDS
7
Sn Requirement
1 Physical infrastructure
2 Human resource
3 Equipment for OPD:
Equipment for IPD:
4 Furniture requirement
Space–
OPD:250 sq. ft
IPD: 1250 sq. ft.
Doctor – 2
Pharmacist – 1
Nurses- 2
Attendant – 1
Multipurpose worker – 1
Stethoscope – 2
B.P. apparatus – 2
Torch – 2
Thermometer – 4
Tongue depressor – 5
Weighing machine – 2
Stethoscope – 3
B.P. apparatus – 3
Torch – 5
Thermometer – 8
Tongue depressor – 4
Weighing machine – 1
Enema pot– 4
Tray – 2
Others as required
Iron beds – as per number of beds Beside lockers – as per number of beds Stretcher – 1
HOSPITAL with 11 – 25 BEDS
5 Others – Display the name of doctor with the degree. Registration number of the doctor
Fee (both OPD & IPD – daily IPD charges) Timing of the clinic
Experience of the doctor
Facilities provided
Signage in IPD
Separate toilets and bathrooms for male & females.
8
Sn Requirement
1 Physical infrastructure
2 Human resource
3 Equipment for OPD:
Equipment for IPD:
Space–
OPD:500 sq. ft
IPD: 2500 sq. ft.
Doctor: 3-4
Pharmacist: 1-2
Nurse: 3
Attendant: 2-3
Multipurpose worker: 2
Stethoscope – One per OPD
B.P. apparatus – One per OPD
Torch – One per OPD
Thermometer – One per OPD
Tongue depressor – One per OPD
Weighing machine – One per OPD
Stethoscope – 3
B.P. apparatus – 3
Torch – 5
Thermometer – 8
Tongue depressor – 4
Weighing machine – 1
Enema pot – 4
Tray – 2
Equipments used for the panchakarma therapy (as per requirement based on the requirements of 100 bedded hospitals) – optional
HOSPITAL with 26 – 50 BEDS
4 Furniture requirement Iron beds – as per number of beds Beside lockers – as per number of beds
Stretcher – 1
5 Others – Display the name of doctor with the degree.
Registration number of the doctor
Fee (both OPD & IPD – daily IPD charges)
Timing of the clinic
Experience of the doctor
Facilities provided
Signage in IPD
Separate toilets and bathrooms for male & females.
9
HOSPITAL with 51 – 100 BEDS
Sn Requirement
1 Physical infrastructure
2 Human resource
Space–
OPD:1000 sq. ft
IPD: 5000 sq. ft.
Doctor – 4 – 5
Pharmacist – 4
Nurses – 5
Attendant – 5
Multipurpose worker – 3
Technical staff – optional (as per need of the hospital)
3 Equipment for OPD: Stethoscope – One per OPD B.P. apparatus – One per OPD
Equipment for IPD:
Torch – One per OPD
Thermometer – One per OPD
Tongue depressor – One per OPD
Weighing machine – One per OPD
Stethoscope – 3
B.P. apparatus – 3
Torch – 5
Thermometer – 8
Tongue depressor – 4
Weighing machine – 1
Enema pot – 4
Tray – 2
Equipments used for the panchakarma therapy (as per requirement based on the requirements of 100 bedded hospital)
4 Furniture requirement Iron beds – as per number of beds Beside lockers – as per number of beds
Stretcher – 1
Furniture for panchkarma – as per need (based on the requirement of 100 bedded hospitals)
5 Others – Display the name of doctor with the degree. Registration number of the doctor
Fee (both OPD & IPD – daily IPD charges) Timing of the clinic
Experience of the doctor
Facilities provided
Signage in IPD
Separate toilets and bathrooms for male & females.
10
HOSPITALS HAVING MORE THAN 100 BEDS
Sn Requirement
1 Physical infrastructure
2 Human resource
Space–
OPD:2500 sq. ft
IPD: 7500 sq. ft.
Doctor – 5 – 10
Pharmacist – 5
Nurses – 5
Attendant – 5
Panchkarma technician – as per requirement Multipurpose worker – 4
3 Equipment for OPD: Stethoscope – One per OPD B.P. apparatus – One per OPD
Equipment for IPD:
Torch – One per OPD
Thermometer – One per OPD
Tongue depressor – One per OPD
Weighing machine – One per OPD Stethoscope – 3
B.P. apparatus – 3
Torch – 5
Thermometer – 8
Tongue depressor – 4
Weighing machine – 1
Enema pot – 4
Tray – 2
Other equipment (List attached in annexure)
4 Furniture requirement Iron beds – as per number of beds Beside lockers – as per number of beds
5 Others –
Stretcher – 1
Others – list attached in annexure
Display the name of doctor with the degree. Registration number of the doctor
Fee (both OPD & IPD – daily IPD charges)
Timing of the clinic
Experience of the doctor
Facilities provided
Signage in IPD
Separate toilets and bathrooms for male & females.
11
TEACHING HOSPITALS
All the teaching Hospitals must fulfill all the minimum standards as per the gazette notification of Central Council of Indian Medicine (CCIM) regd. no. D.L. 33004/99 no. 115 dated 22.04.2013 New Delhi.
12
General specifications for OPD –
The basic infrastructure for an outpatient department for an Ayurvedic Hospital must have following sections –
1. Reception and waiting hall
2. Registration counter
3. OPD medical record room
4. Clinic / consultation room
5. Dressing room (mandatory for hospitals having more than 50 beds)
6. Procedure room (mandatory for hospitals having more than 50 beds)
7. Minor OT (optional but mandatory for hospitals having more than 100 beds)
8. Dispensary (mandatory for hospitals having more than 50 beds)
Other facilities which are required in the OPD are listed below –
1. Proper provision for drinking water and electricity
2. Toilet facilities for patients
3. OPD cafeteria (Optional)
1. Reception & waiting area –
The space requirement for the reception & waiting area depends upon the hospital size. It is small for clinic with proper sitting arrangement of patients and attendants. It must be 50 sq. ft. for every 10 beds.
For hospitals having more than 50 beds it must be situated at prominent place of entrance, good communicable. There must be a guide map for various OPD units along with the service unit display.
Waiting area-
Situated at main entrance at reception.
Subsidiary waiting area for the patients at each clinic, diagnostic & therapy rooms for hospitals having more than 5 OPDs.
Waiting area should have tiled floor with comfortable benches and chairs. Waiting area can be used for health education.
13
Adequate toilet facilities as per the load of the patients. One urinal per 50 persons. Public telephone.
Provision for wheelchairs & trollies.
It must have good drinking water facility & must be well illuminated.
2, 3.Registration counter & record room –
For clinic it must be a small but for the large hospital it may have following requirement –
It is situated at one end of waiting area.
There must be clear distinction between registration counter & medical record room.
The medical record room requires minimum 100 sq. ft. space for medical records for the OPD for hospitals with more than 50 beds where records of both OPD & IPD can be maintained.
4. Consultation & Examination rooms –
Doctor chamber should have at least 10×10 sq ft chamber size with one chair, table for the doctor along with two chairs for the attendant of the patient and one stool for the patient. There should be an examination table of 6×3 ft. dimension. The teaching hospital can develop the consultation rooms in three small block: one for the PG scholar, one examination block and one consultation chamber.
5. Dressing room – A minimum of 100 sq. ft. space is required for dressings in the hospital having more than 50 beds, however it is optional for the hospitals below 50 beds and clinic.
6. Procedure Room – This is required in the hospitals having more than 100 bed strength where agnikarma, kshara karma like procedures can be performed for the OPD patients. However this requirement is applicable for those hospitals that entertain such OPD patients in good numbers. The area depends upon the numbers of procedures.
7. Minor OT – A minor OT is needed for the hospitals with more than 50 beds and 400 – 500 outpatients where many minor OPD surgical procedures as well as Kshara sutra
14
applications can be performed. The minimum area required for the minor OT is 100 sq.ft.
8. Others – The hospitals having more than 100 beds and having the outpatient number more than 500 can also develop specialty clinics such as Diabetic clinic, Skin clinic, Rasayana & Vajikarana clinic along with special therapy rooms for raktamokshana as per the space availability in the OPD blocks.
9. Proper signage – There must be proper signage in OPD which provides the following information to the visitors –
OPD timings
Various OPD clinics with the room numbers and services provided
Directions of various OPD units
Complaints and grievances
Fee
Toilets
Cafeteria
Facilities provided by hospital
No smoking zone
General specifications for IPD –
Classification of ward accommodation – Primary –
Bed accommodation
Nursing station
Treatment room
Secondary –
Doctor’s room
Nurses’ room
Clean utility
Sanitary –
Toilet block
15
Dirty utility
House keeper Ancillary –
Kitchen (required for hospitals having more than 50 beds)
Day room
Stretcher trolley
Area per bed must be 50 sq. ft. per bed with the minimum distance between two beds is 3.5 ft. and the minimum distance between two rows of bed must be 5 ft. one nursing station in between two wards with minimum of 100 sq. ft dimensions with one nurse for every 10 beds.
As a general guideline, in the case of Ayurveda specialty hospitals the facilities available should be commensurate and appropriate with the nature of services provided.
The services provided at the hospital shall be consistent with the principles of classical Ayurveda. In particular, diet lifestyle and basic treatment of diseases. Options offered to the patients shall be consistent with that expected from an Ayurvedic medical care facility. Circulation area at least 200 sq. ft. per 25 beds. The doctors’ duty room must have minimum of 100 sq. ft dimension.
Operation Theatre – mandatory for the hospitals having more than 100 beds, however it is optional for the hospitals with less than 100 beds.
Area – 2700 sq. ft.
Functional distribution –
1. Major OT with attached toilet & bathroom
2. Minor OT
3. Scrub room
4. Sterilization store
5. Equipment store
6. Recovery room
Labour room – 300 sq. ft for 100 bedded hospital with duty room. It is optional for hospitals with below 100 bed strength.
Neonatal care room – 150 sq. ft for 100 bedded hospital (Optional).
Panchakarma unit –
Area – 2000 sq. ft for hospitals having 100 beds and more. However the hospitals
16
having 51 – 100 beds the space requirement is appx. 1000 Sq. ft. and hospitals having less than 50 beds space requirement is appx. 500 Sq. ft. The hospitals having 25 beds or 10 beds can have the space as per the requirement however it is optional for hospitals up to 25 beds.
Specifications is listed below (Hospitals more than 100 beds) –
1. Snehana room male
2. Snehana room female
3. Swedana room male
4. Swedana room female
5. Shirodhara room male
6. Shirodhara room female
7. Vamana room male
8. Vamana room female
9. Virechana room male
10. Virechana room female
11. Basti room male
12. Basti room female
13. Panchakarma therapist room
14. Store room
Auxiliary Functions –
Central laboratory –
Central lab must be located at a place that is easily accessible for all and ideally in between OPD & IPD.
It may have the facility of clinical pathology, microbiology, biochemistry and histopathology.
There must be separate sections for collection, media preparations, sterilization & storage.
There must be provision of waiting area, toilet facilities and result distribution counter.
The area required for the central lab must be 1200 sq. ft. for the hospitals having more than 100 beds while for the hospitals having more than 50 beds, the minimum area is 150 sq.ft. For hospitals below 50 beds it is optional. They can tie up with laboratories.
17
Radiology –
The minimum area required for the X-ray unit is 150 sq.mt. for hospitals having more than 100 beds. It is optional for the hospitals below 100 beds.
The space can be functionally divided into radiographer room, X-ray room, dark room, drying room, waiting area and report distribution area. An X-ray record room is required in the teaching & training hospitals.
Support services
The hospitals having good outdoor and indoor setup for the management of various ailments of the society cannot perform to the expectation of the society if its supportive services & supply are not up to the mark. So it is a necessity for a good hospital or the small clinic setup that they must have excellent support services. The support services comprise following details –
Dietary services
Water supply
Electricity
Toilet facilities
Laundry service
Housekeeping & sanitation
Medicine preparation area
Ambulance services
Circulation
Medical records
Waste management
Dietary services or kitchen –
Kitchen is necessary for the hospitals having more than 50 beds as it is mandatory to provide food the patients admitted in the hospital. Ideally, kitchen should be situated on the ground floor but if it is situated on the first floor, then the ground floor beneath should be used as kitchen.
The area of the kitchen should be 250 ft. for 50 bedded hospitals and 500 sq. ft for the hospitals having 100 or more than 100 beds.
18
Water supply –
Water supply is essential component of the any hospital. Water closet in IPD is minimum one per 12 beds.
Electricity –
Electricity should be at least 3 hours backup or generator for critical areas. Hospitals having more than 100 beds must have their power substation. The minimum area for power substation is 80 sq. mt.
Toilet facilities – Separate toilets and bathrooms for both male & female patients as per the bed strength of the hospital.
Laundry services – The term linen and laundry services includes the laundering of linen, storage of clean linen and repair and replacement of all linen. The service therefore, has two components –
1. The laundry component responsible for efficient laundry operations.
2. The linen management component comprising procurement, classification,
holding, distribution, repair and replacement of linen.
The linen used in the hospital can be classified into general purpose linen, patient body linen, bed linen and OT, labour and procedure room linen.
Linen requirement- bed sheet: 3 per bed, pillow cover: 3 per bed, blanket: 1 per bed with 20% extra.
Housekeeping & sanitation – maintenance of wards, cleaning of ward areas are functions of housekeeping staff of hospital. In places where sewage disposal system is available, the hospital sewage is directly disposed of into such as central system. Medicine preparation area – A room with minimum 100 sq. ft is required (optional for the hospitals below 50 beds & necessary for the hospitals more than 50 beds). Ambulance service – The hospital with more than 100 beds must have one ambulance.
Circulation route –
The circulation route is of two types: internal & external circulation. The internal circulation comprises stairs, ramps, steps and corridors. Corridors must be more than 8 ft. in width in any hospital with IPD.
19
Parking –
One parking per 5 beds is desirable for the hospital. The area of the parking depends upon the load of the outpatient & inpatient number. There must be separate parking area for the employees and staff.
Security –
Security of the hospital premises is essential. There must be security personnel deputed in the hospital. The hospital can hire a security service agency which is responsible for the security of the hospital infrastructure as well as the patient’s assets. The monitoring of the visiting hours of the hospital and the public influx is also the responsibility of the security agency. The total number of security deployed in the hospital depends upon the size of the hospital.
Waste management –
Incidences of inappropriate hospital waste disposal and the fear of HIV & other infections have drawn medical attention to hospital waste management practices. Any good waste disposal system should be planned for –
1. Good appearance
2. Safety
3. Pest control
4. Odour control
5. Public health safety
In general classifications of the waste from the final disposal point of view are –
Type 0 waste (Trash) – such as paper, cardboard cartons, wooden boxes etc.
Type 1 waste (Rubbish) – such as wood scrap, paper and floor sweeping.
Type 3 waste (Refuse )
Type 4 waste (garbage)
Type 5 waste (pathological)
Biomedical waste –
Biomedical waste must be segregated, disposed and transported through color coded plastic containers and sent to the nearest biomedical waste treatment facility.
20
Legal & statutory requirements – List of statutory compliance –
Authorization under Biomedical Waste Rules 2016 for management and handling of biomedical waste.
No objection certificate from competent fire authority.
Vehicle registration certificate for ambulance.
Right to Information Act.
Consumer Protection Act
Clinical Establishments Act 2010. Legal aspects –
Societies Registration Act 1860
Consumer Protection Act
Drug & Cosmetic Act
Patients’ Bill of Right
Medical negligence
Drug handling
Hospital infection
Anesthesia – given with proper & valid consent.
Invasion of privacy
Handling of medical records
Records maintenance & reporting –
Medical records –
The medical record of the hospital has the following documents –
1. A clinical document
2. A scientific document
3. A administrative document
4. A legal document
The characteristics of good medical must be complete, adequate and accurate. Medical record must be properly organized & all the documents are placed safely. Each record should be identified by indexing the record as alphabetical, numerical, serial unit and terminal digit. The record must be placed in the file which is placed in a cabinet. There
21
must be segregation of the cabinet for the medico legal record, admission record, birth & death records etc.
Retention of records is necessary for the need of the patient up to 7 years, for medico legal record up to 10 years or till the disposal of ongoing cases in any of the courts related to these records.
Computerization of the medical record – very useful for the following:
a. Location monitoring
b. Automatic assignment
c. Improved procedures for generating the admission, discharge, birth, death and
other records.
Reports – (mandatory for the hospitals having more than 100 beds & teaching hospitals)
Average daily census ward wise, specialty wise
Average length of stay
Bed occupancy rate
Bed turnover rate
Outpatient clinics – number of new cases, number of repeat cases, specialty wise break up, Unit wise break up of cases
Left against medical advice (LAMA) rate
Number of X-Ray done – OPD, IPD
Number of laboratory investigations
Number of surgical operations
Number of panchakarma done – break up of various procedures for OPD & IPD
Number of deliveries done along with other gynecological procedures.
Numbers of para surgical procedures done in the breakup of agnikarma,
jalaukavcharana etc.
Hospital Infection control measures –
1. Aseptic techniques
2. Segregation of contaminated instruments
3. Disinfection practices
4. Sterilization practices
22
5. Isolation facilities
6. Precautions for staff
7. Hygienic dietary practices
8. Aseptic & standard panchakarma procedures.
9. Aseptic leech therapy
Material management –
Operative goals of material management are –
1. Optimum material acquisition
2. Optimum inventory turnover
3. Good vendor relationship
4. Material cost control
5. Effective issue & distribution
6. Elimination of losses & pilferage.
The material management functions cater to planning for material, its demand, estimation, procurement, stocking and issue to ensure the availability of right material, right quantity, at right time, at right price, from right source and in least cost.
The purchasing procedure involves value analysis, rate contracts. Purchase order with supplier’s name, quotation, description of material, price with total value. The store must ensure the received item verified as per order with the proper receipts. The central store of the hospital should have good atmospheric condition & good lighting. It must be well organized making effective use of the space with adjustable, fixed location racking system. There must be allocation of space of various varieties of items stored. Store record should be maintained in the stock register with issue register and disposal register.
Engineering services – Area of the engineering services are –
Electricity supply to the hospital.
Water supply
Repair
Maintenance
Expansion
23
Others –
Ayurvedic specialty hospital, hospital attached with medical education or apex hospitals of Ayurveda can extend their services to the population by developing specialty clinics like Diabetic, cardiovascular, dermatology, respiratory, geriatric, neuromuscular etc. They can also develop separate panchakarma unit for balroga. In indoor, they can develop deluxe and private ward as per the influx of patients.
Human Resource
Essential OPD Staff for 100 bedded hospital –
1. Physicians: All teachers of clinical and other subjects.
2. Casualty Medical Officer: 3 (where Atyayik department exists)
3. Vaidyas: OPD-in-charge:2
4. Kalpak/Pharmacist: 4 (upto 100 patients daily), one for every additional 50 patients. 5. Nurse: 2
6. Dresser: 2
7. OPDAttendant: 3(in addition to Departmental attendants)
8. Clerk (Registration&Record):2
9. Sweeper: 2 or on contract basis
IPD staff for 100 bedded hospitals –
The minimum staff required in a 100-bed non-teaching hospital, liable to be increased proportionately in accordance with bed strength, shall be as given below.
1.
2.
3. hospital
4. Resident Medical Officer
5. Nursing staff, Panchakarma technicians as per General Structural standards.
6. Consultant Dietician (Ayurvedic)
7. Canteen staff- Cook and minimum 1 helper for every 50 patients &
bystanders served
Medical Superintendent
Dy. Medical Superintendent
Consultant Physicians- depending on scope of services offered by the
24
8. All other staff- commensurate in number and availability, for scope of services offered by hospital, and to fulfill the quality of service standards stated in the quality management system of the hospital.
Details specifications of staff for 100 bedded hospital is as given below –
Sn
Post
Requirement
1.
Medical Superintendent
Principal or Dean as ex-officio.
2.
Deputy Medical Superintendent
Full time regular incumbent with postgraduate qualification in a clinical specialty.
3.
Consultants
Teachers of clinical departments including Swasthavritta and Yoga Department.
4.
Casualty Medical Officers
4 (2 Ayurveda and 2 Allopathic on contract)
5.
House Officers or Clinical Registrars/Senior Residents (Ayurveda)
2 for Kayachikitsa department and 1 each for all other clinical departments.
6.
Resident Medical Officers/Surgical
Officers (RMO/RSO)
1 RMO and I RSO for 100-bedded hospital and both 1 extra each for every
50 additional beds.
7.
Matron / Nursing Superintendent
1
8
Assistant Matron
1 for 100 beds and
1 extra each for every 50 additional beds.
9.
Staff Nurses for IPD
1 for every 10 beds.
10.
Nurses for OPD
2 for OPD attendance up to 150 patients and 1 extra each for additional 100
11.
Mid Wife/Ward Boy/Ayah
patients.
1 for every 10 beds – (10).
12.
Pharmacists
4 (2 for OPD and 2 for IPD of 100 beds) and 6 above 100 beds (for OPD and IPD both).
13.
Dresser
2
14.
OPD attendants
3 plus teaching departmental attendants will also work in the hospital.
15.
Store Keeper
1
16.
Office Staff (f o r registration, record maintenance, data entry
3
17.
etc.)
Dark-Room Attendant
1
18.
Operation Theater Attendant
2
19.
Labour Room Attendant
2
20.
Telephone Operator cum Receptionist
4 (8 hrs. duty)
\
25
Modern Medical Staff (on contract)
1
Medical Specialist
1
2
Surgical Specialist
1
3
Obstetrician & Gynecologist
1
4
Dentist
1
5
Refractionist
1
6
Audiometrist
1
7
Radiologist
1 (Postgraduate in Allopathic Radiology or
Vikiran Vigyan of Ayurveda
discipline)
from teaching department of Shalya.
8
X-Ray Technician/Radiographer
1
9
Medical Specialist
1
10
Surgical Specialist
1
Panchakarma Specialists
Panchakarma Specialists
Teachers of Panchakarma teaching department.
House Officer /
Clinical Registrar/
Senior Resident (Ayurveda)
1
Panchakarma Technician
4 (2 Male + 2 Female)
Panchakarma Assistant
2 male and 2 female
Yoga teacher/expert
1 (from Swasthavritta & Yoga Department)
Sweepers
2
Staff of Operation Theatre and Ksharasutra Therapy
Shalya and Ksharsutra Therapy Specialists
Teachers of Shalya department
House Officer/ Clinical Registrar/Senior Resident (Ayurveda)
1
Operation Theatre Attendant
2
Dresser
1
Nurses
2; these will be in addition to the nurses indicated at sl.no. 9.
Sweeper
1
Shalya and Ksharsutra Therapy Specialists
Teachers of Shalya department
26
Labour room
Prasooti evum Stri Roga Specialists
Teachers of Prasooti evum Stri roga department
Lady House Officer or Clinical Registrar/Senior Resident (Ayurveda)
1
Nurses
2; these will be in addition to the nurses indicated at sl.no. 9.
Midwife
2
Attendant
1
Sweeper
1
Pathologist/Microbiologist for Hospital & College
1
Bio-chemist for Hospital & teaching work
1
Laboratory Technicians
2
Laboratory Assistants
2
Clerk/Typist/Computer Data Entry Operator
1
Sweeper
1
Peon/Attendant
1
Machine Man
1
Workers
2
Analytical Chemist
1 (For teaching as well as Q.C.)
Pharmacognosist
1 (For teaching as well as Q.C.)
27
Bibliography
1. Anand RC, Satpathy – Hospital waste management: a holistic approach 2nd edition 2000.
2. Francis CM, D Souza C Mario – Hospital administration 3rd edition 2000.
3. Gill R – Hospital and law, Hospital administration 21 (1 and 2). 1984
4. Gupta Shakti Kumar, Kant Sunil, Chandrashekhar R, Satpathy Sidhartha – Modern
trends in planning and designing of hospitals principles and practice. 1st edition
2007.
5. Indian Public Health Standards (IPHS) Directorate General of Health Services
Ministry of Health & Family Welfare, Government of India. Revised Edition 2012.
6. Sarkar BM – Principle of hospital administration and planning Jaypee brothers
medical publication (P) ltd 2nd edition 2009.
7. http://www.ayurvedauniversity.edu.in
9. http://www.clinicalestablishments.gov.in
10. http://www.gujarathealth.gov.in
11. http://www.indianmedicine.nic.in
28
ANNEXURE I
Instruments for the IPD of 100 bedded hospital
Sn. Name of Article No.
1. Iron beds simple 64
2 Iron beds(Surgical) 20
3 Iron beds(children) with sides closed 6
4 Iron bed with cradle 10
5 Fowler’s bed 10
6 Bedside lockers 100
7 Bed head tickets holders 100
8 Temperature chart holders 100
9 Spittoon with stands 50
10 Office table
11 Office chair
12 Racks
13 Linen Box
14 Dirty linen boxes
15 Stretcher
6
20
8
As per requirement As per requirement 6
16 Trolley
17 IV stands
18 Screens(folded)
19 IV Sets with boxes
20 Blood Transfusion
21 Rectangular Trays
22 Enamel Bowels
23 BP Instrument
24 Bed Pan EI
25 Urine Pots, Male &
26 Ice Bags
27 Hot Water Bags
28 Air Cushion
29 Ryles Tube
30 Stomach Tube
31 Bucket EI
32 Tongue Depressor
33 Suction Machine
34 Suction tube
35 Artery Forceps, Small and Big 20
sets
with cover lid 10
Female 40(20+20) 5
6
10
10
As per requirement As per requirement
10 10 20
10
5
10
5
20
10
6
10
29
36 Back rest 10
37 Oxygen Cylinder with stand 10
38 Thermometers 10
39 Syringes (2cc 4cc) 10
40 Dressing Drums (Big) 10
41 Stools, either wooden or steel 100
42 Tracheotomy Set 5
43 Enema Pot with Nozzle and Tube 20
44 AutoScope 4
45 FundoScope 2
46 RetinoScope 2
47 LaryngoScope 2
48 Endotracheal Tubes different sizes 6
49 Feeding cup 10
50 Enema Syringes 20
51 Infra-red lamp 2
52 Torches 10
53 Scissors 10
54 Sputum Mugs 10
55 Measuring Glasses 10
56 Steel Almirah 6
57 Chair Trolley with Wheels 2
58 Refrigerator 1
59 Trolley different sizes 10
60 Wastage Trolley 3
61 Thermos Type of Kettle for Tea/Milk (50 Cup size) 02
62 Thermos Type of Kettle for Kwath (different sizes) 02
63 Examination table 8
64 ECG Machine 3
65 Nebulizer 3
66 Wheel Chair 4
67 Hot plate 2
68 Glucometer 4
69 Weighing machine 4
30
ANNEXURE II
PATHOLOGY LABORATORY (CENTRAL) S.No. Name
1. Beakers Different sizes
2. Micro Pipettes Different sizes
3. Spirit Lamps
4. Capillary Tubes
5. Test Tubes(Medium)
6. Test Tube (small)
7. Blood Grouping Tiles
8. Centrifuge Machine
9. Incubator
10. Oven
11. Microscope (Binocular)
12. Refrigerator
13. F.S.R.Westergren’s Racks
14. F.S.R.Wintrobe’s Racks
15. Metal Racks (small tube)
16. Small Tube Racks Plastic
17. Hemoglobin Meter
18. Neubar’s Chamber
19. Micro tone No.1
20. Micro tone o.4
21. Stop Watch
22. Tourniquet Belts
23. Centrifuge Tubes(Plastic)
24. Water Bath
25. Auto Analyzer
26. Rotary Machine Timer Remi Equipments
27. Computer
28. ELISA Test Machine
29. F.S.R. Machine (auto) Micro Sed
30. Fridge
No.
10 10
4
1 Box 100 150 2
1
1
1
2
1
2
4
4
4
4
4
1
1
2
6
24
1
1
1
1
1
1
1
31
ANNEXURE III
X RAY DEPARTMENT
1.X-Ray 300 Ma
2.Cassettes
3.X-Ray films (Different Sizes) 4.Film Dryer
5.View Box
6.Hanger
7.Dark Room
8.Fixures/ Developer Etc. 9.Lead Apron
10.Cylindride Core
1
6
As Per Requirements
1
2
18
2
2
32
ANNEXURE IV PANCHKARMA
Poorva Karma
I. Snehana Karma Essential Items
1.Separate Unit is proposed for male & female
2.Complete bedding/cot one for male, one for female Rooms (One)
Equipments/Instruments
1. Measuring glasses
i)200ml. 2
ii)100 ml. 2
iii)50 ml. 2
2. Simple steel glasses 6
3. Gas/Stove/heater with fittings 1
4. Lighter/Matchbox 1
5. Abhyanga (Massage)Table/Droni 2
6. Steel bowls
i)50 ml. 6
ii)100 ml. 6
7. Towels, Dusters 12
8. Plastic aprons 4
9. For Shirodhara
(i)Shirodharayantra 2
(ii)Stand 2
(iii)Dharapatra 2
10. For Shirobasti
i) Plastic Caps/Leather caps
ii) Large 2
ii) Medium 2
iv)Small 2
11. Holder (Chimata/Pakkad) 2
12. Big spoons, Tea spoons 4
13. Steel Pots (Patila)
i)2 litre 2
ii)1 litre 2
33
Materials
1. Til Oil
2. Dashmoola Oil
3. Different Medicated Oils
4. Masjapishta (Blackgram Flour)
5. Bandage
6. Cotton
7. Gauge Piece
Pradhana Karma
I. VAMANA KARMA
Essential It
1. Rooms/Chamber(2) Preferably with attached toilets
2. Instruments/Equipments
1. Measuring glasses
i) ii) iii) iv)
2. Buckets/Plastic tubs/Basin(with provision of measuring scale) 2
3. Towels/Napkins 6
4. Plastic Aprons 6
5. Kharala/Mostar 2
6. Gas/Stove 1
7. Big steel patela 5 litre 2
8. Steel jug/Plastic jug 2
9. Steel glasses 4
10. Bowls-100 ml. 4
11. Table spoons 4
12. Vamanpeetha (Adjustable chair) 2
13. Cots with complete beddings 2
14. Dhumapana Yantra 2
15. Spittoons 2
16. Rubber Catheters 4
1 litre 2
200 ml. 2
100 ml. 2
50 ml. 2
34
Materials
i) Vamaka dravya
ii) Vamanapaga dravya
iii) Emergencydrugs
VIRECHANA KARMA BASTI
Essential items
1 Rooms (2) fitted with toilet and bathroom (common) 2. Equipments/Instruments
i) Basti Yantra (4) Enemapot
ii) Niruhabasti Yantra (4)
iii) Anuvasanabasti Yantra 4
iv) Uttarabasti Yantras (Douche cane fitted with rubber tube and nozzle of various sizes)
v) Urinary catheters (Rubber and metallic) Different Nos. For Females
i) Sim’s speculum
ii) Cusco’s Speculum
iii) Anterior Vaginal wall retractor iv)Vulsellum
3. Uterine sound
4. Bladder sound (Urethral dilators) of different sizes
5. Kharal
6. Basti Netra (Metalic)
7. Bowls
8. Rubber Sheets
9. Focus lamp/Torch
10. Gynaecological Table with attachment for Lithotomic position
11. Easy chairs
12. Cotton
13. Gauze pieces
14. Sponge holding Forceps
15. Cots with complete beddings
16. Revolving stools
17. Bedpans
18. Towels/Napkins-one towel/bed for female & central hole
19. Measurig glass 1 litre
20. Teaspoon, Tablespoon
21. Plastic aprons
2
2
2
2
4
4
2
4
4
6
2
2
2
2
2 (Common)
2 4
4 6 6
35
22. Buckets 2
23. Glycerine Syringe 4
24. Glass/Plastic syringes
i) 100 ml. 4 ii) 50 ml. 4 iii)20 ml. 4
Material
i) Bastidravya for various types of basti, Gudavarti
ii) Medicines for management of Vyapada
NASYA Essential Items
1. Rooms
2. Equipments/Instruments
2(Common)
i. Nasyapeetha (Chairs)
3
ii. Adjustable Tables
2
iii. Droper/Droper bottles
12
iv. Cotton
v. Gauze
vi. Pradhamana Nasya Yantra
2
vii .Dhuma Yantra
2
viii. Kharal
2
ix. Steel glasses
4
x. Bowls
100 ml.
4
50 ml.
4
xi. Steamer (Facial Steam)
3. Material
i. Different types of Nasyadravya, Medicines for complications, Gandusha Dravyas and Dhumpana dravyas
36
ANNEXURE V
Records To Be Maintained By Clinical Establishments
The various medical records to be maintained by clinical establishment:
1. Outpatient Register
2. Inpatient Register
3. Operation Theater register
4. Labor room register
5. MTP registers (if registered under the MTP Act)
6. Case sheets
7. Medico legal register
8. Laboratory Register
9. Radiology and imaging register
10. Discharge summary
11. Medical certificate in duplicate
12. Complaint register
13. Birth register (Notified to such medical officer as authorized
14. Death register by Government in such format as prescribed by Government/
State level authority)
15. Information in terms of government programmes / areas of work (eg maternal
health, child health, immunization, family planning, Vector borne disease, NLEP,
RNTCP, IDSP. NRHM initiatives-ASHA, JSY)
16.Number of beds system-wise and specialty-wise in Clinical Establishments
providing in- patient care (e.g General Med/Surg. Beds; Special Care Beds) 17. Total Discharges
37
ANNEXURE VI Signages
1. Display of all radiation hazard signage in radiation areas (if applicable).
2. Display of Biomedical waste segregation at all location where BMW bins are
kept
3. Display of danger signage at all electric panels and other dangerous areas
4. Display of General instructions like ‘No Smoking’, ‘Keep Silence’, ‘Use
dustbin’, etc. at various patient and visitor areas in the hospital
5. Display of hand–washing techniques compliant with WHO guidelines at all
hand wash basins
6. Display of how to use fire extinguisher at all point where fire extinguisher is
installed
7. Display of important phone contact numbers of hospital authorities
8. Displays required by regulations like PCPNDT, Lifts, Fire, etc.
9. Display of Material Safety Data Sheet at all locations where Hazardous
Materials are stored
10. Display of patient rights and responsibilities in OPD, emergency and wards
11. Display of safety instructions in areas where any kind of safety hazard may
be expected. This includes areas like transformers, Cylinder storage, LPG
storage etc.
12.Emergency exit signage (preferably in auto illumination material, like
radium)
13. Fire Protection
14. Hazards- electrical, fall, pipe locations, prohibited areas
15. Notice board for general information to staff
16. Notice board in front of all OPD and Wards.
17. Notice board in Operation theatre
18. Routes for all areas
19.Signage for parking. (Signage for ambulance parking shall be separately
mentioned)
20. Safety signage will be displays as per the requirements of respective Indian
Standards: Ex. Fire Protection Safety Signs IS 12349:1988
38
ANNEXURE VII
Furniture/Fixture Requirements for In-Patient Department (IPD)
Sr. No.
Name of the Equipment
Min. 10 bedded Hospital
Up to 25 bedded Hospital
26 – 50 bedded hospital
51 – 100 bedded hospitall
>100 bedded hospital
Teaching hospitals
Ad1e.quate wall or steel Cupboards
Optional
1
2
4
8
15
2.
Arm Board Adult
Optional
Optional
6
12
24
24
3.
Back rest
2
4
8
20
4.
Bain Marie trolley stainless steel 1 per floor
1 per floor
5.
Bed side cabinets
1 per 5 patients
6.
Bed side Screen
1 per ward or full length curtains between the beds
7.
Bucket Plastic
2
3
6
12
24
24
8.
Ceiling Fans
As per requirement
9.
Clock 1per ward
1 per ward
10.
Containers for kitchen
As needed
11.
Doctor’s chair for OP & ward,
As needed
12.
Doctor’s or Office table
1
2
3
3
10
20
13.
Dressing trolley-1 per floor/ ward depending on layout
1
1
2
4
8
10
14.
Dust bins in each ward & consultation room
1
2
3
6
12
15
15.
Duty table for nurses
1
2
4
8
20
30
16.
Emergency
1 per floor
39
resuscitation kit
17.
Enema Set
1
2
2
4
4
8
18.
Fire extinguisher
ABC 1 per ward/ floor based on layout
19.
Foot stools
2
4
8
16
25
25
20.
Fridge
1 Per Area/ Ward
21.
Heavy duty Torch light
1 per ward
22.
Hospital Cots
10
As per beds
23.
Hospital Cots Pediatric
Optional
Optional
Optional
5
10
20
24.
Hot Water Bags
2 per ward
25.
Hot Water geyser
1
2
2 per ward
2 per ward
2 per ward
2 per ward
26.
I V Stands – 2 per 10 beds
5
10
25
50
100
100
27.
Infra-Red lamp
Optional
Optional
Optional
3
5
5
28.
Intercom System
2 per ward
2 per ward
2 per ward
2 per ward
2 per ward
2 per ward
29.
Kidney Trays1 per 5 beds
2
4
10
25
25
25
30.
Kitchen utensils
Adequate
31.
Massage table of 7ft. x 2.5ft (wood or fibre)
Optional
One per procedure room
32.
Medicine trolley
1 per ward
33.
Office chairs
1
2
4
8
20
20
34.
Office Table
1
2
3
6
10
10
35.
Patient Beds with side rails
20% of total beds
36.
Patient call Bell System
Optional
Optional
1 per bed
37.
Patient locker
Optional
Optional
1 per bed
38.
Patients examination table– 1 per ward/ floor a per the profile of
– 1 per ward/ floor a per the profile of patients & layout of facility
40
patients & layout of facility
39.
Patients side table
1 per bed
40.
Pediatric cots with railings as per scope of services
as per scope of services
41.
Steel or Wooden cup board
2
4
8
16
20
25
42.
Steel rack
1
2
5
10
20
40
43.
Stool 1Per Bed
2
4
8
8
15
25
44.
Stools revolving – 1 per ward
1
1 per ward
1 per ward
2 per ward
2 per ward
2 per ward
45.
Stretcher/ Patient trolley – 1 per ward
1
1
1 per ward
1 per ward
1 per ward
1 per ward
46.
Urinal Male and Female
2
5
10
20
50
100
47.
Waiting chairs / benches for patients relatives
50% of the bed strength
48.
Weighing Machine
1 per ward
49.
Wheel chair
1
1
2 per 50 beds
50.
Wooden massage bed
One
One per service room
51.
X-ray viewer
one per ward
41
MINIMUM STANDARDS FOR
CLINICAL ESTABLISHMENTS OF
UNANI
42
UNANI STANDARDS FOR
1. Clinics
2. Hospitals with 1 to 50 beds
3. Hospitals with 51 to 100 beds
4. Hospitals with 101 to 200 beds
5. Hospitals with 201 and above beds
43
CONTENTS
SL TITLE PAGE A Introduction
A.1 General A.2 Scope
B. Functions
B.1 Core functions (Clinical services)
B.2 Auxiliary Functions (support services)
C. Physical Facilities
C.1 Space requirement
C.1.1 Minimum area
C.1.2 Functional space
C.1.3 Dimensions of the sub areas C.1.4 Basic signage
C.1.5 Others
C.2 Furniture & Fixtures
C.2.1 Furniture/Fixture Requirements
C.2.2 Sundry Articles
C.2.3 Others
C.3 Engineering Services Requirements
C.3.1 Electrical Requirements
C.3.2 Plumbing Requirements
C.3.3 Civil Requirements
C.3.4 HVAC / AC / Ventilation / Cross Ventilation Requirements C.3.5 Others*
C.4 Public Utilities
C.4.1 Potable drinking water
C.4.2 Sanitary Requirements
D. Equipment /instruments D.1 Therapeutic equipment D.2 Surgical equipment
D.3 Diagnostic equipment D.4 Emergency equipment D.5 Sterilizing Equipment
E. Manpower
E.1 Medical practitioners E.2 Therapists
E.3 Paramedics
E.4 Nurses
E.5 Administrative staff
46
47 47
48
48 50
51
51 51 51 56
57 58 59 59 62
63 63
63 63 65
65 65 65 65 65
66
66 69 71 73 75
74
74 75 76
79 80
44
F. Drugs
80
F.1 Anaesthetic drugs
80
F.2 Emergency drugs
81
F.3 General Drugs
82
G. Consumables
87
G.1 Surgical
87
G.2 Dressing Material
88
G.3 Disinfectants
89
G.4 Tubing
89
G.5 Linen
89
G.6 Stationery
90
G.7 Adhesives and gels
91
G.8 Others*
91
H. Licenses
91
I. Basic Processes
93
I.1 Registration
93
I.2 Assessment
94
I.3 Infection Control
94
I.4 Safety considerations
95
I.5 Clinical Treatment Records
98
45
A. Introduction
As for the present state of Unani Medicine in India, the country has the largest infrastructure of academic, research and healthcare institutions of this system. There are 41 educational institutions of Unani Medicine in the country that are recognized by Central Council of Indian Medicine (CCIM), a statutory body established by Government of India by an Act of Parliament, the Indian Medicine Central Council (IMCC) Act, 1970. The health care services have undergone a steady transformation with the wide coverage of every aspect of human welfare as part of health care- like physical, mental and social wellbeing, a reach out to the community, training of health workers, biosocial researches, etc.
A hospital forms an integral part of a social and medical organization, the function of which is to provide for the complete healthcare in terms of both curative and preventive aspect. The hospital is also a center for the training of health workers and for biosocial research. The health is influenced by the accessibility, affordability, quality, availability and utilization of health services.
Traditionally the aim of healthcare facility is to provide Promotion of health, Prevention of disease, Early diagnosis & treatment and Rehabilitation.
Functions of the hospital –
Intramural functions –
1. Restorative – Diagnostic, Curative, Rehabilitative, Emergency care
2. Preventive
3. Education – Medical UGs & PGs, Paramedical
4. Research
Extramural functions –
1. Outpatient services
2. Outreach services
3. Mobile clinics
4. Medical care camps
The health care in Unani system of Medicine is provided at various levels –
1. Dispensaries (Clinics)
2. Hospitals having bed strength up to 50
3. Hospitals having bed strength up to 100
46
4. Hospitals with bed strength more than 100 up to 200 (Teaching and Training)
5. Hospitals with more than 200 bed strength (Teaching and Training)
A.1 General
The standards thus framed are on account of the minimum requirement of this category of healthcare provider. There are no exclusions. They are dependent on the basic functions of the unit/hospital/provider. All sections mentioned are mandatory and include both structure and basic processes.
A.2 Scope
This includes the services being provided by the facility to which the standards will be applicable (For example common minimum standards framed for a polyclinic are applicable to a polyclinic only and not to a single specialty hospital)
Now a days the role of hospital has changed with the emphasis shifting from –
1. Acute to chronic illness
2. Curative to preventive medicine
3. Restorative to comprehensive medicine
4. In patient care to outpatient & home care
5. Individual orientation to community orientation
6. Isolated functions to area wise or regional function
7. Tertiary & secondary to primary health care
8. Episodic care to total care
Unani system of Medicine is an ancient healthcare system which deals with the prevention and cure of the disease with an ecological approach. Today is the era of life style disorders and Unani system of Medicine has a unique approach towards these ailments. So there is considerable scope of the Unani hospital today. The scopes are –
1. Health Promotion
2. Disease Prevention
3. Diagnosis of disease
4. Cure of the patients
47
Services –
Sn
Services
Clinic
1 – 50 beds
51 – 100 beds
101- 200 beds
201 & above beds
1.
Preventive
Yes
Yes
Yes
Yes
Yes
2.
Diagnostic
No
Yes
Yes
Yes
Yes
3.
Therapeutic
Yes
Yes
Yes
Yes
Yes
4.
Follow up
Yes
Yes
Yes
Yes
Yes
5.
Rehabilitative
No
Yes
Yes
Yes
Yes
6.
Scheduled
Yes
Yes
Yes
Yes
Yes
7.
Unscheduled
No
Yes
Yes
Yes
Yes
B. Functions
This section includes the basic services provided by facilities. It is subdivided into two parts
B.1 Core functions (Clinical services)
(Clinics & Outdoor Patients facilities of health care organizations with bed strength of 1 to 50, 51 to 100, 101 to 200 & 201 and above.
SN
Minimum Clinical Services to be provided
Clinics
1 to 50 beds
51 to 100 beds
101 to 200 beds
201 and above
1
Moalijat
Moalajat
2
Amraz-e-Jild wa Zohrawi
Optional
Amraz-e-Jild wa Zohrawi
3
Jarahat
Optional
Jarahat
4
Ain
Optional
Optional
5
Uzn, Anaf, Halaq- wa-Asnan
Optional
Uzn, Anaf, Halaq-wa- Asnan
6
Tahaffuzi wa samaji Tibb
Optional
Tahaffuzi wa samaji Tibb
7
Ilaj bil Tadbir
Optional
Ilaj bil Tadbir
8
Qabalat wa Amraz-e-Niswan
Optional Only antenata l care and Amraz – e Niswan
Qabalat-wa-Amraz-e-Niswan
9
Amraz-e-Atfal
Optional
Optional
Amraz-e-Atfal
10
Izterari (Casualty)
Optional
48
Ilaj bit Tadbeer
Dry Cupping
optional
optional
Dry Cupping
Dry Cupping
Dry Cupping
Wet Cupping
Optional
Optional
Wet Cupping
Wet Cupping
Wet Cupping
Fasd
Optional
Optional
Fasd
Fasd
Fasd
Dalak
Optional
Optional
Dalak
Dalak
Dalak
Riyazat
Optional
Optional
Riyazat
Riyazat
Riyazat
Natool
Optional
Optional
Natool
Natool
Natool
Pashowya
Optional
Pashowya
Pashowya
Pashowya
Pashowya
Hammam
Optional
Optional
Optional
Optional
Hammam
Taleeq
optional
Taleeq
Taleeq
Taleeq
Taleeq
Indoor patients facilities
The indoor department of the hospital shall have separate male and female wards and distribution of beds at the rate of 65 sq. meter area per bed ward as under –
Indoor patient’s facilities:
The indoor department of the hospital shall have separate male and female wards and distribution of beds at the rate of 65 sq. ft. area per bed ward as under –
SN
Minimum Services to be provided
In 1 to 50 beds
51 to 100 beds
101 to 200 beds
201 and Above
1
Moalijat
Moalijat
2
Amraz-e-Jild wa Zohrawi
Amraz-e-Jild wa Zohrawi
Amraz-e-Jild wa Zohrawi
3
Jarahat
Optional
Jarahat
4
Ain
Optional
Optional
5
Uzn, Anaf, Halaq-wa- Asnan
Optional
Optional
6
Tahaffuziiwa samaji Tibb
optional
Tahaffuziiwasamaji Tibb
8
Qabalat-wa- Amraz-e- Niswan
Qabalat-wa-Amraz-e-Niswan
9
Amraz-e- Atfal
Optional
Amraz-e-Atfal
10
Izterari (Casualty)
Optional
49
Ilaj bit Tadbeer
1.
D1ry Cupping
optional
Dry Cupping
Dry Cupping
Dry Cupping
2.
Wet Cupping
Optional
Wet Cupping
Wet Cupping
Wet Cupping
3.
Fasd
Optional
Fasd
Fasd
Fasd
4.
Dalak
Optional
Dalak
Dalak
Dalak
5.
Riyazat
Optional
Riyazat
Riyazat
Riyazat
6.
Natool
Optional
Natool
Natool
Natool
7.
Pashowya
Pashowya
Pashowya
Pashowya
Pashowya
8.
Hammam
Optional
Optional
Optional
Hammam
9.
Taleeq
Taleeq
Taleeq
Taleeq
Taleeq
B.2 Auxiliary Functions (support services for eg – diagnostics) Tashkheesh Amraz Lab.
(Central Laboratory for clinical diagnosis and investigations).
1. There shall be a central laboratory in the hospital complex with proper infrastructure and manpower for carrying out routine, pathological, biochemical and hematological investigations and Unani diagnostic techniques on the patients referred from outdoor and indoor departments of the hospital.
2. There shall be a central Imaging- X-Ray unit in the hospital complex with proper infrastructure and manpower for carrying out routine, imaging investigations on the patients referred from outdoor and indoor departments of the hospital.
Support Services:
1. Accounting
2. Ambulance services
3. Billing
4. Dietary services/ Canteen
5. Essential commodities like water supply, electric supply etc.
6. Finance
7. Financial accounting and auditing
8. Housekeeping and Sanitation
9. Inventory Management
10. Laundry services
11. Medical records
12. Medicine preparation area
13. Medico legal
14. Office Management (Provision should be made for computerized medical
records with anti-virus facilities whereas alternate records should also be
maintained)
15. Personnel Department
16. Pharmacy/ dispensary
50
17. Purchase
18. Reception,
19. Security services
20. Stores
21. Waste management Housekeeping/ sanitation
C. Physical Facilities C.1 Space requirement
This entails the minimum space required for carrying out the basic functions of the facility which includes:
C.1.1 Minimum area required for establishing the facility,
Type of Health Care Organization
Requirements
If Stand alone building
If part of another building
Clinic
As permitted Development control Floor Space Index, regulations, etc.
under rules, Local
Minimum area should be adequate to accommodate doctors table, consultation chair, two stools/ chairs, examination bed of the size 6 ft X 2.5 ft., privacy screen around examination area while having free mobility.
1to10bed
Local regulations related to building structures, occupancy, etc. will be followed.
11to25
26to50
51 to 100
Teaching Hospitals
C.1.2 Functional space planning of the facility like reception area, waiting area etc 1. Treatmentrooms:
a. Maximum 15 Treatments/Day/Treatment Room.
b. Number of treatments will depend on type & nature of treatments.
2. Consultation & examination room
a. Minimum 10 ft. x 10 ft.
51
b. Consultation room should be adequate to accommodate:
i. Doctors table,
ii. Consultation chair,
iii. Two stools/ chairs,
iv. Examination bed of the size 6 ft X 2.5 ft.,
v. Privacy screen around examination area while having free mobility
3. Pharmacy/Dispensary specs:
a. The pharmacy should be located in an area conveniently accessible
b. Temperature & humidity to be maintained as per the requirement of the stored medications.
c. The size should be adequate to contain 5 percent of the total clinical visits to the OPD in one session for hospitals more than 50 beds.
d. Pharmacy should have adequate medicine storage and dispensing facility for indoor and outdoor patients.
4. Entrance hall with reception area, enquiry counter, cash counter and record area
a. Preferably 100 sq. ft per 25 beds
5. Waiting area in entire organization
a. Preferably 100 sq. ft per 25 beds i.e. 10% seats of average number of patients visiting daily to hospital
6. Kitchen area: Applicable only if food is cooked in the hospital. Providing food is mandatory for hospitals of size over 100 beds.
a. Kitchen area should be sufficient size to prepare food for inpatients as per diet schedule advised by the physician
b. Kitchen layout and functioning should follow the flow of materials as: Entry-> washed->cutting-> cooking->loadingTo Serve
c. Utensil washing area is separate from the cooking area.
7. Medicine preparation area: Mandatory for hospitals of size over 50 beds.
a. Preparation area should be of minimum 50 sq. ft: only if medications are prepared in the hospital.
8. Medical Stores specs:
a. The medical store may be part of pharmacy or separate and secured.
52
b. Area should be clean, well ventilated, well lit, without any dampness or fungal growth on walls.
9. RMO Duty Rooms:
a. Minimum 1 room with attached bathroom & WC, per 2 doctors with separate rooms for male & females with separated sleeping facility with ceiling fan, drinking water facility, intercom, mattress, pillows, blankets, bed sheets. Cupboards/ wardrobes.
10.Nursing station/ duty room (Nurses):
a. One nursing station/room per 15 beds.
b. Applicable for clinics only if there is a day care ward.
c. Nursing stations should be spacious enough to accommodate a table, requisite chairs, working platform, medicine racks, a work counter, sinks, dress table, screen, pedal operated trash bins.
d. Station should accommodate all nurses on duty at any time.
11.Clinical laboratory specifications:
a. Laboratory services can be outsourced or can be optional for hospitals up to 100 beds.
b. Laboratory services are mandatory for hospitals above 100 beds for quick diagnosis of blood, urine, etc., a small sample collection room facility shall be provided.
c. Separate Reporting Room for doctors should be there.
12.Radiology section:
a. Role of imaging department should be radio-diagnosis and ultrasound along with hire facilities depending on the bed strength.
b. The department should be located at a place which is accessible to both OPD and wards and also to operation theatre department.
c. The size of the room should depend on the type of instrument installed.
d. It should confirm to AERB requirements.
e. The room should have a sub-waiting area with toilet facility and a change room facility, if required.
f. Film developing and processing (dark room) shall be provided in the department for loading, unloading, developing and processing of X-ray films.
g. Separate Reporting Room for doctors should be provided.
53
13.Laundry (optional)
a. Laundry services can be outsourced or can be optional.
b. If it is provided in house, it should have necessary facilities for drying, pressing and storage of soiled and cleaned linens.
c. If outsourced, disinfection of linen is carried out by the hospital before handing over the linen to the out-sourced organization.
14.Emergency Room specifications:
a. Emergency room should be spacious enough to accommodate a table, requisite chairs, working platform, medicine racks, a work counter, sinks, dress table, screen, pedal operated trash bins.
b. Station should accommodate all nurses & doctors on duty at any time.
c. Room should allow free movement of wheel chair or trolley.
d. Emergency Room should preferably have different entry than the hospital entry.
e. Access to Emergency Room should have a ramp for wheel chairs and stretchers.
15. House-Keeping:
a. b. c.
Housekeeping services should be made available for effective cleanliness. Housekeeping services can be outsourced.
Designated areas within functional areas for housekeeping materials has to be in hospital more than 30 beds
16.Security Services:
a. There is a designated location for each security staff on duty.
Medical record-room:
b. Medical record-room should be of adequate size as per the load of the documents of the hospital.
c. Tamperproof material and locking facility Cabinets/ cupboards/ Boxes will be used.
d. Fire extinguishers of correct type should be made available nearby all locations.
17.Store rooms:
a. Store room should be lockable & of adequate size with exhaust fan.
54
b. Area should be clean, well ventilated, well lit, without any dampness or fungal growth on walls.
18. Wards:
a. Treatment areas for male and female patients shall be segregated if managed as wards and there should be privacy for individual patients. Alternatively individual or sharing rooms can be used to segregate patients of different gender.
b. The ward planning will address minimization of the work for the nursing staff and shall provide basic amenities to the patients located within an area or unit.
c. Ward unit will include nursing station, preferably a treatment/ procedure room, nursing store and toilets as per the norms.
d. At the minimum one nursing station per ward of upto 45 beds will be provided.
e. There should be minimum 50 ft area per bed with 7 feet distance between the mid-points of adjoining beds and at least 3 feet distance between the beds and a 8″ distance between the bed and the wall.
f. Width of the door to be at least 4 feet.
g. Permanent, semi-permanent or temporary partition should be present between two beds.
Partitions may be used as and when needed
h. Ward store area with lockable wall or steel cupboard(s).
19. Duty rooms for doctors
a. To accommodate 1 bed of 6 feet X 3 feet and a side table.
b. Separate beds if sharing for same gender.
c. Separate rooms for separate genders will be provided.
20. Duty rooms for nurses:
a. To accommodate 1 bed of 6 feet X 3 feet and a side table.
b. Separate beds if sharing for same gender.
c. Separate rooms for separate genders will be provided.
21.Duty rooms for technicians: (optional but prerequisite with functional casualty)
a. To accommodate 1 bed of 6 feet X 3 feet and a side table.
b. Separate beds if sharing for same gender.
55
c. Separate rooms for separate genders will be provided.
Needed only when emergency is functioning, Man power for technicians will increase accordingly
22.Dirty utility room:
a. Separate area of minimum 15 sq feet.
24: Regimental Therapy Unit or treatment room:
a. The department is more frequently visited by out-patients and IPD patients but should be located at a place which may be at convenient access to both outdoor and indoor patients with privacy.
b. It should also have separate rooms for cupping, and leeching with a leech bank and other regimens.
C.1.3 Dimensions of the sub areas of the facility, including the flow of the processes which in turn will give a layout of the department /unit.
Specifications of the Regimental Therapy Unit:
1. Room Size: Minimum 10 ft. X 10 ft. (As size of massage table is 7ft X 3 ft. the size of room should be 10ft X 10 ft.)
2. Mandatory if procedures are done.
3. Separate Unit is proposed for male & female with attached toilet and bathroom
4. Optional and depending on work load. If more than 15 procedures are carried out per day, separate rooms should be provided.
Specifications of the Operation Theater/ Minor OT for Fasd (Venesection), cautrization:
OT/ procedure room should have sterile zone of at least 10 ft X 10 ft; Size is exclusive of clean zone, independent enclosure to accommodate equipment & maintaining adequate privacy.
1. OT is mandatory if surgical procedures are provided in any hospital. Waiting area:
a. Adequate number of seats/ chairs with respect to the bed strength and load of the patients will be provided.
b. Separate waiting area for Regimental therapy services is mandatory only in health care units which provide stand-alone Regimental therapy services. Otherwise common waiting areas of the facility can be utilized.
2. Consultation room with examination room: adequate to accommodate Doctors table, consultation chair, two stools/ chairs, examination bed of minimum size of 6 ft. X 2.5 ft., privacy screen around examination area.
56
3. Sterilization room: adequate to accommodate sterilization equipment & sterilized material.
4. Separate Recovery room for regimental therapy is mandatory only in health care units which provide stand-alone services. Otherwise ward beds of the facility can be utilized.
5. Separate disposal zone for storage of waste as per bio-medical waste management rule
C.1.4 Basic signage
1. A signage within or outside the facility should be made available containing the following information.
2. *All signage meant for patients and visitors shall be bilingual – Local language and Hindi / English.
C.1.4.1Name of the care provider with registration number,
1. Name of organization.
2. Display of Registration under clinical establishment act
C.1.4.2 Fee structure,
1. Display of tariff list at OPD, Emergency etc.
2. Display of citizen charter in OPD and emergency
C.1.4.3Timings of the facility
1. Display of OPD timings with names and respective specializations of consultants in OPD.
C.1.4.4 Services provided
Directional signage at main entrance towards emergency and OPD
1. Directional signage for patients for utilities and conveniences like toilets, drinking water, telephone booths, shops
2. Directional signage within the hospital building for all departments within the building
3. Display of department / area name on the entrance of each area / room / counter
4. Display of hospital layout at various entrances in the hospital
5. Display of hospital’s scope of services at OPD, Emergency and at Campus
entrance
6. Floor Plan With Location Of Departments
57
7. Plan of Facility
8. usages: departments, OPD & IP room & wards, waiting areas,
C.1.5 Others
1. Display of all radiation hazard signage in radiation areas (if applicable).
2. Display of Biomedical waste segregation at all location where BMW bins are kept
3. Display of danger signage at all electric panels and other dangerous areas
4. Display of General instructions like ‘No Smoking’, ‘Keep Silence’, ‘Use dustbin’, etc. at various patient and visitor areas in the hospital
5. Display of hand–washing techniques compliant with WHO guidelines at all hand wash basins
6. Display of how to use fire extinguisher at all point where fire extinguisher is installed
7. Display of important phone contact numbers of hospital authorities
8. Displays required by regulations like PNDT, Lifts, Fire, etc.
9. Display of Material Safety Data Sheet at all locations where Hazardous Materials are stored
10. Display of patient rights and responsibilities in OPD, emergency and wards
11. Display of safety instructions in areas where any kind of safety hazard may be expected. This includes areas like transformers, Cylinder storage, LPG storage etc.
12.Emergency exit signage (preferably in auto illumination material, like radium)
13. Fire Protection
14. Hazards- electrical, fall, pipe locations, prohibited areas
15. Notice board for general information to staff
16. Notice board in front of all OPD and Wards.
17. Notice board in Operation theatre
18. Routes for all areas
19. Signage for parking. (Signage for ambulance parking shall be separately mentioned)
20. Safety signage will be displays as per the requirements of respective Indian Standards: Ex. Fire Protection Safety Signs IS 12349:1988
58
C.2 Furniture & Fixtures:
This will entail the details about the furniture and sundry items commensurate to the service delivery requirements.
C.2.1Furniture/Fixture Requirements:
Furniture/Fixture Requirements for Outpatient Department (OPD):
Name of the Equipment
Clinic
Hospital
Clinic
1 to 50 beds
51-100 beds
101- 200 beds
201 and above beds
Room with well-lighted and ventilated and equipped with a chair and a table for doctor
1 per consultation room
X-ray viewer
1 per consultation room
Two chairs for patients & attendants
1 per consultation room
An examination table of 6 ft. X 2.5 ft. With privacy screen
1 per consultation room
Blood pressure apparatus
1 per consultation room
Stethoscope
1 per consultation room
Torch
1 per consultation room
Thermometer
1 per consultation room
Weighing machine
1 per consultation room
Essential diagnostic tools required for examination of patients as per the scope of services offered by the hospital.
As per requirement
Light source which gives light colour and temperature similar to solar light,
Light intensity of at least 500 lux at the point of examination.
As per requirement
Refrigerator if temperature sensitive medication are stored (if required)
1 per consultation room
Computers, (if required)
1 per consultation room
Telephone equipment
As per requirement
Air conditioning
As per requirement
Computers, (if required)
1 per consultation room
59
51-100 beds
101-200 beds
4
8
Name of the Equipment
Adequate wall or steel Cupboards per Ward Arm Board (Adult) Back rest
Bain Marie trolley (stainless steel) 1 per floor
Bed side cabinets
Bed side Screen
Bucket metallic As needed
Ceiling Fans As per requirement
Clock ( 1 per ward) 1 per ward
Containers for kitchen As needed
Doctor’s chair As needed
Doctor’s or Office table As needed
Dressing trolley-1 per floor/ 1 per ward
ward depending on layout
Dust bins in each ward & 1 per ward
consultation room
Duty table for nurses 1 per ward
Emergency resuscitation kit 3 per ward
Enema Set 2 per ward
Fire extinguisher – ABC 1 per ward/ floor based on layout Foot stools 8 25 Fridge 1 Per Area/ Ward
Heavy duty Torch light 1 per ward
Hospital Cots 50 500 Hospital Cots Pediatric 5 50 Hot Water Bags 2 per ward
Hot Water geyser 2 per ward
IV Stands – 2 per 10 beds 10 100
1 to 50 beds 201 and above beds
2
15
As needed As needed 1 per floor
1 per 5 patients
1 per ward or full length curtains between the beds
16
25
100
300
10
30
20
50
5
10
Infra-Red lamp 3
Intercom System 1 per ward
Kidney Tray 1 per 5 beds 20
Kitchen utensils, Adequate
Massage table of 7ft. x 2.5ft One per procedure room
(wood or fibre)
Medicine trolley 1 per ward
Office chairs 4
Office Table 3
Patient beds with side rails
Patient call Bell System
Patient locker
Patients examination table– 1 – 1 per ward/ floor a per the profile of patients & layout
10 50
20 10
40
50
8
20
6
10
20% of total beds 1 per bed
1 per bed
60
per ward/ floor a per the profile of patients & layout of facility
of facility
Patients side table
1 per bed
Pediatric cots with railings as per scope of services
as per scope of services
Steel or Wooden cup board
8
16
20
25
Steel rack
5
10
20
40
Stool 1Per Bed
8
8
15
25
Stools revolving – 2 per ward
2 per ward
Stretcher/ Patient trolley – 1 per ward
1 per ward
Urinal Male and Female
10
20
50
100
waiting chairs / benches for patients relatives
50% of the bed strength
Weighing Machine
1 per ward
Wheel chair
2 per 50 beds
Wooden massage bed
One per service room
X-ray viewer
one per ward
Name of the Equipment
Clinic
1 to 50 beds
51-100 beds
101-200 beds
201 and above beds
Arm chair
One per service room
Examination table
Minimum 1
Focus lamp
Minimum 1 per service room
Foot stool
One per service room
Gas/Stove
One per service room
Glass containers (1 liter capacity) for storing used leeches:
5-10 (for each patient requires separate container and the number may vary according to the number of patients)
Good light source
Minimum 1 per service room
hamox stretchers / Stretchers with wheels
One per service room
Heating facilities
One per service room
Hot water bath
One per service room
IV stands
One per service room
Massage table of 7ft. x 2.5ft (wood or fibre)
One per service room
Mixture/Grinder/Churner
One per service room
OT table / Lithotomy Table with Side Railings
Minimum one
Plastic aprons, gloves and mask
One per service room
61
Amal tariq (wooden chamber)
One per service room
Revolving stools
Minimum 1 per service room
Stool
One per service room
Sufficient light and ventilation
One per service room
Surgical trolley
Minimum 1
Torch
Minimum 1 per service room
Wheel chairs
One per service room
Pressure cooker (10 litre minimum)
One per (massage)service room
Nutool table with flexible hanging stand
One per (nutool) service room
Tubs for Pashowya and Abzan
One per (nutool) service room
C.2.2 Sundry Articles Requirement
Name of the Equipment
Clinic
1 to 50 beds
51-100 beds
101-200 beds
201 and above beds
Air conditioners Central A/C for OT
Optional
Minimum 1
Ambulance
Optional
Minimum 1
Ceiling / wall Fans
As needed
Clock
1 per ward
Computer with modem with UPS, printer with internet connection
As needed
Coolers
As needed
Drinking Water purifier
As needed
Emergency lamp
2 Per Area/ Ward
Emergency trauma set
2 per ward
Exhaust Fan
As needed
Fire extinguishers
As needed
Geyser
2 per ward
Refrigerator
1 per ward
Storage Geyser
1 per ward
Tables & Chairs
As needed
Telephone/ cell phone
1 per ward
Tube lights
As needed
Vacuum cleaner
As needed
62
C.2.3 Others
Name of the Equipment
Clinic
1 to 50 beds
51-100 beds
101- 200 beds
201 and above beds
Computer with Modem with UPS, Printer with Internet Connection
As needed
Photocopying Machine
As needed
As needed
1 per ward
1 per ward
1 per ward
Intercom (10 lines)
As needed
Fax Machine
–
As needed
As needed
As needed
As needed
Telephone
One per organization
Two per organiz ation
Public Address System
–
Covering Indoor and OPD Areas
C. 3 Engineering Services Requirements
This will include the detail information about the basic requirements including
C.3.1Electrical Requirements
1. At least 3 hours backup or generator for critical areas
2. Primary electrical Supply is available as provided by the local utility provider. Lighting back up for at least 1 hour covering all functional areas must be available during the functioning time.
3. Primary electrical Supply as supplied by utility provider. Emergency backup for at least 3 hours backup for electricity & for lighting and critical equipment must be available during the functioning time. Take over time must be less than 30 seconds. Electric supply to lighting will be backed up with UPS/ Inverter/ Battery.
4. The illumination in the hospital is provided as per the prescribed standards.
5. Shadow less lights should be provided in operation theatres and delivery
rooms.
6. Emergency portable light units should be provided in the wards and departments.
C.3.2Plumbing Requirements 1. Number of Wash basins
63
2.
3.
a.
i. 1 for every 20 persons or part there
ii. Doctor, staff, patients and visitors have an access to wash basin(s) 1 for every 50 persons or part there.
iii. Dirty utility & surgical / procedural hand wash basin will be separate from general use & one each.
Number of Water closets
i. 1 for every 20 beds or part thereof.
ii. Doctor, staff, patients and visitors have an access to wash closet(s) 20 beds or part thereof.
For in-patient department
No. of Wash basins
i. 1 for every 12 beds or part thereof
ii. Doctor, staff, patients and visitors have an access to wash basin(s);
iii. Procedure hand wash basins are separate and located close to procedure area.1 for every 12 beds or part thereof
No. of Water closets
i. 1 for every 6 beds or part thereof
ii. Separate water closets are available for use for outpatient and in-patient areas.
iii. For in-patient areas the water closets are provided in the ratio of 1 per 6 beds and are located close to patient care areas.
b. No. of bathrooms
ii. Minimum1 bathroom per 6 beds/ one for each therapy rooms
c. WC
i. Minimum1 bathroom per 6 beds/ one for each ward rooms
i. Minimum 1 WC per 6 beds/ one for each Male & Female wards
ii. Average size of toilet : 810 mm X 1800mm with grab bars
iii. Minimum 1 WC per 6 beds/ one for each Male & Female wards
iv. At least one wheel chair friendly toilet of dimensions 2200mm X 1800mm must be provided.
64
C.3.3Civil Requirements
1. Space between 2 rows of beds in a ward should be minimum 5 ft.
2. Distance between 2 beds should be minimum 3.5 ft. if more than one bed is present
3. If clinic has beds then: measured between the facing borders of adjoining beds there shall be at least 3 feet of distance if the beds are mobile and provided with functional wheels and at least 4 feet if beds do not have functional wheels.
4. If there are no beds then this requirement is not applicable.
5. Size of hospital bed should be minimum 6’ x 3’
6. Area per bed should be Minimum 50 sq. ft. / bed
C.3.4 HVAC / AC / Ventilation / Cross Ventilation Requirements
1. Air-conditioning and Room Heating in operation theatre and neo-natal units should be provided.
2. The ventilation in the hospital may be achieved by either natural supply or by mechanical exhaust of air.
3. Cross ventilation/ Mechanical ventilation by fans and or exhausts to achieve comfortable environment without noxious odours.
C.3.5 Others
1. Air coolers or hot air convectors may be provided for the comfort of patients and staff depending on the local needs.
C.4 Public Utilities C.4.1Safe drinking water
1. Round the clock availability of safe drinking water for patients, staff and visitors.
2. Hospital should be provided with water coolers and refrigerator in wards and departments depending upon the local needs.
C.4.2 Sanitary Requirements
1. Arrangement should be made for round the clock piped water supply along with an overhead water storage tank with pumping and boosting arrangements.
2. Approximately 10000 liters of potable water per day is required for a 100 bedded hospital.
3. Separate provision for firefighting should be available.
65
4. Water softening plant should be considered where hardness of water is a major problem.
C. 4. 3. Drainage and Sanitation
1. The construction and maintenance of drainage and sanitation system for waste water, surface water, sub-soil water and sewerage shall be in accordance with the prescribed standards. Prescribed standards and local guidelines shall be followed.
2. Waste Disposal System: National guidelines on Bio-Medical Waste Management and a Notification of Environment and Forests are at Annexure – I.
D. Equipment /instruments
This includes the type, number, minimum specification & functionality of equipments
required in the facility under the following headings
D.1 Therapeutic equipment
1: Outpatient department (OPD)
Name of the Equipment
Clinic
1 to 50 beds
51-100 beds
101- 200 beds
201 and above beds
1
A chair and a table for doctor
1 per consultation room
2
X-ray viewer
1 per consultation room
3
stools for Patients
1
4
Patients waiting chairs / benches
50% of the bed strengths
5
An examination table of 6 ft. X 2.5 ft. With privacy screen
1 per consultation room
6
Blood pressure apparatus
1 per consultation room
7
Stethoscope
1 per consultation room
8
Torch
1 per consultation room
9
Thermometer
1 per consultation room
10
Weighing machine.
1 per consultation room
11
Essential diagnostic tools required for examination of patients as per the scope of services offered by the hospital.
As per requirement
12
Light source which gives light colour and temperature similar to solar light,
Light intensity of at least 500 lux at the point of examination.
As per requirement
66
2: In-Patient department (IPD) Sn Name of the Equipment
1 Ambu bags
2 Arm Board Adult
3 Autoclave Drums
4 Back rest
5 Bain marie trolley stainless steel 1 per
floor
6 Bed pans: 1 per 5 patients
7 Biomedical waste colour coded bins
8 Cheatle forceps assorted sizes
9 Clock per ward
10 Containers for kitchen
11 Dressing trolley-1 per floor/ ward
depending on layout
12 Dust bins in each ward & consultation
room
13 Emergency resuscitation kit
14 Enema Set
15 Fridge
16 Heavy duty Torch light – 1 per ward
17 Hot Water Bags 2 per ward
18 I V Stands – 2 per 10 beds
19 Infra-Red lamp
20 Instrument tray – minimum 1 per ward
21 Instrument trolley – 1 per ward
22 Intercom System
23 Kidney Trays-1 per 5 beds
24 Massage table of 7ft. x 2.5ft (wood or
fiber)/ Wooden massage bed
25 Medicine trolley
26 Needle cutter – 3 per ward
27 Non mercury Thermometer clinical
28 O2 cylinder with spanner
29 Patients examination table– 1 per ward/
floor a per the profile of patients & layout
of facility
30 Sphygmomanometers-Stand Type 1&
Portable (aneroid or Digital) Type X
31 Stretcher/ Patient trolley
32 Weighing Machine
33 X-ray viewer – one per ward
3: Regimental Therapy Room
1 to 50 beds
51-100 beds
101- 200 beds
201 and above beds
3
6
6
6
6
12
24
24
3
6
9
12
2
4
8
20
1
2
4
8
10
20
50
100
Each per floor
5
8
16
25
1 per ward
As required
1 per ward
1 per ward
1 per floor
As required
As required
1 per ward
2 per ward
2 per 10 beds
3
5
10
10
minimum 1 per ward
minimum 1 per ward
As required
1 per 5 beds
1 per treatment room
minimum 1 per ward
3 per ward
1 per ward
1 per ward
1 per ward
1 per ward
1 per ward
1 per ward
1 per ward
67
3: Equipments /instruments for Regimental Therapy Room
SN
Name of the Equipment
Clinic
1 to 50 beds
51-100 beds
101- 200 beds
201 and above beds
1.
Amaltariq (wooden chamber)
Minimum 1
2.
As per requirement: Dressing tray with gloves, bandage cloth, bandages etc.
Adequate
3.
Autoclave equipment for sterilization
Minimum 1
4.
Autoclave/ Sterilizer
Minimum 1
5.
Bedpan (male and female)
As needed
6.
Buckets/Plastic tubs/Basin(with provision of measuring scale)
As needed
7.
Bunsen flame
1 minimum
8.
Clock
1 Per Area/ Ward
9.
Consumables
Adequate
10.
crash cart
Minimum 1
11.
Disposable syringes (5- 10cc, 20-50cc)
As needed
12.
Enema pot
As needed
13.
Examination table
Minimum 1
14.
Focus lamp
Minimum 1
15.
Foley’s Catheter
As needed
16.
Gas/Stove
Minimum 1
17.
Glass containers (1 liter capacity) for storing used leeches:5-10 (for each patient requires separate container and the number may vary according to the number of patients)
Minimum 1
18.
hamox stretchers / Stretchers with wheels
Minimum 1
19.
Hot water bag
Minimum 1
20.
Instruments : Different types of Forceps, Scissors, Needles, Suturing material etc. (as per requirement)
Adequate
21.
IV stands
As needed
22.
Kidney trays
Minimum 1
23.
Knife and scissor1 each
As needed
68
24. Leeches :As per the requirement, usually 3-5 leeches per patient/ treatment period)
25. Mahjama of different sizes (cupping instruments)
26. Massage table of 7ft. x
2.5ft (wood or fibre)
27. Measuring glasses set
28. Metallic or disposable
insemination cannula
29. Mixture/Grinder/Churner
30. OT instruments
31. OT Table with stand
32. Plastic aprons, gloves and
mask
33. Rubber Catheters without
cracks & without frayed
edges
34. scalpel
35. Small pillows covered with rexin sheet
36. Sphygmomanometer
37. spittoon
38. Sterile apron
39. Sterile cotton
40. Sterile Gauze
41. Sterile gloves
42. sterile urinary catheters
43. Sterilizer or Autoclave
44. Stethoscope
45. stop watch
46. Storage Aquarium for
fresh leeches: 20-25 liters capacity (may be with partitions)
47. Stretchers with wheels
48. Sufficient light and
ventilation
49. Surgical tray
50. Surgical trolley
51. Surgical trolley
52. Thermometer digital
53. Toothed forceps
54. Torch
D.2 Surgical equipment
Optional
As needed
Minimum 1set
As needed
Minimum 1 Minimum 1
Minimum 1 Minimum 1 Minimum 1 As needed
As needed
As required As needed
Minimum 1 Minimum 1 Minimum 1 As per use As per use As per use As per use Minimum 1 Minimum 1 Minimum 1
Optional
Minimum 1 As needed
1 per ward/therapy room Minimum 1 /therapy room
Minimum 1 Minimum 1 Minimum 1
Minimum 1
Minimum 1
69
1: Operation Theater
sn Name of the Equipment
1 Anterior vaginal wall retractor
2 Artery forceps
3 Auto Clave HP Vertical /horizontal (2 bin)
4 Autoclave equipment for
sterilization/Sterilizer
5 Bladder sound (Urethral dilators) of
different sizes
6 Crash Cart with lifesaving drugs and
Resuscitation Kit
7 Cusco’s Speculum
8 Diathermy Machine (Electric Cautery)
9 Disposable syringes (5-10cc)
10 Enema Pot
11 Focus lamp Ordinary
12 Foley’s Catheter
13 Formalin dispenser
14 General Surgical Instrument Set Piles,
Fistula, Fissure, etc
15 Instrument Trays of various Sizes
16 Instrument Trolley
17 IV stands
18 Kidney tray
19 Knife and scissor 1 each
20 L. P. Tray
21 Magill’s forceps (two sizes)
22 Metallic or disposable insemination
cannula
23 Operation table Hydraulic Minor with
stand
24 OT Spot light (Shadowless ceiling fitted/
stand mounted)
25 Oxygen Cylinder
26 Oxygen Mask with Circuit
27 Plastic aprons, gloves and mask
28 Shadowless lamp ceiling type major /
minor
29 Shadowless Lamp stand model
30 Sims speculum in small, medium & large
size
31 Sphygmomanometer
32 Sterile cotton
33 Sterile gloves
Clinic
1 to 50 beds
51- 100 beds
101- 200 beds
201 and above beds
Adequate
Adequate
Minimum 1
Minimum 1
Minimum 1
Minimum 1
As needed
As needed
As needed
Minimum 1
Minimum 1
As needed
Minimum 1
Minimum 1
Adequate
As needed
As needed
As needed
As needed
Adequate
Adequate
Adequate
Minimum 1
Minimum 1
Minimum 1
Minimum 1
Adequate
1
2
Minimum 1
Adequate
Minimum 1
As needed
As needed
70
34
Steriliser Small (Instruments)
As needed
35
Sterilizer big (Instrument)
As needed
36
Sterilizer Medium (Instrument)
Minimum 1
37
Stethoscope
Minimum 1
38
Suction Apparatus – Electrical
Minimum 1
39
Suturing Set
Minimum 1
40
Swab holders
Minimum 1
41
Thermometer
Minimum 1
42
Tongue depressors
Minimum 1
43
Toothed forceps
Minimum 1
44
two long (8 inch)& two short (6 inch) Artery forceps
Minimum 1
45
two Uterine sound
Minimum 1
46
Uretheral Dilator Set
Minimum 1
47
Vaginal Examination set
Minimum 1
48
Vulsellum
Minimum 1
2: Anesthesia
Sn
Name of the Equipment
Clinic
1 to 50 beds
51-100 beds
101- 200 beds
201 and above beds
1
Airway female & male
Adequate
2
Anaesthesia Trolley / Boyle’s Apparatus
Minimum 1 if anesthesia is given
Minimum 1
3
Anesthetic- laryngoscope magills with four blades
Minimum 2
4
CO2 cylinder for laparoscope
Minimum 1
5
Connector set of six for ETT
Minimum 1
6
Defibrillator/ AED
Minimum 1
7
Endotracheal tube sets
Minimum 1
8
Magills forceps (two sizes)
Minimum 1
9
Mouth prop
Minimum 1
10
Multi-parameter Monitor
Minimum 1
11
N2O Cylinder for Boyle’s Apparatus
Minimum 1
12
O2 cylinder for Boyle’s Apparatus
Minimum 1
13
Tongue depressors
Adequate
14
Tubes connecting for ETT
Adequate
D.3 Diagnostic equipment
71
1: Imaging Equipment
Sn
Imaging Equipment
Name of the Equipment
Clinic
1 to 50 beds
51-100 beds
101- 200 beds
201 and above beds
1
300 M.A. X-ray machine
Optional
Minimum 1
2
Ultra Sonogram (Obs & Gyne. department should be having a separate ultra-sound machine of its own)
Optional
Minimum 1
3
Echocardiogram
Optional
4
X-ray developing tank
Minimum 1 if X –ray machine exists
Minimum 1
5
Safe light X-ray dark room
Minimum 1 if X –ray machine exists
6
Cassettes X-ray
Minimum 1 if X –ray machine exists
7
Lead apron
Minimum 1 if X –ray machine exists
8
Intensifying screen X-ray
Minimum 1 if X –ray machine exists
9
Thyroid shield
Minimum 1 if X –ray machine exists
10
TLD batches
One per person
11
Gonadial guard
Minimum 1 if X –ray machine exists
12
X-ray lobby single
Minimum 1 if X –ray machine exists
2: Laboratory Equipments
Sn
Name of the Equipment
Clinic
1 to 50 beds
51-100 beds
101-200 beds
201 and above beds
Alarm clock 1
Optional
1 Per/ Ward
Automatic cell counter
Optional
Minimum 1
Auto analyzer/ Semi auto analyzer
Optional
Minimum 1
Binocular Microscope
Minimum 1
Chemical Balances
Minimum 1
Counting chamber
Minimum 1
Electric Colorimeter
Minimum 1
Electric centrifuge, table top
Minimum 1
ESR stand with tubes
Minimum 1
Electrolyte analyzer
optional
Minimum 1
Glucometer
1 Per Area/ Ward
Hemoglobinometer
Minimum 1
72
Sn
Name of the Equipment
Clinic
1 to 50 beds
51-100 beds
101-200 beds
201 and above beds
Hot air oven
As needed
Hot plates
As needed
Lab Incubator
As needed
Laboratory Auto Claves
As needed
Micro pipette of different volumes
As needed
PH meter
As needed
Refrigerator
Minimum 1
Rotor / Shaker
Minimum 1
Simple balances
Minimum 1
Spirit lamp
Minimum 1
TCDC count apparatus
As needed
Test tube holders
As needed
Test tube rack
As needed
Test tube stands
As needed
Timer stop watch
As needed
Water bath
As needed
D.4 Emergency equipment
S No.
Name of the Equipment
Clinic
1 to 50 beds
51-100 beds
101-200 beds
201 and above beds
1.
Emergency equipment box for first aid & BLSS
Minimum 1
2.
Crash-Cart trolley:1
Optional
Minimum 1
3.
Portable defibrillator:1
Optional
Minimum 1
4.
Disposable syringes
As needed
5.
Ambu Bag:1
Minimum 1
6.
Laryngoscope with cell
Minimum 1
7.
Sealed battery cell
Minimum 1
8.
Endotracheal tubes
As needed
9.
Monitor
As needed
73
D.5 Sterilizing Equipment
Sterilizing Equipments
Sr. No.
Name of the Equipment
Clinic
1 to 50 beds
51-100 beds
101- 200 beds
201 and above beds
1.
Auto Clave HP Vertical (2 bin)
As needed
Minimum 1
2.
Autoclave equipment (drums or trays) for sterilization/Sterilizer
Adequate
E. Manpower
This includes the Designation, minimum qualification & number of people required in the facility.
E.1Medical practitioners
1. Category: Doctors
2. Minimum Qualifications: Degree/ Post Graduate Degree from recognized university by Central Government or State government of Indian Medicine.
3. Registration: (if applicable): with state or central council of Indian Medicine
4. Trained / skilled: Trained
Strength (The minimum number of staff required as per the function.)
Sr. no.
Doctors BUMS/ MD
Clinic
1 to 50 beds
51-100 beds
101-200 beds
201 and above beds
1.
Hospital Superintendent1
1
1
1
1
1
2.
Hakim Specialist (Moalijat)
2
2
2
4
5
3.
Hakim Specialist (Jarahat)
1
1
1
2
2
4.
Hakim specialist Amraz-e-JIld –wa zohrawia
2
2
2
5.
Hakim specialist Amraz-e-Dimag – wa Asab
2
2
74
6.
Hakim specialist Nafsiyat
1
2
7.
Hakim specialist Amraz Ain
1
2
2
8.
Hakim specialist Amraz Uzn Anaf wa Halaq
1
2
2
9.
Hakim Specialist (NiswanwaQabala )
1
1
2
4
4
10.
Hakim Specialist (Atfal)
1
1
2
3
3
11.
Hakim Specialist (Regimental Therapy)
1
1
2
3
4
12.
Hakim Specialist (Preventive Medicine)
1
1
2
3
3
13.
Anesthetist
1
1
1
2
2
14.
Radiologist DMRE/ MD in concerned subject
1
1
1
2
2
15.
Pathologist (visiting/part time/full time)
1
1
1
2
2
16.
General Duty Hakims
7
7
15
25
30
E.2 Therapists:
1. Category: Therapists:
2. Minimum Qualifications (diploma/degree from recognized university by Central Government or State government of Indian Medicine.)
a. This encompasses certified course in Regimental Therapy from recognized state or central council for Unani medicine
b. On the job training or allied course in Unani medicine.
3. Registration with the concerned council(if applicable): state or central council
of Indian Medicine
4. Trained / skilled: Trained
75
Strength: Minimum 2 per treatment room; male and female separate; i.e. minimum 2 male technicians or 2 female technicians for a treatment room.
Sr. no
Therapists – Technicians
Clinic
1 to 50 beds
51-100 beds
101-200 beds
201 and above beds
1.
Hammam Female Technician
1
1
2
3
4
2.
Hammam Male Technician
1
1
2
3
4
3.
Dalak Tecnician Male
1
1
1
2
2
4.
Dalak Tecnician Female
1
1
1
2
2
5.
Technician for Riyazat
1
1
1
2
2
E.3 Paramedics
1. Category:Paramedics
2. Minimum Qualifications (diploma/degree from recognized university by Central Government or State government of Indian Medicine.)
3. Registration with the concerned council(if applicable): state or central council of Indian Medicine
4. Trained / skilled: Trained
Sr. no
Staff
Minimum qualification
Clini c
1 to 50 beds
51-100 beds
101- 200 bedsl
201 and above bedded hospital
1.
Clerk for Billing
12th Standard passed.
_
1
1
2
2
2.
Cook
(if food is cooked in- house)
Experience of working in mass kitchen for at least 1 year at senior cook or at in charge level.
As per requirement
3.
Driver (Only in case hospital has its own vehicle for patient or ambulance services)
Driver’s License for the category of vehicle
With State Road Transport Office.
If driving an
As per requirement
76
ambulance, specific training is required.
4.
ECG Technician
(if ECG services are provided in- house)
1 year experience of taking ECG
–
1
1
1
2
5.
Electrician
If exists, Diploma in Electrical Engineering
–
1
2
2
3
6.
Hospital worker (OP/ward +OT)
Eight standard completed
5
5
10
20
7.
Housekeepin g Staff
Ability to read national or local language
1
1
2
3
6
8.
Kitchen Servant
(if food is cooked in- house)
–
As per requirement
9.
Laboratory Attendant (Hospital Worker)
(if lab is in- house)
Ability to read national or local language
_
2
2
6
10
10.
Laboratory Technician
(if Lab is in- house)
Qualified Laboratory Technician
_
2
3
6
10
11.
Maintenance person
If exists, Diploma in Electrical
_
1
1
2
3
77
Engineering.
12.
Medical Records Officer / Technician
MR Technician/Min imum qualification- 12th Standard passed.
_
1
1
1
2
13.
OT Assistant
(if surgical services are provided)
OT TechnicianMini mum qualification- 12th Standard passed.
1
2
2
3
4
14.
Peon
Eight standard completed
_
1
1
1
2
15.
Pharmacist
(if pharmacy is in-house)
Diploma in Unani Pharmacy (D.Pharma) Bachelor in Unani Pharmacy (B.Pharma) Master in Unani Pharmacy (M.Pharma)- Master of Science in Medicinal Plants (M.Sc Medicinal Plants)- PG Diploma in Unani Drug Standardisation Certificate course
–
2
4
6
8
16.
Physiotherapist
Qualified PT
_
1
1
1
2
78
17.
Plumber
–
_
1
1
1
2
18.
Radiographer
(if Imaging is in-house)
Qualified Radiographer
1
1
1
1
19.
Sanitary Worker
–
5
5
10
15
20.
Store keeper/ Manager
Minimum qualification- 12th Standard passed.
_
_
1
1
1
21.
Therapy Attendant
Eight standard completed
Minimum 1 and as per requirement
22.
Ward Ayah
Eight standard completed
Minimum 1 per ward/ floor and as per requirement
23.
Ward boy
Eight standard completed
Minimum 1 per ward/ floor and as per requirement
E.4Nurses:
1. Category: Nursing
2. Minimum Qualifications: GNM or BSc or MSc Nursing
3. Registration: State Nursing Council of where hospital is located
4. Trained / skilled: Trained
Nurses to Beds Ratio: 1 per 20 beds
Sn
Nursing Staff
Clinic
1 to 50 bedded Hospital
51-100 bedded Hospital
101-200 bedded hospital
201 and Above bedded hospital
1.
Staff Nurse
1
1 for every 20 beds in IPD and 2 for OPD attendance up to 150 patients and 1 extra each for additional 100 patients.
2.
Matron
–
1
1
2
2
79
E.5 Administrative staff: The number would vary as per requirement and may be outsourced.
Administrative staff
Sr. no
Administrative staff
Clinic
1 to 50 bedded Hospital
51-100 bedded Hospital
101-200 bedded hospital
201 and Above bedded hospital
1.
Office Superintendent/ Hospital Administrator
–
1
1
1
1
2.
Accountant
–
2
2
3
5
3.
Computer Operator
–
6
6
10
15
4.
Security Staff*
–
2
4
6
10
F. Drugs
This segment includes the minimum essential drug which needs to be maintained in the facility.
F.1 Anaesthetics drugs
Category: Anesthetics drugs
Sr. no.
Name of the Drug
Strength
Minimum Quantity
1.1 General Anesthesia (to be given only by a qualified allopathy anesthetist)
1.
Ether,
As per requirement
2.
Halothane
As per requirement
3.
Isoflurane*
As per requirement
4.
Ketamine Hydrochloride Injection
10 mg / ml, 50 mg / ml
As per requirement
5.
Nitrous Oxide
medical grade
As per requirement
6.
Oxygen
medical grade
As per requirement
7.
Injection Thiopentone Sodium
0.5 g, 1 g powder
As per requirement
1.2 Local Anesthesia
8.
Injection Bupivacaine Hydrochloride
0.25%,0.5% 0.5% + 7.5% Glucose
As per requirement
9.
Spray Ethyl Chloride
1%
As per requirement
10.
Injection Lignocaine
Topical Forms 2-5%
As per requirement
80
11.
Hydrochloride 1-2% Spinal 5% + 7.5% Glucose
As per requirement
12.
Injection Lignocaine Hydrochloride + Adrenaline
1%, 2% +Adrenaline 1:200,000 In vial 1.3
As per requirement
1.3 Preoperative Medication and Sedation for Short Term Procedures
13.
Injection Atropine Sulphate
0.6 mg / ml
As per requirement
14.
Injection Diazepam
5 mg Injection 5 mg / ml
As per requirement
15.
any other medication as decided by the concerned anesthetist
As per requirement
F.2 Emergency drugs
Category: Emergency Drugs
Minimum Quantity
Minimum 10 Ampoules/ Vials Minimum 10 Ampoules/ Vials Minimum 10 Ampoules/ Vials Minimum 10 Ampoules/ Vials Minimum 10 Ampoules/ Vials Minimum 10 Ampoules/ Vials Minimum 10 Ampoules/ Vials Minimum 10 Ampoules/ Vials Minimum 10 Ampoules/ Vials
Minimum 10 Ampoules/ Vials
Minimum 10 Ampoules/ Vials Minimum 10 Ampoules/ Vials Minimum 10 Ampoules/ Vials Minimum 10 Ampoules/ Vials Minimum 10 Ampoules/ Vials Minimum 10 Ampoules/ Vials Minimum 10 Ampoules/ Vials Minimum 10 Ampoules/ Vials Minimum 10 Ampoules/ Vials Minimum 10 Ampoules/ Vials Minimum 10 Ampoules/ Vials Minimum 10 Ampoules/ Vials Minimum 10 Ampoules/ Vials Minimum 10 Ampoules/ Vials Minimum 10 Ampoules/ Vials Minimum 10 Ampoules/ Vials Minimum 10 Ampoules/ Vials Minimum 10 Ampoules/ Vials Minimum 10 Ampoules/ Vials
Sr. no.
Name of the Drug
Strength
1.
Inj. Adrenaline
As per I.P.
2.
Inj. Atropine
As per I.P.
3.
Inj. Calcium Carbonate
As per I.P.
4.
Inj. Dopamine
As per I.P.
5.
Inj. Dobutamine
As per I.P.
6.
Inj. Nitroglycerine
As per I.P.
7.
Inj. Sodium Bicarbonate
As per I.P.
8.
Inj. Hydrocortisone
As per I.P.
9.
Inhaler Beclomethasone (250 micro/dose)
As per I.P.
10.
Inhaler Salbutamol (200 micrograms)
As per I.P.
11.
Inj. Frusemide
As per I.P.
12.
Inj. Diazepam/Midazolam
As per I.P.
13.
Inj. Deriphyllin
As per I.P.
14.
Inj. Phenytoin sodium
As per I.P.
15.
Inj. Avil
As per I.P.
16.
Inj. Ondansetrone
As per I.P.
17.
Inj. KCl
As per I.P.
18.
Inj. Lignocaine 2%
As per I.P.
19.
Inj. Amiadarone
As per I.P.
20.
Inj. Magnesium sulphate
As per I.P.
21.
Inj. Mannitol
As per I.P.
22.
Inj. Morphine/Inj. Pethidine
As per I.P.
23.
Inj. Noradrenaline bititrate
As per I.P.
24.
Inj. Fentanyl
As per I.P.
25.
water for Injection
As per I.P.
26.
Inj. Sodium Valporate
As per I.P.
27.
Inj. Voveran
As per I.P.
28.
Inj. Paracetamol
As per I.P.
29.
Mannitol Injection
As per I.P.
81
30.
Metoprolol Injection
As per I.P.
Minimum 10 Ampoules/ Vials
31.
N/2 saline Injection
As per I.P.
Minimum 10 Ampoules/ Vials
32.
Oxygen Inhalation
As per I.P.
Minimum 10 Ampoules/ Vials
33.
Oxytocin Injection
As per I.P.
Minimum 10 Ampoules/ Vials
F.3 General Drugs:
LIST OF MEDICINES / INSTRUMENTS / EQUIPMENTS /LAB REAGENTS / OTHER CONSUMABLES AND DISPOSABLES
Single Unani Drugs Unani Name
• Abhal
• Afsanteen
• Ajwain
• Amaltas
• Amba Haldi
• Amla
• Anisoon
• Anjbar
• Anjeer
• Aqaqia
• Aqarqarha
• Asabgol
• Asarun
• Asgandh
• Asl-us-Soos
• Atees
• Azaraqi
• Babchi
• Babool
• Badiyan
• Badranjboya
• Bakayin
• Balhchar
• Balela
• Baobarang
• Baqla
• Bazrul Banj
• Bedanjeer
• Bedmushk
• Beej Band
Beekh Baadiyan
Beekh Karafs
• Behidana
• Bisbasa
• Bisfayej
• Biskhapra
• Brinjasif
Botanical Name
Juniperus communisLinn.
Artemisia absinthium Linn. Trachyspermum ammi (Linn.) Sprague Cassia fistula Linn.
Curcuma amada Roxb.
Emblica officinalis Gaertn.
Pimpinella anisum Linn.
Polygonum bistorata Linn.
Ficus hispida Linn.f.
Acacia arabica Willd.
Anacyclus pyrethrum DC.
Plantago ovata Forsk.
Ruscus aculeatus Linn.
Withania somnifera (Linn.) Dun. Glycyrrhiza glabra Linn.
Aconitum heterophyllum Wall. ex Royle Strychnos nuxvomica Linn.
Psoralea corylifolia Linn.
Acacia arabica Willd.
Foeniculum vulgare Mill.
Melissa parviflora Benth.
Melia azedarach Linn.
Narbostachys jatamansi DC. Terminalia bellirica (Gaertn.) Roxb. Embelia ribes Burm. f.
Mentha longifolia (Linn.) Huds. Hyoscyamus niger Linn.
Ricinus communis Linn.
Salix caprea Linn.
Rumex maritimus
Foeniculum vulgare Mill
Apium graveolens
Cydonia oblonga Mill.
Myristica fragrans Houtt.
Polyjpodium vulgare Linn.
Trianthema portulacastrum Linn. Achillea millefoliumLinn.
82
• Chaksu
• Chiraita
• Chobchini
• Darchini
• Darunj-e-Aqrabi • Dhatura
• Enabus Saleb
• Filfil Daraz
• Filfil Siyah
• Gaozaban
• Ghariqoon
• Gheekawar
• Ghongchi Sufaid • Gilo
• Gular
• Gul-e-Babuna
• Gul-e-Banafsha
• Gul-e-Gurhal
• Gul-e-Madar
• Gul-e-Surkh
• Gul-e-Tesu
• Gulnar Farsi
• Gurmar Buti
• Halelah
• Halyun
• Hanzal
• Heel Kalan
• Heel Khurd
• Heeng
• Hina
• Inderjau Shireen • Inderjau Talkh
• Irsa
• Izhkhar
• Kahu
• Kaifal
• Kali Ziri
• Kamila
• Karanjwa
• Kateera
• Kattha
• Khatmi
• Khulanjan
• Khurfa
• Kishneez Khushk • Kulthi
• Madar
• Majeeth
• Marorphali
Cassia absus Linn.
Swertia chirayita (Roxb. ex Flem.) Karst.
Smilax china Linn.
Cinnamomum zeylanicum Blume
Dornoicum hookeri
Datura innoxia Mill.
Solanum nigram Linn.
Piper longum Linn.
Piper nigrum Linn.
Onosma bracteatum Wall.
Agaricusalba Linn.
Aloe barbadensis Mill.
Abrus precatorius Linn.
Tinospora cordifolia Miers
Ficus racemosa Linn.
Matricaria chamomilla Linn.
Viola odorata Linn.
Hibiscus rosa-sinensis Linn.
Calotropis gigantea (Linn.) Ait. f.
Rosa damascena Mill.
Butea monosperma (Lam.)
Punica granatum Linn.
Cephaelis ipecacuanha (Brot.) A. Rich.
Terminalia chebula Retz.
Asparagus officinalis Linn.
Citrulluscolocynthis (Linn.) Schrad.
Amomum subulatum Roxb.
Elettaria cardamomum (Linn.) Maton
Ferula foetida regel
Lawsonia inermis Linn./Jasminum sambac (Linn.) Ait. Wrightia tinctoria (Roxb.) R. Br.
Holarrhena antidysenterica (Roxb. ex Flem.) Wall. ex DC. Iris ensata Thunb.
Cymbopogon jawarancusa (Jones) Schult.
Lactuca sativa Linn.
Myrica esculenta Buch.-Ham. ex D. Don Syn.: M. nagi Thunb. Centratherum anthelminticum (Linn.) Kuntze
Mallotus phillipensis Muell.-Arg.
Caesalpinia bonducella Flem.
Cochlospermum religiosum (Linn.) Alston.
Acacia catechu Willd.
Althaea officinalis Linn.
Alpinia galanga (Linn.)Willd.
Portulaca oleracea Linn.
Coriandrum sativum Linn.
Dolichos biflorus Linn.
Calotropis gigantea (Linn.) Ait. f.
Rubia cordifolia Linn.
Helicteres isora Linn.
83
• Methi
• Mochras
• Mulethi
• Mundi
• Murmakki
• Musli Siyah
• Musli Sufaid
• Nana
• Narkachoor
• Neem
• Nilofer
• Parsioshan
• Podina
• Post Bekh-e- Madar • Pumbadana
• Rasaut
• Rewand Chini
• SaadKoofi
• Salab
• Sanna Makki
• Sarphokha
• Shahtara
• Shalgham
• Shitraj
• Sudab
• Suranjan Shireen
Sipistaan
Tirphala
Tuhkme Khatmi
• Talmakhana
• Tamar Hindi
• Tukhm-e-Kasni
• Tukhm-e-Kasoos
• Tulsi
• Turbud
• Ustukhuddus
• Zanjabeel
• Zaranbad
• Zarawand indica
• Zoofa
Compound Unani Drugs
• Araq-e-Badiyan
• Araq-e-Gaozaban
• Araq-e-Gulab
• Araq-e-Kasni
• Araq-e-Mako
• Araq-e-Mundi
Trigonella foenum-graecum Linn. Bombax malabaricum DC. Glycyrrhiza glabra Linn. Sphaeranthus indicus Linn. Commiphora myrrha (Nees) Engl. Curculigo orchioides Gaertn. Chlorophytum arundinaceum Bak. Mentha arvensis Linn.
Zingiber zerumbet Rosc ex Smith Azadirachta indica A. Juss. Nymphaea alba Linn.
Adiantum capillus-venerisLinn. Mentha arvensisLinn.
Calotropis gigantea (Linn) R.Br.ex Ait. Gosypyum herbacum Linn.
Berberis aristata DC.
Rheum officinale Baill.
Cyperus rotundus Linn.
Orchis latifolia Linn.
Cassia angustifoliaVahl Tephrosiapurpurea(Linn.) Pers. Fumaria indica Pugsley Brassica rapa Linn.
Plumbago zeylanica Linn. Ruta graveolens Linn. Colchicum luteumBak. Cordia latifolia
Embilica officinalis,Terminalia chebula,Terminalia beleria Althaea officinalis
Asteracantha auriculata Nees.
Tamarindus indica Linn.
Cichorium intybus Linn.
Cuscuta reflexa Roxb.
Ocimum sanctum Linn.
Operculina turpethum (Linn.) S. Manso Lavandula stoechas Linn.
Zingiber officinale Roscoe Curcuma zedoaria (Christm.) Rosc. Aristolochia indica Linn. HyssopusofficinalisLinn.
84
• Araq-e-Nana Araq e Zeera
• Habb-e-Dabba Atfal
• Habb-e-Hilteet
• Habb-e-Kabid Naushadri
• Habb-e-Kibreet
• Habb-e-Mudir
• Habbe-e-Papita (Desi)
• Habb-e-Rasnt
• Habb-e-Shifa
Habb e rewand
Habb e zaranbad
Habb e Gule Aakh
• Habb-e-Suranjan
• Itrifal-e-Kishneezi
Itrifal Mundi
• Itrifal-e-Mulaiyin
• Itrifal-e-Ustukhuddus
• Itrifal-e-Zamani
• Jawarish-e-Amla Sada
• Jawarish-e-Kamooni
• Jawarish-e-Zanjabeel
Joshand e Munzije balgham
Joshand e Sauda
Joshand e Safra
Joshand e Musaffi
Joshand e Mudir Haiz
Joshand e Zeequn Nafs
o Joshand e Mushil
• Khamira-e-Gaozaban Sada
• Khamira-e-Sandal Sada
• Kushta-e-Faulad
• Kushta-e-Gaodanti
• Kushta-e-Hajr-ul-Yahud
o Laaoq e Sapistan o Laaoq e Kataan
• Majoon-e-Dabeed-ul-Ward
• Majoon-e-Falasifa
• Majoon-e-Najah
o Majoon-e Ushba
o Majoon-e Halela
o Majoon-e Mocharas o Majoon-e Suparipak
• Majoon-e-Seer Alwi Khani
• Majoon-e-Suranjan
Marham e Dakhliyoon
Marham e Kafoor
Marham e Raal
85
Marham e Safeid
Nuqoo Nazla
Qurs Alkali
Qurs deedan
Qurs Jiryaan
Qurs Kushtae Faulaad
Qurs Kushtae Sadaf
Qurs Mulayyan
Qurs Muhazzil
Qurs Zarishk
Qurs Ziabetees sada
Qurs Ziabatees khas
• Raughan-e-Babuna Sada
• Raughan-e-Banafsha
• Raughan-e-Bedanjeer
Raughan-e- Gul
Raughan-e- Hindi
Raughan-e- Haft barg
Raughan-e- Kamela
Raughan-e- Neem
• Sharbat-e-Anjabar
Sharbat-e Aalobalu
Sharbat-e Bazoori
Sharbat-e Unnab
Sharbat-e Zanjabeel
• Sharbat-e-Banafsha
• Sharbat-e-Deenar
• Sharbat-e-Ejaz
• Sharbat-e-Sadar
• Sikanjabeen Buzoori Motadil
• Sufoof-e-Chutki
• Sufoof-e-Namak-e-Shaikh-ur-Raees
Sufoof-e-Bars
Sufoof-e-Beejband Khas
Sufoof-e-Dawae Pechish
Sufoof-e-Mullian
Sufoof-e-Sailaan
• Tiryaq-e-Arba
• Tiryaq-e-Nazla
• Banadiq-ul-Buzoor
• Dawa-ul-Kurkum
• Dayaqooza
• Habb-e-Azaraqi
Habb-e Bawaseer
Habb-e Kabid naushadri
Habb-e Muqil
Habb-e Musaffi khoon
Habb-e Rasout
86
Habb-e Shifa
Habb-e Tinkar
• Habb-e-Bohat-us-Saut Haad
• Habb-e-Ghafis
• Habb-e-Hindi Mohallil
• Habb-e-Hindi Sual
• Habb-e-Hindi Zeeqi
• Habb-e-Iyarij
• Habb-e-Momyaee Sada
• Habb-e-Muqil
• Itrifal-e-Deedan
• Jawarish-e-Barshasa
• Jawarish-e-Kundur
• Jawarish-e-Pudina
• Khamira-e-Banafsha
• Zimad-e-Sumbul-ut-teeb
• Zimad-e-Tehal
• Zimad-e-Waram-e-Pistan
• Zimad-e-Waram-e-Unsayain Muzmin
Zimad-e-Muhasa
Zimad-e-Massa
Zimad-e-Nana
• Zuroor-e-Qula Abyaz Zuroor zaj
G. Consumables
This includes the minimum quantity of the commonly used consumables in the facility which should be made available.
G.1 Surgical
S. no.
Surgical Consumables
1.
Bandage rolled
2.
caps & mask
3.
Catgut Chromic a)1 No., 2 No., 1-0 No, 2-0 N0, 8-0
4.
Clinical thermometer
5.
Developer
6.
Draw sheets
7.
ECG Paper Roll
8.
Ether Anesthetic 500ml
9.
Fixer
10.
Gown
11.
Halothane
12.
HIV Kits if necessary
13.
Hypodermic Needle (Pkt of 10 needle) No.19, 20, 21, 22, 23, 24, 25, 26
14.
Indicator tape for sterilization by pressure autoclave
87
15. Isopropyl Alcohol swab
16. IV Cannula
17. Leg drape
18. Mackintosh
19. Mask
20. Non Sterile Surgical rubber gloves
21. Plastic aprons
22. Prolene
23.
24.
25. Shaving blade –packet of 5
26. Small and large plastic bottle for keeping his to histo-pathological samples
27. Sterile sheets
28. Sterile disposable syringes
29. Sterile Dressing pads
30. Sterile Infusion sets(Plastic)
31. Sterile Surgical rubber gloves
32. Surgical Disposable
33. Surgical Gloves a)6 “, 6.1/2″, 7″, 7.5″
34. Surgical marking pens/permanent marker ink pen
35. Sutupak 1,1/0,2,2/0
36.
37. Tongue depressor
38. Ultrasound scan film
39. Unani Oral Rehydration powder
40. Vicryl No.1
41. X Ray film 50 film packet(in Pkt) size, 6.1/2×8.1/2″, 8″x10″, 10″x12′, 12″x15″
G.2 Dressing Material
Rubber Mackintosch Sheet in meter
Scalp vein sets no a)19, 20, 21, 22, 23, 24, 25, 26
Syringes 2ml,5ml,10ml, 20ml
S. no
Dressing Material
1.
Absorbent cotton I.P 500gm Net
2.
Adhesive plaster 7.5cm x 5mtr
3.
Adhesive tape
4.
Antiseptic cream
5.
Antiseptic solution
6.
Bandage cloth(100cmx20mm)
7.
Bandages
8.
Pad and Rolls
9.
Marham Hinna
10.
Marham Gulabi
11.
Rolled Bandage a)6cm,10cm,15cm
12.
Sterile & non sterile Gloves of different sizes
88
13.
Sterile cotton, gamjee pads, gauze pieces
14.
Surgical Gauze (50cmx18m)
15.
Suture removal
G.3Disinfectants: As applicable in adequate quantity
S. no
Disinfectants
1.
Hypochlorite 4%-6%
2.
Ortho-phthalaldehyde (OPA)
3.
70% ethanol plus10ppm Bitrex
4.
Formaldehyde solutions (1%–2%)
5.
Glutaraldehyde
6.
Hydrogen peroxide
7.
Quaternary ammonium compounds
8.
Phenolic germicides
G.4Tubing
S. no
Tubing
1.
Connecting tubing’s for endotracheal suction
2.
Connecting tubing’s for oxygen delivery
3.
Oxygen catheters
4.
Oxygen masks
5.
Suction catheters
6.
Foley catheters
G.5Linen
Sn
Linen
Clinic
1 to 50 beds
51 to 100 beds
101 to 200 beds
201 and above beds
1.Abdominal sheets for OT
–
30
30
30
30
2.Abdominal sheets for OT
–
6
10
25
25
3.Apron for cook
–
As per requirement
4.Bed sheets
–
200
300
400
500
5.Bed spreads
–
300
400
400
500
6.Blankets
–
one per bed
one per bed
one per bed
one per bed
7.Curtain cloth windows and doors
As per requirement
8.Doctor’s overcoat
one per doctor per year
89
9.Draw sheet for wards & OT
Two per bed
10H. ospital worker OT coat
one per worker per year
11L.eggings
as per patient load
12M. ackin tosh sheet (in meters)
one per bed
13M. ats (Nylon)
one per bed
14M. attress (foam) adults
one per bed
15P.aediatric Mattress
one per bed
1 6P . a t i e n t h o u s e c o a t (for female)
Two per bed
1 7P . a t i e n t s p a j a m a (for male) shirts
Two per bed
18to.wels
Two per bed
19P.ereneal sheets for OT
as per patient load
20P.illow covers
Two per bed
21P.illows
Two per bed
22T.able cloth
adequate quantity
23U.niform / Apron
As per requirement
G.6 Stationery
Sn
Item
1.
Consents Forms
2.
Continuation Sheets for IPD
3.
Continuation sheets for OPD
4.
Death Certificate Books
5.
Birth certificate book
6.
Diet Cards
7.
Diet Sheets
8.
Discharge cards
9.
Gynecological and Obst. Case sheets
10.
ANC Cards/book lets
11.
Immunization / Vaccination cards
12.
Indoor Admission Form & Case Sheets
13.
Intake Output Charts
14.
Medical Case Sheets
15.
Medico-Legal Forms
16.
Nursing Monitoring Forms
17.
OPD Forms
18.
Pathological Books
90
19.
Requisition forms for investigations
20.
Registers
21.
Registration Card
22.
Sentinel Event Form
23.
Supplementary Sheets
24.
Surgical Case Sheets
25.
Temperature and BP Charts
26.
Treatment Cards
27.
White Papers
28.
X-ray Forms
G.7 Adhesives and gels: NA G.8 Other: NA
H. Licenses
This includes the minimum statutory compliance applicable as per the central or state government along with licensing body.
Sr. no.
Name of the Act
Department/Area
Licensing body
1.
Registration under Shops and Establishment Act
Organization
Jurisdictional Authorities like Panchayat/ Nagarpalika/ Mahanagarpalika/ Municipality/ Municipal Corporation
2.
Registration under Clinical Establishment Act
Organization
Jurisdictional Authorities like Panchayat/ Nagarpalika/ Mahanagarpalika/ Municipality/ Municipal Corporation
3.
AERB clearances for CT/ MRI/ X ray & Radiation
Imaging
Atomic Energy Regulatory Board
4.
Agreement for Common Biomedical Waste Collection, Transportation, Treatment, Storage and Disposal Facility
Organization
Local Pollution Control Board
5.
Registration under Air (prevention and control of pollution) Act, 1981.
Organization
Local Pollution Control Board
6.
Approval of Radiation Safety Officer
Imaging
Atomic Energy Regulatory Board
91
7.
Boiler license under Indian Boiler Act, 1923
Boiler
Concerned regulatory Body
8.
Building Permit (From the Municipality).
To be obtained from
Jurisdictional Revenue Authorities like Panchayat/ Nagarpalika/ Mahanagarpalika/ Municipality/ Municipal Corporation
9.
Certificate for Narcotics & Psychotropic Substances
Pharmacy and / Hospital
Drug Controller
10.
Certificate of Registration under society act 1860
Organization
Registrar of societies/ Charity Commissioners office
11.
Certificate u/s 80-G of IT Act
Organization
If applicable.
12.
Class clearance certificate issued to manufacturer/ importer of mobile X ray equipment
Imaging
AERB Class Clearance issued to Manufacturer/ dealer of imaging equipment
13.
Commissioning approval of Linear Accelerator
Radiation Therapy
AERB
14.
ESIS registration in case of >20 employees
Organization
Employee State Insurance Company
15.
Excise permit to store Spirit.
Organization
Excise department
16.
Generator Exhaust air Quality Report
Generator
Authorized Air Testing Laboratory
17.
License to sale or distribute drugs Form 20, 21, 21C
Pharmacy
FDA
18.
License for lift
Lift
Mobile Electric Vehicles Department
19.
License to play music for public use
Organization
Indian
20.
No objection certificate from the Chief Fire Officer.
Organization
Fire Department
21.
Obtaining clearances for weighing equipments in all the hospital units under The Standards of Weights and
Weights and measures
Department of Weights and Measures
92
Measures Act, 1976.
22.
Occupation Certificate
To be obtained from
Jurisdictional Revenue Authorities like Panchayat/ Nagarpalika/ Mahanagarpalika/ Municipality/ Municipal Corporation
23.
PC PNDT Act, 1996.
Sonography
Health Department of Regulatory Body assigned with the responsibility
24.
Registration of births and deaths Act, 1969.
Organization
Health Department of Regulatory Body assigned with the responsibility
25.
SMPV License for Storage of Liquid Oxygen, Form III (License to compressed gas in pressure vessel or vessels)
Medical Gases in Pressurized Vessels
Licensing Authority
26.
TAN Number
Organization
Income Tax Department
27.
PAN Number
Organization
Income Tax Department
28.
Vehicle Registration certificates for Ambulance
Ambulance and Vehicles owned by the organization
Road Traffic Authority
29.
Water Prevention and control of pollution Act
Organization
Pollution Control Board
I. Basic Processes
I.1 Registration (This will help in developing a database at State / Central level).
1. Name,
2. Age,
3. Gender ,
4. Socioeconomic status
5. Address with PIN code,
6. Marital Status,
7. Contact Number,
8. Type of Diet (Veg, Non-veg),
93
9. CR/OP/ IP Number,
10. Date & Time of visit for OP/ admission for IP,
11. Diagnosis
12. Name of Treating Doctor
I.2 Assessment
1. Primary Complaint of the patient:
2. History of Primary Complaint:
3. History of Medication:
4. History of Implants/ Pacemaker/ Surgery:
5. Past History
6. History of allergies
7. Diet and Lifestyle History
8. Family History
9. Personal History
10. General Examination
11. Systemic Examination
12. Physical Examination
13. Pain Scoring
14. Nutritional Assessment
15. Mizaj assessment
16. Diagnosis Provisional / Final
17. Preventive Aspects
18. Plan of Care
19. Treatment
I.3 Infection Control
1. Cleaning: to be done with defined solution with dilution as advised by the manufacturer. Defined schedule with full cleaning at least once a day.
2. Disinfectants: Defined solution with dilution as advised by the manufacturer. Defined schedule with full cleaning at least once a day.
94
3. Advisable to have designated Infection Control Officer for hospital more than 50 beds.
4. Advisable to have designated Infection Control Committee for hospital more than 50 beds.
5. Infection control activities should be monitoring by define method & schedule.
I.4Safety considerations
(Surgical safety, infection control, biomedical waste, first aid & basic life support, disaster preparedness)
1. Following physical safety aspects shall be taken care in the hospital
1. AERB safety rules shall be followed in Radiology and other radiation areas.
2. All areas where a physical hazards may occur, like near DG set, transformer, Cylinder storage, electric panels, steep slope etc. shall be provided with safety signage and safety instructions
3. All balconies and opening on higher floors shall have grills
4. All bottles containing acids or alkalis shall be stored on cupboards at height below the shoulder level to prevent them from falling while taking out. It shall never be stored on height above the head level
5. All electric panels shall be enclosed in insulated and nonflammable box and shall be kept locked
6. All entry doors, windows and furniture shall be maintained in good maintained condition
7. All equipments, furniture awaiting condemnation shall be stored in separate condemnation area
8. All stretchers and wheelchairs shall have safety belts for fastening the patient
9. Anti-skid mats shall be placed on entrance of bathrooms
10. Boundary wall of the hospital’s campus shall be of sufficient height with metal fencing on top. Entire boundary wall shall be kept in intact condition
11. Corridors and passages shall not be blocked by chairs, tables or equipments
12. Displays of ‘floor is wet’ or ‘under repair’ or similar precautions in required areas and time shall be available with the hospital
13. Doors height shall be at least of 8 feet
14. Electric rooms shall not be used as store room or for any other purpose
15. Emergency exit routes shall be kept clear all the times
95
16. Hospitals ground shall be properly maintained. There shall be no openings, or pits in the ground. The surfaces shall be kept even
17. Lab shall be provided with safety equipments like eye wash cups
18. Material safety data sheet shall be available for all hazardous materials
19. No door shall open towards public areas like crowded lobby etc. (the door shall preferably open towards the inside of room)
20.No inflammable materials like, diesel, LPG, acids etc. shall be stored near electrical panel
21.Personal protective gears shall be available everywhere and in adequate quantity. These include gears like, gloves, masks, gowns, boots, caps, goggles etc. Earplugs shall be provided to staff in areas where there is continuous noise, like AC plant.
22. Protection from stray dogs and other animals shall be ensured in the hospital campus
23. Rubber matting shall be placed on the floors below electric panels
24. Seepage shall not be allowed in areas where electric panels or wires are present
25. Terrace should have side walls of at least 4 feet height
26. The beds shall have provision for providing side guardrails.
27.There should be no losing of electrical wiring. All electrical wiring shall be concealed and kept intact
2. Surgical safety
1. There are two independent identifiers for each patient. Name of patient with some other independent identifier.
2. Identification bands for patients should be considered in cases where patient cannot be relied upon to give correct information on his own identity. E.g. pediatric, disoriented, altered consciousness, etc.
3. Use of surgical safety check list based on WHO Criteria is used consistently for each procedure and surgical intervention. The Checklist should divide the operation into three phases, each corresponding to a specific time period in the normal flow of a procedure
a. the period before induction of anesthesia,
b. the period after induction and before surgical incision
c. The period during or immediately after wound closure but before removing the patient from the operating room.
4. In each phase the checklist task must be completed before proceeding forward.
96
3. Infectioncontrol:
1. Biological safety assessment is done for all areas of patient care and risks defined for the same.
a. Needle Stick Injury and related Transmissions
b. Patient to staff, patient to patient and staff to patient risk of transmission of diseases is addressed and preventive measures are instituted.
c. Procedure site and surgical site infections are monitored.
2. Preventive measures and remedies for correction are kept available wherever such risk exists.
3. Hand washing practices as per WHO recommended criteria are followed and monitored regularly.
4. Facility and consumables for hand washing are available tat convenient locations in the healthcare facility.
5. Adequate equipment and disposables related to personal safety for infection transmission are available to staff and patients in the organization. E.g. equipment like fogging machine, UV sterilizers, Insect Killer Machines and consumables such as Gloves, hand washing materials/ hand gels, surgical Masks, N95 Masks, industrial gloves, etc.
4. Biomedical waste:
1. Biomedical waste is collected, segregated, packed, transported and disposed according to the regulatory guidelines.
2. Biological Waste Management is monitored on regular basis.
3. Biomedical waste disposal is a part of infection control activities.
5. First aid & basic life support
1. At all times there is a staff member who is adequately qualified and is trained in giving at least Basic Life Support System.
2. Adequate qualifications will include qualified nurse or doctor from any specialization who has undergone training on Basic Life Support.
3. There will be a full resuscitation set maintained for use exclusively during such events, irrespective of existence of similar equipment anywhere else in the hospital.
6. Disaster preparedness: Mandatory for all hospitals of all sizes.
1. Healthcare organization must identify various possible disasters and prepare for the same by stocking necessary consumables, training adequate staff and conducting drills regularly.
2. Keeping equipment in a state of readiness for use during such events.
97
3. Separate stock is maintained as per the risk perceived for the anticipated disorder(s).
4. Keeping a back-up of consumables at all times in usable condition for use during disaster.
5. Personnel are trained for disaster management
6. Disaster drills are carried out at least once in six months for various disaster anticipated.
7. Anticipated list of disasters can include and is not restricted to any of:
a. Fire
b. Terrorist attack
c. Invasion of swarms of insects and pests.
d. Earthquake.
e. Civil disorders effecting the Organization.
f. Sudden failure of supply of electricity. (Disaster)
I.5 Clinical Records (including consents)
Sr. no
Records
1.
OPD/ IPD Records
2.
Treatment Orders
3.
Medication Records
4.
Procedure Records
5.
Nursing Monitoring Records
6.
Nursing Treatment Records
7.
Reports of investigations
8.
Consents: General Consent at admission, Procedure consents
I.6 Discharge
1. Discharge Summary should have following details:
a. Primary data of Name, Gender, Age, Address with PIN code, Marital Status, Contact Number, Type of Diet (Veg, Non-veg), CR/OP/ IP Number, Date of visit for OP/ admission for IP, Treating Doctor
b. Primary Complaint of the patient
c. History of Primary Complaint:
d. History of allergies
e. Salient Examination Findings
98
f. Investigations carried out
g. Pain Relief Advice
h. Nutritional Advice
i. Diagnosis – Final
j. Preventive Aspects
k. Treatment Given
l. Details of procedures performed
m. Treatment advised
n. Contact number in case of emergency
99
MINIMUM STANDARDS FOR
CLINICAL ESTABLISHMENTS OF
SIDDHA
100
MINIMUM STANDARDS FOR SIDDHA CLINICAL ESTABLISHMENTS
Categories of Clinical Establishments
I. Clinic
II. Dispensary
III. Therapy Centre IV. Hospital
i. Minimum 10 Beds ii. 11 to 25 Beds
iii. 26 to 50 Beds
iv. 51 to 100 Beds
V. Teaching Hospital
101
CONTENTS
SN A.
A.1 A.2 B. C. D. E.1
F.
F.1 F.1.1 F.1.2 F.1.3
F.1.4 F.1.5 F.2 F.2.2 F.2.3
F.3 F.3.1 F.3.2 F.3.3 F.3.4 F.3.5 F.4 F.4.1 F.4.2
G.
G.1
G.2 G.3
H.
H.1 H.2 H.3 H.4 H.5 H.6
I.
J.
TITLE PAGE
Introduction
Aim 104 Scope 105
Clinics, Dispensaries and Therapy Centres 106 Hospital 112 Core functions (Clinical services) 112
Auxiliary Functions (support services) 116
Physical Facilities
Space requirement 117 Minimum area 117 Functional space 118 Dimensions of the sub areas 121
Basic signage 122 Others 122 Furniture & Fixtures 123 Sundry Articles 128 Others 129
Engineering Services Requirements 129 Electrical Requirements 129
Plumbing Requirements 129 Civil Requirements 130 HVAC / AC / Ventilation / Cross Ventilation Requirements 130
Others* 130 Public Utilities 130 Potable drinking water 130 Sanitary Requirements 130
Equipment /instruments
Therapeutic equipment 131
Surgical equipment 135 Diagnostic equipment 137
Manpower
Medical practitioners 139
Therapists 141 Paramedics 141 Nurses 143
Administrative staff 143 Miscellaneous staff 144
Drugs 145
Consumables
102
J.1
Surgical
145
J.2
Dressing Material
146
J.3
Disinfectants
147
J.4
Tubing
147
J.5
Linen
148
J.6
Stationery
149
J.7
Consumables for Karanool
149
J.8
Laboratory
150
J.9
Leech Therapy
151
J.10
Suttigai
151
K.
Licenses
152
L.
Basic Processes
154
L.1
Registration
154
L.2
Assessment
154
L.3
Infection Control
154
L.4
Safety considerations
155
M.1
Clinical Treatment Records
157
M.2
Discharge
158
Teaching Hospitals
159
N.
References
160
O.
Abbreviations
160
103
In pursuance of notification of Clinical Establishments (Registration and Regulation) Act, 2010 on 28th February 2012, National Council for Clinical Establishments has been constituted and notified on 20th March 2012. One of the mandate for the council is to develop minimum standards of clinical establishments for achieving the objectives of the act.
Defining minimum standards for different types of clinical establishments would facilitate implementation of Clinical Establishments, Act 2010. The registration and regulation of clinical establishments will ensure the delivery of assured quality in health services. The enforcement of regulation measure for clinical establishments raises the level of confidence and faith in Siddha Medicine. There has been misleading advertisements by fake establishments which needs to be curbed by introducing the transparent system of control over them. It would also help other related service agencies like health Insurance and CGHS for empanelment and enlisting their service through them.
The standards thus framed will provide clear, unambiguous minimum requirement for different category of clinical establishments. There are no exclusions. They are dependent on the basic functions of the clinic/hospital/provider. All sections mentioned are Yes and include both structure and basic processes.
A.1.1. Aim
To develop minimum standards for clinical establishments of Siddha Medicine for Clinics, Dispensaries, Therapy Centres, Hospitals and Teaching Hospitals
A.1.2. Methodology
Department of AYUSH letter vide F.No.Z.25023/12/2013-DCC (AYUSH) dated 10-10-13 has directed to develop a draft standard for each category of AYUSH establishments. Accordingly, a meeting was convened with participation of all faculty members to appraise the background and need for preparing minimum standards.
Director has apprised about the notification issued for registration of clinical establishments and need for development of minimum standards of clinical establishments of various categories. Then, the survey report of Indian Medical Association has been examined through LCD projector to understand the prevailing standards of clinical establishments. The draft minimum standard of clinical establishments sent by Department of AYUSH was also examined to learn about the template and structure of the guidelines. The faculty members were sensitized regarding the process of clinical establishments of Siddha Medicines.
A.1.3. Formation of Core Committee
1. A core committee comprising 3 to 4 members for various sections of the report were formed. The identified sections were Introduction, Functions, Physical facilities, Equipments, Manpower, Drugs, Consumables, Licences, Basic Process and Bibliography. A member was given the responsibility of co-ordinating with all committee members
2. All the committee were given the copy of draft minimum standards prepared for Ayurveda and IMA report and directed to study the report for understanding the template and contents of report
104
3. After 2 days, the committee for “Introduction” section presented their views on different categories of Clinical establishments. After the deliberation and decided to list – Clinic, Minimum 10 Beds, 11-25, 26-50, 51-100, 101-200 > 200 and above considering the NABH.
4. The committee meant for “Functions” was asked to prepare the section B-Function within a week time and present in the next meeting considering the different categories of clinical establishments
5. The committee meant for “Functions” presented their report on B.1. Core functions (Clinical services) for OPD and IPD followed by Auxiliary functions
6. All the faculty members deliberated in detail about the identified speciality areas under ‘B.1.Core Functions” referring speciality education (Doctor of Medicine / Post Graduate Diploma) courses offered under CCIM regulations
7. With inputs from faculty members, the core functions were modified and a copy of draft was given to all members. All the committee members were directed to refer the functions and prepare the standards for each sections assigned to them for submission after a week time.
8. Then, a meeting held to deliberate on the draft report prepared by the respective committee. Each committee has presented their sections and discussed
A.1.4. Meeting in Department of AYUSH
1. Finally the draft report has been compiled and presented at the meeting convened by Dr.D.C.Katoch, Convenor on 13-11-2013 in Department of AYUSH
2. The outcome of the meeting was, categorisation of clinical establishments 1) Unambiguous understanding and intent for development of standards
2) Categorisation of Hospitals
3) Conceptualisation of different sections of minimum standards
3. In the light of outcome of the meeting in Department of AYUSH, a draft standard prepared
4. Review comments obtained from selected private Siddha practitioners
A letter vide No.K.25023/12/2013-DCC (AYUSH) dated 7-2-2014 from Department of AYUSH conveyed the classification of AYUSH Clinical Establishments with approval of Secretary (AYUSH) and directed to revise the standards of AYUSH clinical establishments. Then a meeting of selected faculty members under the Chairmanship of Director conducted on 13-2-2014 for preparing the documents.
A.2 Scope
This includes the services being provided by the facility to which the standards will be applicable (For example common minimum standards framed for a Dispensary are applicable to a Dispensary only and not to a single speciality hospital).
105
B.1. Definition: Clinic
CLINICS DISPENSARIES THERAPY CENTRES
Outdoor care facility managed by a single Siddha medical practitioner or a group of Siddha practitioners with or without a day care facility. No overnight stay or care is provided here. Care is provided by Siddha Medical Practitioner or a group of Siddha practitioners qualified in the concerned system of medicine having graduate or postgraduate qualifications
Dispensary
Outdoor care facility managed by a single Siddha medical practitioner or a group of Siddha practitioners with or without a day care facility along with dispensing unit. No overnight stay or care is provided here. Care is provided by Siddha Medical Practitioner or a group of Siddha practitioners qualified in the concerned system of medicine having graduate or postgraduate qualifications
Therapy Centre
Outdoor care facility managed by a single Siddha medical practitioner or a group of Siddha practitioners with day care facility providing at least any one of the 32 external therapies” or special therapies like Varmam, Yogam, Purgation, therapeutic emesis etc. Care is provided by Siddha Medical Practitioner or a group of Siddha practitioners qualified in the concerned system of medicine having graduate or postgraduate qualifications
B.2. Functions
Clinical Services
Clinic
Dispensary
Therapy Centre
General Siddha Care
Yes
Yes
Yes
32 External therapies@ / Special Therapies $
Optional
Optional
Yes
(At least any one of the procedure/therapy)
Dispensing medicines
Optional
Yes
Optional
@ 32 External Therapies
106
Sn
Name of the external therapy Procedure (Pura Marunthukal)
Description
1.
Dressing and Bandaging (Kattu)
The application of medicine made of botanicals, inorganic substances etc. to the affected area and bandaging it.
2.
Poultice (Patru)
Is a soft moist mass, usually made of herbals, which is applied in skin disease as emollient, anti-microbial and anti- allergic.
3
Fomentation (Õttradam)
Application of hot or cold packs topically.
4.
Painting (Poochu)
Application of liquid formulation locally.
5
Steam inhalation (Vethu)
1. A steam inhalation and steam application to either localized regions or the whole body.
2. Vapour inhalation. – Vapour bath / Steam bath.
6.
Medicated pouches (Pottanam)
Induction of perspiration by applying heat using heated packs of herbal powder.
7
Massage manipulation therapy (Thokkanam)
Special therapy consisting of 9 types of manipulation techniques such as pressing, pulling, moving, griping, and striking with fist with or without applying oil in the treatment especially of vatha diseases.
8
Fumigation (Pukai)
Artificial impregnation of the atmosphere, with the fumes or the smoke of any vegetable or aromatic substance, which is also used in inhalation therapy.
9
Opthalmic applications (Mai)
A method of applying drugs onto the mucous membrane of one or both eyes. The medication may be in the form of drops directly instilled in the eye or paste form applied in the inner margin of the lower eyelid.
10
Powder smearing (Podi thimiral)
Rubbing of the whole body with some medicinal substances.
11
Eye salve (Kalikkam)
Applying eye drops obtained by dissolving medicated pills in honey, breast milk, plant juice etc.
12
Nasal instillation (Naciyam)
A process by which the drug is administered through the nostrils.
13
Blowing (Oothal)
The physician chewing the medicated substance and blowing the aroma into the ears or nose of the patient.
14
Medicated snuff (Akkiranam)
Inhaling medicated substances in powder form.
15
Ointment (Kalimbu)
A viscous semisolid preparation used topically.
16
Medicated gauze/Plaster (Seelai)
i) Is a adjunct used for application to a wound in order to promote healing.
107
ii) A external covering used in the preparation of medicine.
17.
Medical water for wash (Neer)
Raw drugs are soaked in water or made into decoction to concentrate or powerfully potent substances are greatly diluted and used to wash wounds usually used as anti- septics.- Medicated water for wash.
18.
Medicated Wick (Vartthi)
Prepared by soaking the ribbon gauze in herbal juices/ decoctions/ substances that are ground well with herbals juices/decoctions.
19.
Cauterization (Suttigai)
Burning of the tissues to remove or close a part of it. Usually used to stop heavy bleeding.
20
Probe (Salagai)
The instrument used for probing. The probe has three faces and made of copper. It should be of 10cms in length and 60 grams in weight.
21
Ointment/Cream (Pacai)
A semi-solid lipid or resin/gum based applications.
22
Poultice (Kali)
Medicinal materials are mixed with rice flour or flour of any cereals or pulses and cooked.
23
Dusting powder (Podi)
Dry fine powder of herbs or inorganic substances used externally.
24.
Therapeutic fracture manipulation (Murichal)
Physical manipulation by which dislocated joints and malunited fractured bones are brought to their normal position by means of either simple reduction or breaking of malunited fractured bones, as it may require.
25.
Incision (Keeral)
A surgical procedure to remove accumulated pus, blood etc.
26
Caustic ablation (Karam)
Application of drugs to are to be excised or to chronic ulcers, wherein unwanted growth, slough and debris are removed and healing process in initiated. Application of caustic substances.
27
Leech application (Attai Vidal)
A procedure used to remove toxin from blood using leeches.
28.
Surgical procedures (Aruvai Chikichai )
A set of procedures includes incision, excision, scrapping, puncturing, probing, extraction, letting out of fluid etc.
29
Bone setting with bamboo splints (Kombu Kattal)
A procedure for immobilising the fractured bone using splints and bandages.
30.
Suction/ Aspiration (Urinjal)
Oral Suction of the accumulated fluids/pus/blood from abscess/ulcers by using instruments.
31
Blood letting (Kuruthi Vankal)
A procedure used to remove toxins from blood by blood letting.
32
Enema (Peechu)
Enema using medicated water or medicated oil to evacuate the bowels.
108
$ Special Treatment
1. Muthiyor maruthuvam (Geriatric Care)
2. Kuzhanthai Maruthuvam (Paedatric Care)
3. Moola Noigal (Ano-rectal disease)
4. Thottra Noigal (NCD Care)
5. Mano Noi (Psychiatric disease)
6. Narambu Noigal (Neurological disorders)
7. Enbu & Poruthu Noigal (Rhematology & Orthopaedics)
8. Thol Noigal (Dermatology)
9. Kan Noigal (Ophthalmology)
10. Aruvai Maruthuvam (Surgery)
11. Sool & Mahalir Maruthuvam (O & G)
12. Putru Noi (Cancer therapy)
13. Ootachathu Noigal (Nutritional disorders)\
B.3. Physical Facilities
B.3.1. Space Requirement
Clinic
Dispensary
Therapy Centre
Area
80 sq ft
100 sq ft.
200 sq ft.
Rest room
Optional
Yes
Yes
B.3.2. Furniture
Consultation Table
Yes
Y es
Yes
Consultation Chair
Yes
Yes
Yes
Stools / Chairs
Yes
Yes
Yes
Examination Table / Bed (6 x 2.5 ft)
Yes
Yes
Yes
Privacy Screen Around Examination Area
Yes
Yes
Yes
B.3.3. Equipments / Instruments
BP Appratus
Yes
Yes
Yes
Stethoscope
Yes
Yes
Yes
Knee Hammer
Yes
Yes
Yes
Tongue Depressor
Yes
Yes
Yes
Torch light
Yes
Yes
Yes
Clinical Thermometer
Yes
Yes
Yes
Wash Bason with Stand
Yes
Yes
Yes
Measuring tape
Yes
Yes
Yes
Surgical Cotton & Gauze
Yes
Yes
Yes
Neikkuri apparatus
Yes
Yes
Yes
Weighing machine
Yes
Yes
Yes
Name Display Board (Doctor Name, Qualification and Centre Name)
Yes
Yes
Yes
B.3.4. Engineering Services (Electrical & Plumbing)
Electrical – light facility
2
4
4
Electrical – points for use
1
3
3
109
Wash Basin
Optional
1
2
Fire & Safety measures
Optional
Optional
Yes
B.4.Manpower
Manpower
Clinic
Dispensary
Therapy Centre
Institutionally Qualified Siddha Physician
Yes
Yes
Yes
Pharmacist
(D.Pharm -Siddha /Diploma in Integrated Pharmacy / or Equivalent)
Optional
Yes*
Optional
AYUSH trained Multi Purpose Health Worker (MPHW)
Optional
Optional
Yes*
Others (House keeping & Security)
Optional
Optional
Optional
* At least one per 100 out patients.
B.5. Essential Documents / Records :
Records
Clinic
Dispensary
Therapy Centre
OPD Nominal Register
Yes
Yes
Yes
OPD Card / Book / Prescription Slip
Yes
Yes
Yes
Inventory Register (Furniture & Instruments)
Yes
Yes
Yes
Stock Register
(Main and / or Substore medicines)
Optional
Yes
Optional
Pharmaco-vigilance Record
Optional
Optional
Optional
Notifiable disease Register
Yes
Yes
Yes
Medical Certificate File / Forms
Yes
Yes
Yes
B.6. Drugs
++ As per Department of AYUSH notification – Essential Drug list, March 2013
Clinic
Dispensary
Therapy Centre
Essential Drugs ++
Optional
Yes
Optional
110
B.7. Miscellaneous
Display of Medical Registration Certificate
Yes
Yes
Yes
Potable Drinking water
Yes
Yes
Yes
Display of Clinical Establishment Registration
Yes
Yes
Yes
111
C.1. Scope :
D. FUNCTIONS
D.1 Core functions (Hospital)
HOSPITAL
Bed Strength
Scope of Services
Minimum 10 beds
Health Care facility with minimum 10 beds for indoor care and ability to monitor and treat patients requiring an overnight stay. Care is provided by Siddha Medical Practitioner or a group of Siddha practitioners qualified in the concerned system of medicine having graduate or preferably postgraduate qualifications
11to25 Beds
Health Care facility with 11 to 25 beds for indoor care and ability to monitor and treat patients requiring an overnight stay. Care is provided by a group of Siddha practitioners qualified in the concerned system of medicine having graduate or preferably postgraduate qualifications
26 to50 Beds
Health Care facility with 26 to 50 beds for indoor care and ability to monitor and treat patients requiring an overnight stay. Care is provided by a group of Siddha practitioners qualified in the concerned system of medicine having graduate or preferably postgraduate qualifications
51 to 100 Beds
Health Care facility with 51 to 100 beds for indoor care and ability to monitor and treat patients requiring an overnight stay. Care is provided by a group of Siddha practitioners qualified in the concerned system of medicine having graduate or preferably postgraduate qualifications
101 and above
Health Care facility with 101 beds and above for indoor care and ability to monitor and treat patients requiring an overnight stay. Care is provided by a group of Siddha practitioners qualified in the concerned system of medicine having graduate or preferably postgraduate qualifications
This section includes the basic services provided by Hospital. It is subdivided into two parts
1. Out-patients facilities – OPD with attached hospitals
2. In-patients facilities – IPD
(A UG / PG (any specialty) Siddha Doctor is enough to provide the clinical service)
112
1. Out-patient facilities – OPD with attached hospitals
( Out-patient facilities of health care organizations with Minimum 10 beds, 11 to 30, 31 to 50, 51 to 100, 101 and above bed strengths categories of clinical establishments).
S. No.
Services
Minimum 10 beds
In 11 to 25 beds
26 to 50 beds
51 to 100
101 and above
1.
General Siddha Medical Care
Yes
Yes
Yes
Yes
beds
beds
Yes
2.
Aruvai Maruthuvam
Optional
Optional
Optional
Optional
Optional
3.
Kann Maruthuvam
Optional
Optional
Optional
Optional
Optional
4.
Karuvakka Maruthuvam
Optional
Optional
Optional
Yes
Yes
5.
Kathu Mookku Thondai Maruthuvam
Optional
Optional
Optional
Optional
Optional
6.
Kayakarpam and Yogam
Optional
Optional
Yes
Yes
Yes
7.
Kuzhanthai Maruthuvam
Optional
Optional
Optional
Optional
Optional
8.
Mana Noi Maruthuvam
Optional
Optional
Optional
Optional
Optional
9.
Muthiyor Maruthuvam
Optional
Optional
Optional
Yes
Yes
10.
Nanju Maruthuvam
Optional
Optional
Optional
Optional
Optional
11
Neerizhivu Maruthuvam
Optional
Optional
Optional
Yes
Yes
12
Putru Noi Maruthuvam
Optional
Optional
Optional
Optional
Optional
13
Sool and Magalir Maruthuvam (Only antenatal care and Magalir Maruthuvam)
Optional
Optional
Optional
Optional
Sool and Magalir Maruthuv am
14.
Thol Maruthuvam
Optional
Optional
Optional
Yes
Yes
15.
Vatha Noi Maruthuvam
Optional
Optional
Yes
Yes
Yes
115
16.
Moola Noigal
Optional
Optional
Yes
Yes
Yes
17.
Thotra Noigal
Optional
Optional
Yes
Yes
Yes
18.
Narambu Noigal
Optional
Optional
Yes
Yes
Yes
19
Enbu Poruthu Noigal
Optional
Optional
Yes
Yes
Yes
20
Ootchathu Noigal
Optional
Optional
Yes
Yes
Yes
Gnaananthriya Suththi Parikara Murai (Udal Suththi)
S. No.
Services
Minimu m 10
In11to 25
26 to 50 beds
51 to 100
101 and above
1.
Aga Pura thilam/nei payanbadu (External Internal application of oil and ghee)
beds
Optional
Optional
Optional
beds
Aga Pura thilam/ nei payanbadu
bAegads Pura thilam/ nei payanbadu
2
Attai vidal
Optional
Optional
Optional
Optional
Optional
3
Enbu Murivou
Optional
Optional
Optional
Optional
Optional
4
Karanool sikichai(*infrastruct ure requirements will apply)
Optional
Optional
Optional
Optional
Optional
5
Kazhiththal
Optional
Optional
Optional
Kazhiththa
Kazhiththal
6
Kuruthi vellipaduthal
Optional
Optional
Optional
l Optional
Optional
7
Nasiyam
Optional
Optional
Optional
Optional
Optional
8
Peechu
Optional
Optional
Optional
Peechu
Peechu
9
Suttigai
Optional
Optional
Optional
Optional
Optional
10
Thalaikku ennai varppu
Optional
Optional
Optional
Yes
Yes
11
Vanthi
Optional
Optional
Optional
Vanthi
Vanthi
12
Vethu
Optional
Optional
Optiona
Vethu
Vethu
13
Thokkanam
Yes
Yes
Yes
Yes
Yes
14
Varmam
Optional
Optional
Optional
Yes
Yes
Maruthuvam
114
2. In-patient facilities – IPD
The inpatient department of the hospital shall have separate male and female wards and distribution of beds at the rate of 65 sq.ft. area per bed ward as under
The specialty services may be provided on call duty basis or full time basis
Clinical Services in IPD
S. No.
Services
Minimu m 10
In 11 to 25 beds
26 to 50
51 to 100 beds
101 and above beds
1.
General Siddha Medical Care
Yes
Yes
Yes
Yes
Yes
2.
Aruvai Maruthuvam
Optional
Optional
Optional
Optional
Optional
3.
Kann Maruthuvam
Optional
Optional
Optional
Optional
Optional
4.
Karuvakka Maruthuvam
Optional
Optional
Optional
Yes
Yes
5.
Kathu Mookku Thondai Maruthuvam
Optional
Optional
Optional
Optional
Optional
6.
Kayakarpam and Yogam
Optional
Optional
Yes
Yes
Yes
7.
Kuzhanthai Maruthuvam
Optional
Optional
Optional
Optional
Optional
8.
Mana Noi Maruthuvam
Optional
Optional
Optional
Optional
Optional
9.
Muthiyor Maruthuvam
Optional
Optional
Optional
Yes
Yes
10.
Nanju Maruthuvam
Optional
Optional
Optional
Optional
Optional
11.
Neerizhivu Maruthuvam
Optional
Optional
Optional
Yes
Yes
12
Putru Noi Maruthuvam
Optional
Optional
Optional
Optional
Optional
13
Thol Maruthuvam
Optional
Optional
Optional
Yes
Yes
14
Vatha Noi Maruthuvam
Optional
Optional
Yes
Yes
Yes
15
Neerizhivu Maruthuvam
Optional
Optional
Optional
Yes
Yes
16
Putru Noi Maruthuvam
Optional
Optional
Optional
Optional
Optional
17
Sool and Magalir Maruthuvam (Only
Optional
Optional
Optional
Optional
Sool and Magalir
beds beds
115
antenatal care and Magalir Maruthuvam)
Maruthuvam
18
Moola Noigal
Optional
Optional
Yes
Yes
Yes
19
Thotra Noigal
Optional
Optional
Yes
Yes
Yes
20
Narambu Noigal
Optional
Optional
Yes
Yes
Yes
21
Enbu Poruthu Noigal
Optional
Optional
Yes
Yes
Yes
22
Ootchathu Noigal
Optional
Optional
Yes
Yes
Yes
23
Attai vidal
Optional
Optional
Optional
Optional
Optional
24
Enbu Murivou
Optional
Optional
Optional
Optional
Optional
25
Karanool sikichai (*infrastructure requirements will apply)
Optional
Optional
Optional
Optional
Optional
26
Kazhiththal
Optional
Optional
Yes
Yes
Yes
27
Kuruthi vellipaduthal
Optional
Optional
Optional
Optional
Optional
28
Nasiyam
Optional
Optional
Optional
Optional
Optional
29
Peechu
Optional
Optional
Peechu
Peechu
Peechu
30
Suttigai
Optional
Optional
Optional
Optional
Optional
31
Thalaikku ennai varppu
Optional
Optional
Optional
Yes
Yes
32
Vanthi
Optional
Optional
Optional
Vanthi
Vanthi
33
Vethu
Optional
Optional
Optional
Vethu
Vethu
34
Thokkanam
Yes
Yes
Yes
Yes
Yes
35
Varma Maruthuvam
Optional
Optional
Optional
Yes
Yes
Puramaruthuva muraigal (External Therapeutic techniques)
Appropriate procedures may be applied on need based E.1 Auxiliary Functions (support services for ex – diagnostic)
(Central Laboratory for clinical diagnosis and investigations)- upto 50 bed IPD Hospital, this services may be outsourced or tie up with other Institutions / Laboratories
3. There shall be a central laboratory in the hospital complex with proper infrastructure and manpower for carrying out routine, pathological, biochemical and hematological investigations on the
116
patients referred from outdoor and indoor departments of the hospital.
4. There shall be a central Imaging- X-Ray unit in the hospital complex with proper infrastructure and manpower for carrying out routine, imaging investigations on the patients referred from outdoor and indoor departments of the hospital.
Support Services:
1. Accounting,
2. Ambulance services
3. Billing
4. Dietary services/ Canteen
5. Essential commodities like water supply, electric supply etc.
6. Finance
7. Financial accounting and auditing
8. Housekeeping and Sanitation
9. Inventory Management
10. Laundry services
11. Medical records
12. Medico legal
13. Office Management (Provision should be made for computerized
medical records with anti-virus facilities whereas alternate
records should also be maintained)
14. Personnel Department
15. Pharmacy/ dispensary
16. Purchase
17. Reception,
18. Security services
19. Stores
20. Waste management Housekeeping/ sanitation,
F. Physical Facilities F.1 Space requirement
This entails the minimum space required for carrying out the basic functions of the facility which includes:
F.1.1 Minimum area required for establishing the facility:
Type of Health Care Organization
Requirements
Stand alone building
Part of another building
1to10bed
As permitted under Development control rules, Floor Space Index,
Local regulations, etc.
Local regulations related to building structures, occupancy, etc. will be followed.
11to25
26to50
51 to 100
101 and above / Teaching Hospitals
117
F.1.2 Functional space planning of the facility like reception area, waiting area etc.
1. Consultation & examination room
a. Minimum 10ft. x 8 ft.
b. Consultation room should be adequate to accommodate:
i. Doctors table, Consultation chair, Two stools/ chairs,
ii. Examination bed of the size 6 ft X 2.5 ft.,
iii. Privacy screen around examination area while having free mobility
2. Treatmentrooms:
a. Maximum 30 Treatments/Day/Treatment Room.
b. Number of treatments will depend on type & nature of
treatments.
c. May include Puramaruthuvam treatment (External Therapy
procedures) alao.
3. Yoga Demonstration and practice rooms:
a. Yes for hospitals of size over 50 beds and above.
b. Room should be spacious enough for practicing Yoga, Meditation
etc.,
4. Pharmacy/Dispensary specs:
a. The pharmacy should be located in an area conveniently accessible
b. Temperature & humidity to be maintained as per the requirement of the stored medications.
c. The size should be adequate to contain 5 percent of the total clinical visits to the OPD in one session for hospitals more than 50 beds.
d. Pharmacy should have adequate medicine storage, compounding and dispensing facility for indoor and outdoor patients.
5. Entrance hall with reception area, enquiry counter, cash counter and record area
a. Preferably 100 sq. ft per 25 beds
6. Waiting area in entire organization
a. Preferably 100 sq. ft per 25 beds i.e. 10% seats of average number of patients visiting daily to hospital
7. Kitchen area: Applicable only if food is cooked in the hospital. Providing food is Yes for hospitals of size over 100 beds.
a. Kitchen area should be sufficient size to prepare food for inpatients as per diet advised by the physician
b. Kitchen layout and functioning should follow the flow of materials as: Entry-> washing->cutting-> cooking->loadingTo Serve
c. Utensil washing area is separate from the cooking area.
118
8. Medical Stores specs:
a. The medical store may be part of pharmacy or separate and secured.
b. Area should be clean, well ventilated, well lit, without any dampness or fungal growth on walls.
9. RMO Room / Quarters:
a. Minimum 1 room with attached bathroom & WC with ceiling fan, drinking water facility, intercom, mattress, pillows, blankets, bed sheets. Cupboards/ wardrobes.
10.Nursing station/ duty room (Nurses):
a. One nursing station/room per minimum 25 beds.
b. Nursing stations should be spacious enough to accommodate a table, requisite chairs, working platform, medicine racks, a work
counter, sinks, dress table, screen, pedal operated trash bins.
11.Clinical laboratory specifications:
a. Laboratory services can be outsourced or can be optional for hospitals up to 50 beds.
b. Laboratory services are mandatory for hospitals above 50 beds for quick diagnosis of blood, urine, etc., a small sample collection room facility shall be provided. The required area for collection and examination be atleast 150 sq.ft
c. Separate Reporting Room for doctors should be there.
12.Radiology section:
a. Role of imaging department should be radio-diagnosis and ultrasound along with hire facilities depending on the bed strength.
b. The department should be located at a place which is accessible to both OPD and wards and also to operation theatre department.
c. The size of the room should depend on the type of instrument installed.
d. It should confirm to AERB requirements.
e. The room should have a sub-waiting area with toilet facility and
a change room facility, if required.
f. Film developing and processing (dark room) shall be provided in
the department for loading, unloading, developing and
processing of X-ray films.
g. Separate Reporting Room for doctors should be provided.
13.Laundry (optional)
a. Laundry services can be outsourced or can be optional.
b. If it is provided in house, it should have necessary facilities for
drying, pressing and storage of soiled and cleaned linens.
119
c. If outsourced, disinfection of linen is carried out by the hospital before handing over the linen to the out-sourced organization.
14. Emergency Room specifications:
a. Emergency room should be spacious enough to accommodate a table, requisite chairs, working platform, medicine racks, a work counter, sinks, dress table, screen, pedal operated trash bins.
b. Station should accommodate nurses & doctors on duty at any time.
c. Room should allow free movement of wheel chair or trolley.
d. Emergency Room should preferably have different entry than the
hospital entry.
e. Access to Emergency Room should have a ramp for wheel chairs
and stretchers.
15. House-Keeping:
a.
b. c.
Housekeeping services should be made available for effective cleanliness.
Housekeeping services can be outsourced.
Designated areas within functional areas for housekeeping materials has to be in hospital
16.Security Services:
a. There is a designated location for each security staff on duty.
17.Medical record-room:
a. Medical record-room should be of adequate size as per the load of the documents of the hospital.
b. Tamperproof material and locking facility Cabinets/ cupboards/ Boxes will be used.
c. Fire extinguishers of correct type should be made available nearby all locations.
18.Store rooms:
a. Store room should be lockable & of adequate size with exhaust fan.
b. Area should be clean, well ventilated, well lit, without any dampness or fungal growth on walls.
19. Wards:
a. Treatment areas for male and female patients shall be segregated if managed as wards and there should be privacy for individual patients. Alternatively individual or sharing rooms can be used to segregate patients of different gender.
b. The ward planning will address minimization of the work for the nursing staff and shall provide basic amenities to the patients located within an area or unit.
c. Ward unit will include nursing station, preferably a treatment/ procedure room, nursing store and toilets as per the norms.
120
d. At the minimum one nursing station per ward of up to 25 beds will be provided.
e. There should be minimum 70 sq.ft. area per bed with 7 ft. distance between the mid-points of adjoining beds and at least 3 feet distance between the beds and 8 inch distance between the bed and the wall.
f. Width of the door to be at least 4 feet.
g. Permanent, semi-permanent or temporary partition should be
present between two beds.
h. Ward store area with lockable wall or steel cupboard(s).
20.Duty rooms for doctors
a. To accommodate 1 bed of 6 feet X 3 feet and a side table.
b. Separate beds if sharing for same gender.
c. Separate rooms for separate genders will be provided.
21.Duty rooms for nurses:
a. To accommodate 1 bed of 6 feet X 3 feet and a side table.
b. Separate beds if sharing for same gender.
c. Separate rooms for separate genders will be provided.
22.Duty rooms for technicians:
a. To accommodate 1 bed of 6 feet X 3 feet and a side table.
b. Separate beds if sharing for same gender.
c. Separate rooms for separate genders will be provided.
23.Dirty utility room:
a. Separate area of minimum 15 sq feet.
24. Pura Maruthuvam(External) Therapy Unit or treatment room:
c. The department is more frequently visited by out-patients and IPD patients but should be located at a place which may be at convenient access to both out-patients and in-patients with privacy.
F.1.3 Dimensions of the sub areas of the facility, including the flow of the processes which in turn will give a layout of the department /unit.
F.1.3.1 Specifications of the Pura Maruthuvam(External)Therapy Unit:
5. Yes if procedures are done.
6. Room Size: Minimum 10 ft. X 10 ft. (As size of massage table/ Droni is 7ft
X 3 ft. the size of room should be 10ft X 10 ft.)
7. Separate Unit is proposed for male & female with attached toilet and
bathroom
8. Optional and depending on work load. If more than 30 procedures are
carried out per day, separate rooms should be provided.
F.1.3.2 Specifications of the Minor OT for Kaara Nool Chikitsai:
1. Minor OT is Yes if surgical procedures are provided in any hospital.
121
2. Minor OT room should have sterile zone of at least 10 ft X 10 ft; Size is exclusive of clean zone, independent enclosure to accommodate Kaara Nool Chikitsai equipment & maintaining adequate privacy.
3. Sterilization room: adequate to accommodate sterilization equipment & sterilized material.
4. Separate disposal zone for storage of waste as per bio-medical waste management rules.
F.1.4 Basic signage
3. A signage within or outside the facility should be made available containing the following information.
4. All signage meant for patients and visitors shall be bilingual – Local language and Hindi / English.
F.1.4.1 Name of the care provider with registration number,
3. Name of organization.
4. Display of Registration under clinical establishment act
5. Name of Doctor, Qualification, Registration Number
F.1.4.2 Fee structure,
3. Display of tariff list at OPD & IPD.
4. Display of citizen charter in OPD and IPD
F.1.4.3 Timings of the facility
2. Display of OPD timings with names and respective specializations of consultants in OPD & IPD Duty Doctor, Nurse, Attendant details – wardwise
F.1.4.4 Services provided
9. Directional signage at main entrance towards OPD & IPD
10. Directional signage for patients for utilities and conveniences like
toilets, drinking water, telephone booths, shops
11. Directional signage within the hospital building for all departments
within the building
12. Display of department / area name on the entrance of each area / room
/ counter
13. Display of hospital layout at various entrances in the hospital
14. Display of hospital’s scope of services at OPD, IPD and at Campus
entrance
15. Floor Plan With Location Of Departments
16. Plan of Facility
17.usages: departments, OPD & IP room & wards, waiting areas,
F.1.5 Others
21. Display of all radiation hazard signage in radiation areas (if applicable).
22. Display of Biomedical waste segregation at all location where BMW
bins are kept
23. Display of danger signage at all electric panels and other dangerous
areas
122
24. Display of General instructions like ‘No Smoking’, ‘Keep Silence’, ‘Use dustbin’, etc. at various patient and visitor areas in the hospital
25. Display of hand–washing techniques compliant with WHO guidelines at all hand wash basins
26. Display of how to use fire extinguisher at all point where fire extinguisher is installed
27. Display of important phone contact numbers of hospital authorities
28. Displays required by regulations like PC PNDT, Lifts, Fire, etc.
29. Display of Material Safety Data Sheet at all locations where Hazardous
Materials are stored
30. Display of patient rights and responsibilities in OPD, IPD and
emergency
31. Display of safety instructions in areas where any kind of safety hazard
may be expected. This includes areas like transformers, Cylinder
storage, LPG storage etc.
32. Emergency exit signage (preferably in auto illumination material, like
radium)
33. Fire Protection
34. Hazards- electrical, fall, pipe locations, prohibited areas
35. Notice board for general information to staff
36. Notice board in front of all OPD and IP Wards.
37. Notice board in Minor Operation theatre
38. Routes for all areas
39. Signage for parking. (Signage for ambulance parking shall be separately
mentioned)
40. Safety signage will be displays as per the requirements of respective
Indian Standards: Ex. Fire Protection Safety Signs IS 12349:1988
F.2 Furniture & Fixtures:
This will entail the details about the furniture and sundry items
commensurate to the service delivery requirements. C.2.1 Furniture/Fixture Requirements:
1: Furniture / Fixture Requirements for Outpatient Department (OPD)
Sl. No.
Name of the Equipment
Minimum 10 bedded Hospital
11-25 bedded Hospit al
26-50 bedded Hospital
51-100
bedded Hospital
101 and above bedded hospital
(Per Consulting Room)
1.
Room with well-lighted and ventilated and equipped with a chair and a table for doctor
1
1
1
1
1
2.
X-ray viewer
1
1
1
1
1
3.
two chairs for patients & attendants
1
1
1
1
1
123
4.
An examination table of 6 ft. X 2.5 ft. With privacy screen
1
1
1
1
1
5.
Blood pressure apparatus,
1
1
1
1
1
6.
Stethoscope
1
1
1
1
1
7.
Torch,
1
1
1
1
1
8.
Thermometer
1
1
1
1
1
9.
Weighing machine.
1
1
1
1
1
10.
Essential diagnostic tools required for examination of patients as per the scope of services offered by the hospital.
As required
11.
Light source which gives light colour and temperature similar to solar light,
Light intensity of at least 500 lux at the point of examination.
As required
12.
Refrigerator if temperature sensitive medication are stored (if required)
1
1
1
1
1
13.
Telephone Equipment – (Intercom)
As required
14.
Air conditioning
As required
15.
Adequate lockable storage space
As required
16.
Foot stools
1
1
1
1
1
1 Per-CR means 1 per Consultation Room
124
2. Furniture / Fixture Requirements for In-Patient Department (IPD) – Male and Female ward separately:
Sr. No.
Name of the Equipment
Minimum 10 bedded Hospital
11-30 bedded Hospital
31-50 bedded Hospital
51-100 bedded Hospital
101 and above bedded hospital
1.
Adequate wall or steel Cupboards
1
2
2
4
8
2.
Arm Board Adult
1
3
6
12
24
3.
Back rest
1
1
2
4
8
4.
Bain Marie trolley stainless steel 1 per floor
1 per floor
5.
Bed side cabinets
1 per 5 patients
6.
Bed side Screen
1 per ward or full length curtains between the beds
7.
Bucket Plastic
2
5
6
12
24
8.
Ceiling Fans
As required
9.
Clock 1per ward
1 per ward
10.
Containers for kitchen
As required
11.
Doctor’s chair for OP & ward,
As required
12.
Doctor’s or Office table
1
2
3
3
10
13.
Dressing trolley-1 per floor/ ward depending on layout
1
2
2
4
8
14.
Dust bins in each ward & consultation room
1
1
3
6
12
15.
Duty table for nurses
1
2
4
8
20
16.
Emergency resuscitation kit
1 per floor
17.
Enema Set
1
2
2
4
4
18.
Fire extinguisher
ABC 1 per ward/ floor based on layout
19.
Foot stools
2
4
8
16
25
20.
Refrigerator
1 Per Area/ Ward
21.
Heavy duty Torch light
1 per ward
22.
Hospital Cots
10
As per beds
23.
Hospital Cots Pediatric
As required
24.
Hot Water Bags 2 per
2 per ward
125
ward
25.
Hot Water geyser
2 per ward
26.
I V Stands – 2 per 10 beds
2
As required
27.
Infra-Red lamp
1
2
3
5
10
28.
Intercom System
2 per ward
29.
Kidney Trays1 per 5 beds
2
5
10
20
50
30.
Kitchen utensils,
Adequate
31.
Massage table of 7ft. x 2.5 ft (wood or fiber)
One per procedure room
32.
Medicine trolley
1 per ward
33.
Office chairs
2
2
4
8
20
34.
Office Table
1
2
3
6
10
35.
patient Beds with side rails
20% of total beds
36.
Patient call Bell System
1 per bed
37.
Patient locker
1 per bed
38.
Patients examination table– 1 per ward/ floor as per the profile of patients & layout of facility
1 per ward/ floor as per the profile of patients & layout of facility
39.
Patients side table
1 per bed
40.
Pediatric cots with railings as per scope of services
as per scope of services
41.
Steel or Wooden cup board
2
4
8
16
20
42.
Steel rack
1
2
5
10
20
43.
Stool 1 Per Bed
10
As required
44.
Stretcher/ Patient trolley – 1 per ward
1 per ward
45.
Urinal Male and Female
(For every 10 bed)
2 (1-M,1-F)
4 (2-M 2- F)
As required
As required
As required
46.
waiting chairs / benches for patients relatives
50% of the bed strengths
47.
Weighing Machine
1 per ward
126
48.
Wheel chair
1
2
3
4
5
49.
Wooden massage bed
One per SR
50.
X-ray viewer
one per ward
SR – Service Room
3. Furniture / Fixture Requirements for Pura Maruthuvam Therapy Room
Sr. No.
Name of the Equipment
Minimum 10 bedded Hospital
11-25 bedded Hospital
26-50 bedded Hospital
51-100 bedded Hospital
101 and above bedded hospital
Per Service Room
1.
Appropriate stand to fix droni : 2.5ft. height
1
1
1
1
1
2.
Arm chair
1
1
1
1
1
3.
Droni: Minimum 7ft. x 2.5ft (wood or fiber)
1
1
1
1
1
4.
Footstool
1
1
1
1
1
5.
Gas/Stove
1
1
1
1
1
6.
hamox stretchers / Stretchers with wheels
1
1
1
1
1
7.
Heating facilities
1
1
1
1
1
8.
Hot water bath
1
1
1
1
1
9.
IV stands
1
1
1
1
1
10.
Massage table of 7ft. x 2.5 ft (wood or fiber)
1
1
1
1
1
11.
Mixture/Grinder/Churner
1
1
1
1
1
12.
Plastic aprons, gloves and mask
1
1
1
1
1
13.
Pressure cooker (5 liters) meant for Vedhu
1
1
1
1
1
14.
Thalaikku Ennai Varppu stand and table
1
1
1
1
1
15.
Stool
1
1
1
1
1
16.
Sufficient light and ventilation
1
1
1
1
1
17.
Viyarvai chamber
1
1
1
1
1
18.
Vanthi set
1
1
1
1
1
19.
Vanthipeedam (Adjustable chair)
1
1
1
1
1
20.
Wheel chairs
1
1
1
1
1
21.
For Peechu
22.
OT Table having bars for giving lithotomy position
1
1
1
1
1
23.
Revolving stools
1
1
1
1
1
24.
Focus lamp
1
1
1
1
1
127
25.
Torch
1
1
1
1
1
26.
Good light source
1
1
1
1
1
27.
Karanool sikichai cabinet
Optional
28.
OT table / Lithotomy Table with Side Railings
1
1
1
1
1
29.
OT light
1
1
1
1
1
30.
Attai Vidal (Leech Therapy)
Optional
31.
Storage Aquarium for fresh leeches: 20-25 liters capacity (may be with partitions)
5-10
5-10
5-10
5-10
5-10
32.
Glass containers (1 liter capacity) for storing used leeches:
1
1
1
1
1
33.
Examination table
1
1
1
1
1
34.
Surgical Trolly
1
1
1
1
1
F.2.2 Sundry Articles Requirement
Furniture / Fixture Requirements – Hospital Fittings & Necessities
Sr. No.
Name of the Equipment
Minimum 10 bedded Hospital
11-25 bedded Hospital
26-50 bedded Hospital
51-100 bedded Hospital
101- 200 bedded hospital
1.
Air conditioners for OT
Optional
Minimum 1
2.
Ambulance
Optional
Minimum 1
3.
Ceiling / wall Fans
As required
4.
Clock
1 per ward
5.
Coolers
As required
6.
Drinking Water purifier
1
2
4
6
10
7.
Emergency lamp
2 Per Area/ Ward
8.
Emergency trauma set
2 per ward
9.
Exhaust Fan
As required
10.
Fire extinguishers
As required
11.
Geyser
1 per ward
12.
Refrigerator
1 per ward
13.
Storage Geyser
1 per ward
14.
Tables & Chairs
As required
15.
Telephone/ cell phone
1 per ward
16.
Tube lights
As required
17.
Vacuum cleaner
As required
128
F.2.3 Others
Sr. No.
Name of the Equipment
Minimum 10 bedded Hospital
11-26 bedded Hospital
26-50 bedded Hospital
51-100 bedded Hospital
101 and above bedded hospital
1.
Computer with Modem with UPS, Printer with Internet Connection
Minimum 1
Minimum 2
Minimum 2
Minimum 3
Minimum 4
2.
Photocopier Machine
Minimum 1
3.
Intercom (10 lines)
As needed
4.
Fax Machine
Minimum 1
5.
Telephone
One per organization
6.
Public Address System
Covering Indoor and OPD Areas
F. 3 Engineering Services Requirements
This will include the detail information about the basic requirements including
F.3.1 Electrical Requirements
7. At least 3 hours backup or generator for critical areas
8. Primary electrical Supply is available as provided by the local utility
provider. Lighting back up for at least 1 hour covering all functional areas
must be available during the functioning time.
9. Primary electrical Supply as supplied by utility provider. Emergency
backup for at least 3 hours backup for electricity & for lighting and critical equipment must be available during the functioning time. Take over time must be less than 30 seconds. Electric supply to lighting will be backed up with UPS/ Inverter/ Battery.
10.The illumination in the hospital is provided as per the prescribed standards.
11.Shadow less lights should be provided in operation theatres and delivery rooms.
12.Emergency portable light units should be provided in the wards and departments.
F.3.2 Plumbing Requirements 2. For in-patient department
d. No. of Wash basins
i. 1 for every 10 beds or part thereof
ii. Doctor, staff, patients and visitors have an access to wash basin(s);
129
e.
f.
iii. Procedure hand wash basins are separate and located close to procedure area.1 for every 10 beds or part thereof
No. of Water closets
i. 1 for every 6 beds or part thereof
ii. Separate water closets are available for use for outpatient and in-patient areas.
iii. For in-patient areas the water closets are provided in the ratio of 1 per 6 beds and are located close to patient care areas.
No. of bathrooms
i. Minimum 1 bathroom per 6 beds/ one for each ward rooms
ii. Minimum 1 bathroom per 6 beds/ one for each therapy rooms
F.3.3 Civil Requirements
7. Space between 2 rows of beds in a ward should be minimum 5 ft.
8. Distance between 2 beds should be minimum 3.5 ft. if more than one bed is
present
9. If clinic has beds then: measured between the facing borders of adjoining
beds there shall be at least 3 feet of distance if the beds are mobile and provided with functional wheels and at least 4 feet if beds do not have functional wheels.
10. If there are no beds then this requirement is not applicable.
11. Size of hospital bed should be minimum 6’ x 3’
12. Area per bed should be Minimum 50 sq. ft. / bed
F.3.4 HVAC / AC / Ventilation / Cross Ventilation Requirements
4. Air-conditioning and Room Heating in operation theatre and neo-natal units should be provided.
5. The ventilation in the hospital may be achieved by either natural supply or by mechanical exhaust of air.
6. Cross ventilation/ Mechanical ventilation by fans and or exhausts to achieve comfortable environment without noxious odours.
F.3.5 Others
2. Air coolers or hot air convectors may be provided for the comfort of patients and staff depending on the local needs.
F.4 Public Utilities F.4.1 Safe drinking water
3. Round the clock availability of safe drinking water for patients, staff and visitors.
4. Hospital should be provided with water coolers and refrigerator in wards and departments depending upon the local needs.
F.4.2 Sanitary Requirements
5. Arrangement should be made for round the clock piped water supply along with an overhead water storage tank with pumping and boosting arrangements.
130
6. Approximately 10000 liters of potable water per day is required for a 100 bedded hospital.
7. Separate provision for fire fighting should be available.
8. Water softening plant should be considered where hardness of water is a
major problem.
Drainage and Sanitation
3. The construction and maintenance of drainage and sanitation system for waste water, surface water, sub-soil water and sewerage shall be in accordance with the prescribed standards. Prescribed standards and local guidelines shall be followed.
4. Waste Disposal System:
National guidelines on Bio-Medical Waste Management and a Notification
of Environment and Forests are at Annexure – I.
G. Equipments /instruments
This includes the type, number, minimum specification & functionality of
equipments required in the facility under the following headings.
G.1 Therapeutic equipments
1. Equipments / Instruments Requirements for Outpatient Department
Sl. No.
Name of the Equipment
10 bedded Hospital
11-25 bedded Hospital
25-50 bedded hospital
51-100 bedded hospital
101 & above Bedded hospital
1.
A chair and a table for doctor
1 perCR
2.
X-ray viewer
1 perCR
3.
An examination table of 6 ft. X 2.5 ft. With privacy screen
1 perCR
4.
Blood pressure apparatus,
1 perCR
5.
Stethoscope
1 perCR 1 perCR
1 perCR
6.
Torch
1 perCR 1 perCR
7.
Thermometer
1 per CR
8.
Weighing machine.
1 perCR
9.
Light source which gives light colour and temperature similar to solar light, Light intensity of at least 500 lux at the point of examination.
Minimum 1
As required
10.
Knee Hammer
Minimum 1
131
11.
Otoscope
As required
12.
Tuning Fork (minimum)
1
1
2
3
3
13.
Measuring Tape(minimum)
1
2
2
3
3
14.
Tongue Depressor ( minimum)
2
3
3
4
5
15.
Glucometer
As required
2: In-Patient department (IPD)
2. Equipments / Instruments for in-patient department (IPD)
Sr. No.
Name of the Equipment
10 bedded Hospital
11-25 bedded Hospital
26 -50 bedded hospital
51-100 bedded hospital
101 & above bedded
1.
Ambu bags
1
1
1
1
1
2.
Arm Board Adult
1/ward
1/ward
1/ward
1/ward
1/ward
3.
Autoclave Drums
2
6
9
12
12
4.
Back rest
2
4
8
20
20
5.
Bain marie trolley stainless steel 1 per floor
—
1
2
4
4
6.
Bed pans, 1 per 5 patients
2
12
12
25
7.
Biomedical waste colour code bins
Each per floor
40
8.
Cheatle forceps assorted
5
8
10
10
9.
sizes
Clock per ward
1 per ward
10
10.
Containers for kitchen
As required
11.
Dressing trolley-1 per floor/ ward depending on layout
1 per ward
12.
Dust bins in each ward & consultation room
1 per ward
13.
Emergency resuscitation kit
1 per floor
14.
Enema Set
As required
15.
Refrigerator
As required
16.
Heavy duty Torch light
1 per ward
17.
Hot Water Bags
2 per ward
18.
I V Stands – 2 per 10 beds
2 per 10 beds
19.
Infra-Red lamp
3
3
5
10
15
132
20.
Instrument tray – minimum 1 per ward
minimum 1 per ward
21.
Intercom System
As required
22.
Kidney Trays
1 per 5 beds
23.
Massage table of 7ft. x 2.5ft (wood or fiber)/ Wooden massage bed
1 per treatment room
24.
Medicine trolley
minimum 1 per ward
25.
Needle cutter – 3 per ward
1 per ward
26.
Non mercury Thermometer clinical – 1 per ward
1 per ward
27.
O2 cylinder with spanner – 1 per ward
1 per ward
28.
Patients examination table– 1 per ward/ floor a per the profile of patients & layout of facility
1 per ward
29.
Sphygmomanometers- Stand Type 1& Portable (aneroid or Digital) Type X 1 – 1 per ward
1 per ward
30.
Stretcher/ Patient trolley – 1 per ward
1 per ward
31.
Weighing Machine – 1 per ward
1 per ward
32.
X-ray viewer – one per ward
1 per ward
33.
Nebulizer
—
—
—
—
1 per ward
133
3. Equipments / Instruments Karanool / Leech therapy Room I Karanool
Sr. No.
Name of the Equipment
10 bedded Hospital
11-25 bedded Hospital
26-50 bedded hospital
51-100 bedded hospital
101-200
Bedded hospital
55.
Karanool cabinet
Optional
56.
OT table / Lithotomy Table with Side Railings
Optional
Optional
Optional
Optional
1 /Theatre
57.
OT light
Optional
Optional
Optional
Optional
1 /Theatre
58.
Autoclave
Optional
Optional
Optional
Optional
1 /Theatre
59.
Autoclave Drum/ tray(s)
Optional
Optional
Optional
Optional
1 /Theatre
60.
Consumables
Optional
Optional
Optional
Optional
1 /Theatre
61.
crash cart
Optional
Optional
Optional
Optional
1 /Theatre
62.
Sterile apron
Optional
Optional
Optional
Optional
1 /Theatre
63.
OT instruments
Optional
Optional
Optional
Optional
1 /Theatre
64.
OT light
Optional
Optional
Optional
Optional
1 /Theatre
65.
Surgical trolley
Optional
Optional
Optional
Optional
1 /Theatre
66.
Torch (Medium Size)
Optional
Optional
Optional
Optional
1 /Theatre
67.
Karanool Probes
Optional
Optional
Optional
Optional
As required
68.
Steriliser
Optional
Optional
Optional
Optional
Min 1
69.
Pedestal Shadowless lamp
Optional
Optional
Optional
Optional
Min 1
70.
Surgical Instruments
Optional
Optional
Optional
Optional
As needed
II Attai Vidal (Leech Therapy):
Sr. No.
Name of the Equipment
10 bedded Hospital
11-25 bedded Hospital
26-50 bedded hospital
51-100 bedded hospital
101-200
Bedded hospital
71.
Storage Aquarium for fresh leeches: 20-25 liters capacity (may be with partitions)
Optional
72.
Glass containers (1 liter capacity) for storing used
Optional
134
leeches:5-10 (for each patient requires separate container and the number may vary according to the number of patients)
73.
Examination table
Optional
74.
Surgical trolley
Optional
75.
Leeches :As per the requirement, usually 3-5 leeches per patient/ treatment period)
Optional
76.
Surgical tray
Optional
77.
Instruments : Different types of Forceps, Scissors, Needles, Suturing material etc. (as per requirement)
Optional
78.
As per requirement: Dressing tray with gloves, bandage cloth, bandages etc.
Optional
79.
Materials: Turmeric, Saindhavalavana, Jatyadi ghrita, honey. (as per requirement)
Optional
G.2 Surgical equipments
1. Equipment Requirement for Minor Operation Theatre (MOT)
Sl. No.
Name of the Equipment
10 bedded Hospital
11-25 bedded Hospital
26-50 bedded hospital
51-100 bedded hospital
101 & above Bedded hospital
1.
Anterior vaginal wall retractor
Optional
Optional
Optional
Optional
As needed
2.
Artery forceps
Optional
Optional
Optional
Optional
As needed
3.
Auto Clave HP Vertical (2 bin)
Optional
Optional
Optional
Optional
As needed
4.
Autoclave equipment for sterilization/Sterilizer
Optional
Optional
Optional
Optional
As needed
Bla5d.der sound (Urethral dilators) of different sizes
Optional
Optional
Optional
Optional
As needed
135
6.
Crash Cart with lifesaving drugs and Resuscitation Kit
Optional
Optional
Optional
Optional
As needed
7.
Cusco’s Speculum
Optional
Optional
Optional
Optional
As needed
8.
Diathermy Machine (Electric Cautery)
Optional
Optional
Optional
Optional
As needed
9.
Disposable syringes (5-10cc)
Optional
Optional
Optional
Optional
As needed
10.
Enema Pot
Optional
Optional
Optional
Optional
As needed
11.
Focus lamp Ordinary
Optional
Optional
Optional
Optional
As needed
12.
Foley’s Catheter
Optional
Optional
Optional
Optional
As needed
13.
Formaline dispenser
Optional
Optional
Optional
Optional
As needed
14.
General Surgical Instrument Set Piles, Fistula, Fissure
Optional
Optional
Optional
Optional
As needed
15.
Instrument Trays of various Sizes
Optional
Optional
Optional
Optional
As needed
16.
Instrument Trolley
Optional
Optional
Optional
Optional
As needed
17.
IV stands
Optional
Optional
Optional
Optional
As needed
18.
Kidney tray
Optional
Optional
Optional
Optional
As needed
19.
Knife and scissor1 each
Optional
Optional
Optional
Optional
As needed
20.
L. P. Tray
Optional
Optional
Optional
Optional
As needed
21.
Magill’s forceps (two sizes)
Optional
Optional
Optional
Optional
As needed
22.
Metallic or disposable insemination cannula
Optional
Optional
Optional
Optional
As needed
23.
Operation table Hydraulic Minor with stand
Optional
Optional
Optional
Optional
Min 1/Theatre
24.
OT Spot light (Shadowless ceiling fitted/ stand mounted)
Optional
Optional
Optional
Optional
Min 1/Theatre
25.
Oxygen Cylinder
Optional
Optional
Optional
Optional
Min 1/Theatre
26.
Shadowless lamp ceiling type major / minor
Optional
Optional
Optional
Optional
Min 1/Theatre
27.
Shadowless Lamp stand model
Optional
Optional
Optional
Optional
Min 1/Theatre
28.
Sims speculum in small, medium & large size
Optional
Optional
Optional
Optional
As needed
29.
Sphygmomanometer
Optional
Optional
Optional
Optional
Min 1/ OT
136
30.
Steriliser Small (Instruments)
Optional
Optional
Optional
Optional
Min 1/ OT
31.
Sterilizer big (Instrument)
Optional
Optional
Optional
Optional
Min 1/ OT
32.
Sterilizer Medium (Instrument)
Optional
Optional
Optional
Optional
Min 1/ OT
33.
Stethoscope
Optional
Optional
Optional
Optional
Min 1/ OT
34.
Suction Apparatus – Electrical
Optional
Optional
Optional
Optional
Min 1/ OT
35.
Suturing Set
Optional
Optional
Optional
Optional
As needed
36.
Swab holders
Optional
Optional
Optional
Optional
As needed
37.
Thermometer
Optional
Optional
Optional
Optional
As needed
38.
Tongue depressors
Optional
Optional
Optional
Optional
As needed
39.
Toothed forceps
Optional
Optional
Optional
Optional
As needed
40.
two long (8 inch)& two short (6 inch) Artery forceps
Optional
Optional
Optional
Optional
As needed
41.
two Uterine sound
Optional
Optional
Optional
Optional
As needed
42.
Uretheral Dilator Set
Optional
Optional
Optional
Optional
As needed
43.
Vaginal Examination set
Optional
Optional
Optional
Optional
Min 1/OT
44.
Vulsellum
Optional
Optional
Optional
Optional
Min1/OT
G.3 Diagnostic equipments 1: Imaging Equipment
Sr. No.
1. 2.
3. 4. 5. 6. 7.
Name of the Equipment
300 M.A. X-ray machine
Ultra Sonogram (Obs & Gyne. department should be having a separate ultra-sound machine of its own)
Echocardiogram
X-ray developing tank Safe light X-ray dark room Cassettes X-ray
Lead apron
10 bedded Hospital
Optional Optional
Optional Optional Optional Optional Optional
11-25 bedded Hospital
Optional Optional
Optional Optional Optional Optional Optional
26-50 bedded hospital
Optional Optional
Optional Optional Optional Optional Optional
51-100 bedded hospital
Min1 Optional
Optional Min 1 Min 1 Min 1 Min 1
101 & above Bedded hospital
Min1 Min1
Optional Min 1 Min 1 Min 1 Min 1
137
8. Intensifying screen X-ray
9. Thyroid shield
10. TLD batches
11. Gonadial guard
12. X-ray lobby single
13. Automatic ECG
2: Laboratory Equipments
Optional Optional Optional Optional Optional Min 1
Optional Optional Optional Optional Optional Min 1
Optional Optional Optional Optional Optional Min 1
Min 1 Min 1 Min 1 Min 1 Min 1 Min 1
Min 1 Min 1 Min 1 Min 1 Min 1 Min 1
Sl. No
Name of the Equipment
10 bedded Hospital
11-25 bedded Hospital
26-50 bedded hospital
51-100 bedded hospital
101 & above Bedded hospital
1.
Alarm clock
Min 1
2.
Automatic cell counter
Optional
Optional
Optional
Min 1
Min 1
3.
Auto analyzer/ Semi auto analyzer
Optional
Optional
Optional
Min 1
Min 1
4.
Binocular Microscope
Min 1
Min 1
Min 1
Min 1
Min 3
5.
Chemical Balances
Min 1
6.
Counting chamber
Min 1
7.
Electric Colorimeter
Min 1
8.
Electricentrifuge, table top
Min 1
9.
ESR stand with tubes
Min 1
10.
Photo colorimeter
Min 1
11.
Glucometer
1 Per Area/ Ward
12.
Hemoglobinometer
Min 1
13.
Hot air oven
As required
14.
Hot plates
As required
15.
Lab Incubator*
As required
16.
Laboratory Auto Claves
As required
17.
Micro pipette of different volumes
As required
18.
PH meter
As required
138
Sl. No
Name of the Equipment
10 bedded Hospital
11-25 bedded Hospital
26-50 bedded hospital
51-100 bedded hospital
101 & above Bedded hospital
19.
Refrigerator
Min 1
20.
Rotor / Shaker
Min 1
21.
Simple balances
Min 1
22.
Spirit lamp
Min 1
23.
TCDC count apparatus
Min 1
24.
Test tube holders
As required
25.
Test tube rack
As required
26.
Test tube stands
As required
27.
Timer stop watch
As required
28.
Water bath
As required
29.
ELISA reader & washer
Optional
Optional
Optional
Optional
Min 1
30.
Fully automated analyser
Optional
Optional
Optional
Optional
Min 1
31.
Laminar air flow chamber
Optional
Optional
Optional
Optional
Min 1
32.
Cold centrifuge
Optional
Optional
Optional
Optional
Min 1
33.
Incubator
Optional
Optional
Optional
Optional
Min 1
34.
Sample Shaker
Optional
Optional
Optional
Optional
Min 1
H. Manpower
This includes the Designation, minimum qualification & number of people required in the facility.
H.1 Medical practitioners
1. Category: Doctors
2. Minimum Qualifications: Degree/ Post Graduate Degreeor Post
Graduate Diploma from recognized university by Central Government
or State government of Indian Medicine.
3. Registration: (if applicable): with state or central council of Indian
Medicine
4. Trained / skilled: Trained
139
Doctors BSMS/ MD
Min 10 beds
11-25 beds
26-50 beds
51-100 beds
101 & above beds
1.
Hospital Superintendent
–
1
1
1
1
2.
BSMS – General Siddha Medical Care
1
2
4
6
8
3.
Spl – Pothu Maruthuvam
Specialty Service of Sl.No 3-13 may be provided by engaging MD / PG Diploma qualified Doctor on hire or contract basis or full time basis as per the requirement
4.
Spl- Kathu Mooku Thondai Maruthuvam
5.
Spl- Sool Magalir Maruthuvam
6.
Spl- Kuzhanthai Maruthuvam
7.
Spl- Varma Maruthuvam
8.
Spl – Putru Noi Maruthuvam
9.
Spl- Vatha Noi Maruthuvam
10.
Spl – Thol Maruthuvam
11.
Spl – Neerizhlvu Maruthuvam
12.
Spl – Muthiyor Maruthuvam
13.
Spl – Kayakarpam and Yogam
14.
Anesthetist
Optional
15.
Radiologist
DMRE/ MD in concerned subject
Optional
16.
Pathologist (visiting/part time/full time)
Option al
Optional
Optional
1
1
17.
Casualty Doctor / General Duty Doctor
1
1
1
1
2
140
H.2 Therapists:
5. Category: Masseur Technicians
6. Minimum Qualifications: (diploma/degree from recognized university by Central Government or State government of Indian Medicine.)
a. Masseur Technicians should have at least done certified course in Masseur of at least 6 months – 1 year duration as recognized by state of central council for Indian Medicine .
b. Masseur Assistant should have at least done certified course in Masseur of at least 6 months duration as recognized by state of central council for Indian Medicine .
7. Registration: (if applicable): state or central council of Indian Medicine
8. Trained / skilled: Trained
(As per Minimum standard requirement of Hospital attached with colleges)
Strength: Minimum 1 per treatment room; male and female separate; i.e. minimum 1 male technicians or 1 female technicians for a treatment room.
Therapists – Technicians
Min 10 bedded Hospital
11-25 bedded Hospital
26-50 bedded hospital
51-100 bedded Hospital
101 & above bedded Hospital
Varmam,Puramaruthuvam
(Masseur) Technicians- Female
1
1
2
3
4
Varmam,Puramaruthuvam
(Masseur) Technicians- Male
1
1
2
3
4
Varmam,Puramaruthuvam
(Masseur) Assistant – Female
1
1
2
3
4
Varmam,Puramaruthuvam (Masseur) Assistant Male
1
1
2
3
4
H.3 Paramedics
5. Category: Paramedics
6. Minimum Qualifications: (diploma/degree from recognized university by
Central Government or State government of Indian Medicine.)
7. Registration with the concerned council(if applicable): state or central council
8. Trained / skilled: Trained
141
Paramedics
Minimum qualification
Min 10 bedded Hospital
11-25 bedded Hospital
26-50 bedded hospital
51-100 bedded hospita l
101 & above bedded hospital
1.
ECG Technician
(if ECG services are provided in- house)
1 year experience of taking ECG
1
1
1
2
2
2.
Hospital worker
Eight standard completed
2
2
4
6
8
3.
Laboratory +OT)
Attendant (Hospital Worker)
(if lab is in-
Ability to read national or local language
2
2
3
4
4
4.
Lhaobuosera)tory Technician
(if Lab is in- house)
Qualified Laboratory Technician
1
2
2
4
4
5.
Medical Records Officer /
Minimum qualification- 12th Standard passed.
1
1
1
2
2
6.
Technician OT Assistant
(if surgical services are provided)
Minimum qualification- 12th Standard passed.
1
1
1
2
2
7.
Radiographer
(if Imaging is in-house)
Qualified Radiographer
1
1
1
1
1
8.
Therapy Assistant
Minimum 1
Eight standard completed
As required
9.
Ward boy or Ayah
Minimum 1 per ward/ floor
Eight standard completed
1
2
2
4
6
(OP/ward
142
H.4 Nurses:
5. Category: Nursing (As per Minimum standard of Hospital attached with colleges)
6. Minimum Qualifications: GNM or BSc or MSc Nursing
7. Registration: State Nursing Council of where hospital is located
8. Trained / skilled: Trained
(As per Minimum standard requirement of Hospital attached with colleges)
Nurses to Beds Ratio: 1 per 10 beds
3
4
H.5 Administrative staff: The number would vary as per requirement and may be outsourced.
Administrative staff
5
6
7
8
Sr. No
Nursing Staff
Min 10 bedded Hospital
11-25 bedded Hospital
26-50 bedded Hospital
51-100 bedded Hospital
100 & above bedded Hospital
.Staff Nurse
1 for every 10 beds in IPD and 2 for OPD attendance up to 150 patients and 1 extra each for additional 100 patients.
.Matron
–
–
1
2
2
Sl. no
Administrative staff
Min 10 bedded Hospital
11-25 bedded Hospital
26-50 bedded hospital
51-100 bedded hospital
101 & above bedded Hospital
.Office Superintendent/ Hospital Administrator
–
–
1
1
1
.Accountant
1
1
2
2
4
.Computer Operator
1
1
2
2
4
.Security Staff*
2
4
6
6
8
143
H.6. Miscellaneous staff
Sl. no
Administr ative staff
Qualification
Min 10 bedded Hospital
11-25 bedded Hospital
26-50 bedded hospital
51-100 bedded hospita l
101 & above bedded Hospital
1.
Clerk for Billing
Minimum qualification- 12th Standard passed.
1
1
2
2
3
2.
Cook
(if food is cooked in- house)
Experience of working in mass kitchen for at least 1 year at senior cook or at in charge level.
Optional
Optional
Optional
4
6
3.
Driver (Only in case hospital has its own vehicle for patient or ambulance services)
Driver’s License for the category of vehicle With State Road Transport Office.
If driving an ambulance, specific training is required.
Optional
Optional
Optional
1
1
4.
Electrician
If exists, Diploma in Electrical Engineering.
Optional
1
1
1
1
5.
Housekeepi ng Staff
Ability to read national or local language
2
2
4
6
6
6.
Kitchen Servant
(if food is cooked in- house)
–
As required
7.
Maintenanc e person
If exists, Diploma in Electrical Engineering.
1
1
1
2
2
144
8.
Peon
Eight standard completed
1
1
1
2
2
9.
Plumber
–
1
1
1
1
2
10.
Sanitary Worker
–
1
2
4
4
6
11.
store keeper/ Manager
Minimum qualification- 12th Standard passed.
_
1
1
1
1
I. Drugs
This segment includes the minimum essential drug which needs to be maintained in the facility.
As per the publication “Essential Drug List – Siddha Medicine” by Department of AYUSH, March 2013, as and where applicable the drug list for treatment conditions to be maintained in all IPD.
J. Consumables
This includes the minimum quantity of the commonly used consumables in the facility which should be made available.
J.1 Surgical
S.No
Surgical Consumables
1.
Absorbent cotton
2.
Adhesive plaster
3.
Bandage Roll
4.
Biomedical waste colour coded covers
5.
Caps & mask
6.
Catguts of different sizes
7.
Developer
8.
Disp-Gown, Cap, Mask, Big Sheet, Draw Sheet & Gloves(for communicable diseases)
9.
ECG Paper Roll , ECG Jelly, Tissue Paper
10.
Enema Can
11.
Ether Anesthetic 500ml
12.
Fixer
13.
Gamjee Pad and Rolls
14.
Gauze Roll
15.
Hypodermic Needle (Pkt. of 10 needle) No.19, 20, 21, 22, 23, 24, 25, 26
16.
Indicator tape for sterilization by pressure autoclave
145
17.
Isopropyl Alcohol swab
18.
IV Cannula (different sizes)
19.
Leg drape
20.
Non Sterile Surgical rubber gloves
21.
Scalp vein sets (Different Sizes)
22.
Shaving blade –packet of 5
23.
Sterile & non sterile Gloves of different sizes
24.
Sterile cotton, gamjee pads, gauze pieces
25.
Sterile disposable syringes
26.
Sterile Infusion sets(Plastic)
27.
Sterile Surgical rubber gloves
28.
Ultra Sound Jelly
29.
Ultrasound scan film
30.
Vicryl No.1
31.
X-Ray film , TLD card
32.
Xylocaine Jelly
J.2 Dressing Material
S.No
Dressing Material
1.
Absorbent cotton
2.
Adhesive plaster
3.
Bandage Roll
4.
Dressing Thylam (Eg. Mathan Thylam)
5.
Gamjee Pad and Rolls
6.
Gauze Roll
7.
Ghada Cloth
8.
Siddha Antiseptic cream (eg. V.Vennai)
9.
Siddha Antiseptic solution (eg. Padikaraneer, Thiripala Kudineer, Neem, Turmeric).
10.
Sterile & non sterile Gloves of different sizes
11.
Sterile cotton, gamjee pads, gauze pieces
12.
Suture material (Eg. Black silk, Catguts)
13.
Wooden Splint
146
J.3 Disinfectants: As applicable in adequate quantity
S.No
Disinfectants
9.
Formaldehyde solutions (1%–2%)
10.
Glutaraldehyde
11.
Hydrogen peroxide
12.
Hypochlorite 4%-6%
13.
Neem Solution
14.
Phenolic germicides
15.
Quaternary ammonium compounds
16.
Turmeric Solution
J.4 Tubing
S.No
Items
7.
Connecting tubings for oxygen delivery
8.
Foleys catheters
9.
Nebilization Mask (Adult & Paed.)
10.
Oxygen catheters
11.
Oxygen masks (Adult & Paed.)
12.
Suction catheters
13.
Uro Bag
147
J.5 Linen
S. No
LINEN
MIN 10
11to25
26to50
51 to 100
101 & above
1
Abdominal Sheets for OT
As required
2
Apron for Cook
As required
3
Bed sheets (1:3)
30
75
150
300
600
4
Bedspreads (1:4)
40
80
150
200
300
5
Blankets
As required
6
Central Hole Sheet
As required
7
Curtain Clothes for Windows & Doors
As required
8
Doctors Overcoat
1 per Doctor
9
Draw Sheet (1:2)
20
50
100
200
300
10
Green sheet (Big) (MOT / Labour Room)
As required
11
Hospital Worker OT Coat
One Per Worker
12
Leggings
As required
13
Mackintosh
1 per Bed
14
Mats (Nylon)
As per requirement
15
Mattress(Foam) (Adult)
1 per Bed
16
Mattress(Foam) (Paediatric)
1 per Bed
17
Patient Gown (OT/Labour Ward)
As required
18
Perineal Sheets
As required
19
Pillow
10+5
25+10
50+20
100+30
200+50
20
Pillow Covers (1:3)
30
75
150
300
600
21
Table Cloth
As required
22
Towels
As required
23
Uniform / Apron
As required
148
J.6. Stationery for Hospitals
S.No
Items
29.
Consents Forms
30.
Continuation Sheets for IPD
31.
Death Certificate Books
32.
Diet Cards
33.
Diet Sheets
34.
Discharge cards
35.
Gynecological and Obst. Case sheets
36.
Indoor Admission Form & Case Sheets
37.
Intake Output Charts
38.
Investigation Requisition and Report Forms
39.
Nurses Report Register
40.
Nursing Monitoring Forms
41.
Pharmaco Vigilance Form
42.
Prognosis and Treatment Charts
43.
Referral Forms
44.
Registers – IPD Nominal
45.
Registers – Medicine Indent Register
46.
Sentinel Event Form
47.
Surgical Case Sheets
48.
Temperature Charts
J.7.Consumables for Karanool
S.No
Items
1.
Achyranthes Powder (Nayuruvi Uppu)
2.
Alternatively Karanool may be procured from reputed agencies
3.
Barbour Thread No.20
4.
Guggulu
5.
Surgical Spirit
6.
Turmeric Powder
149
J.8 Laboratory
S.No Items
1. Benedict’s reagent
2. Bilirubin reagent
3. Blood Sugar Kits for Semi-Auto Analyser
4. Cap & Mask
5. Disposable Syringes
6. Drabkins reagent
7. EDTA Vacutainers
8. ESR Disposable tubes
9. Gingely Oil
10. Gloves
11. Haematocrite Tubes
12. Haematology counter reagent
13. HbsAg Kits
14. HIV Kits
15. Hypo Solution
16. Lancet
17. Leishmen stain
18. Lipid Profile Kits
19. Malaria Kits
20. Microscope cover slips
21. Seedar wood Oil
22. Sodium Citrate Vacutainers
23. Surgical Spirit
24. Test Tubes
25. Tourniquet
26. Urea, Creatinine Kits
27. Xylene reagent Grade Water
28. Ziehl Neelson stain
29. Zinc Sulphate
150
J.9 Leech Therapy
ITEMS
1.
Bandage Roll
2.
Gauze Roll
3.
Gloves
4.
Turmeric
5.
Tuber of Lotus
6.
Tuber of Kotti
7.
Leech
8.
Storage Containers for leech
J.10 Suttigai
S.NO
ITEMS
1.
Mud Pot
2.
Tuber of Turmeric
151
K. Licenses
This includes the minimum statutory compliance applicable as per the central or state government along with licensing body.
Sn
Name of the Act
Department/ Area
Licensing body
1
Registration under Shops and Establishment Act
Organization
Jurisdictional Panchayat/ Mahanagarpalika/ Municipal Corporation
Authorities like Nagarpalika/ Municipality/
1.
Registration under Clinical Establishment Act
Organization
Jurisdictional Panchayat/ Mahanagarpalika/ Municipal Corporation
Authorities like Nagarpalika/ Municipality/
2.
AERB clearances for CT/ MRI/ X ray & Radiation
Imaging
Atomic Energy Regulatory Board
3.
Agreement for Common Biomedical Waste Collection, Transportation, Treatment, Storage and Disposal Facility
Organization
Local Pollution Control Board
4.
Registration under Air (prevention and control of pollution) Act, 1981.
Organization
Local Pollution Control Board
5.
Approval of Radiation Safety Officer
Imaging
Atomic Energy Regulatory Board
6.
Boiler license under Indian Boiler Act, 1923
Boiler
Concerned regulatory Body
7.
Building Permit (From the Municipality).
To be obtained from
Jurisdictional Revenue Authorities like Panchayat/ Nagarpalika/ Mahanagarpalika/ Municipality/ Municipal Corporation
8.
Certificate for Narcotics & Psychotropic Substances
Pharmacy and / Hospital
Drug Controller
9.
Certificate of Registration under society act 1860
Organization
Registrar of societies/ Charity Commissioners office
10.
Certificate u/s 80-G of IT Act
Organization
If applicable.
11.
Class clearance certificate issued to manufacturer/ importer of mobile X ray equipment
Imaging
AERB Class Clearance issued to Manufacturer/ dealer of imaging equipment
12.
Commissioning approval of Linear Accelerator
Radiation Therapy
AERB
152
13.
ESIS registration in case of >20 employees
Organization
Employee State Insurance Company
14.
Excise permit to store Spirit.
Organization
Excise department
15.
Generator Exhaust air Quality Report
Generator
Authorized Air Testing Laboratory
16.
License to sale or distribute drugs Form 20, 21, 21C
Pharmacy
FDA
17.
License for lift
Lift
Mobile Electric Vehicles Department
18.
License to play music for public use
Organization
Indian
19.
No objection certificate from the Chief Fire Officer.
Organization
Fire Department
20.
Obtaining clearances for weighing equipments in all the hospital units under The Standards of Weights and Measures Act, 1976.
Weights and measures
Department of Weights and Measures
21.
Occupation Certificate
To be obtained from
Jurisdictional Revenue Authorities like Panchayat/ Nagarpalika/ Mahanagarpalika/ Municipality/ Municipal Corporation
22.
PNDT Act, 1996.
Sonography
Health Department of Regulatory Body assigned with the responsibility
23.
Registration of births and deaths Act, 1969.
Organization
Health Department of Regulatory Body assigned with the responsibility
24.
SMPV License for Storage of Liquid Oxygen, Form III (License to compressed gas in pressure vessel or vessels)
Medical Gases in Pressurized Vessels
Licensing Authority
25.
TAN Number
Organization
Income Tax Department
26.
PAN Number
Organization
Income Tax Department
27.
Vehicle Registration certificates for Ambulance
Ambulance and Vehicles owned by the organization
Road Traffic Authority
28.
Water Prevention and control of pollution Act
Organization
Pollution Control Board
153
L. Basic Processes
L.1 Registration (This will help in developing a database at State / Central level).
13. Name,
14. Unique Identification Number (If Adhaar available or Id assigned in the Hospital) 15. Age,
16. Gender ,
17. Address with PIN code, / District / State
18. Marital Status,
19. Contact Number,
20. Type of Diet (Veg, Non-veg),
21. OP/ IP Number,
22. Date & Time of visit for OP/ admission for IP,
23. Name of Treating Doctor
L.2 Assessment
20. Primary Complaint of the guest:
21. History of Primary Complaint:
22. History of Medication:
23. History of Implants/ Pacemaker/ Surgery:
24. Past History
25. History of allergies
26. Diet and Lifestyle History
27. Family History
28. Personal History
29. General Examination
30. Systemic Examination
31. Physical Examination
32. Envagai Thervu, Neerkuri, Neikuri, Thegam, Elu Udalkattugal, Uyir Thathukkal
(Vatham, Pitham, Kabam)
33. Pain Scoring
34. Nutritional Assessment
35. Diagnosis Provisional / Final
36. Preventive Aspects
37. Plan of Care
38. Treatment
L.3 Infection Control
6. Cleaning: to be done with defined solution with dilution as advised by the manufacturer. Defined schedule with full cleaning at least once a day.
7. Disinfectants: Defined solution with dilution as advised by the manufacturer. Defined schedule with full cleaning at least once a day.
8. Advisable to have designated Infection Control Officer for hospital more than 50 beds.
9. Advisable to have designated Infection Control Committee for hospital more than 50 beds.
10. Infection control activities should be monitoring by define method & schedule.
154
L.4 Safety considerations
(Surgical safety, infection control, biomedical waste, first aid & basic life support, disaster preparedness)
5.
Following physical safety aspects shall be taken care in the hospital
1. AERB safety rules shall be followed in Radiology and other radiation areas.
2. All areas where a physical hazards may occur, like near DG set, transformer, Cylinder storage, electric panels, steep slope etc. shall be provided with safety
signage and safety instructions
3. All balconies and opening on higher floors shall have grills
4. All bottles containing acids or alkalis shall be stored on cupboards at height
below the shoulder level to prevent them from falling while taking out. It shall
never be stored on height above the head level
5. All electric panels shall be enclosed in insulated and nonflammable box and shall
be kept locked
6. All entry doors, windows and furniture shall be maintained in good maintained
condition
7. All equipments, furniture awaiting condemnation shall be stored in separate
condemnation area
8. All stretchers and wheelchairs shall have safety belts for fastening the patient
9. Anti-skid mats shall be placed on entrance of bathrooms
10. Boundary wall of the hospital’s campus shall be of sufficient height with metal
fencing on top. Entire boundary wall shall be kept in intact condition
11. Corridors and passages shall not be blocked by chairs, tables or equipments
12. Displays of ‘floor is wet’ or ‘under repair’ or similar precautions in required areas
and time shall be available with the hospital
13. Doors height shall be at least of 8 feet
14. Electric rooms shall not be used as store room or for any other purpose
15. Emergency exit routes shall be kept clear all the times
16. Hospitals ground shall be properly maintained. There shall be no openings, or
pits in the ground. The surfaces shall be kept even
17. Lab shall be provided with safety equipments like eye wash cups
18. Material safety data sheet shall be available for all hazardous materials
19. No door shall open towards public areas like crowded lobby etc. (the door shall
preferably open towards the inside of room)
20.No inflammable materials like, diesel, LPG, acids etc. shall be stored near
electrical panel
21.Personal protective gears shall be available everywhere and in adequate
quantity. These include gears like, gloves, masks, gowns, boots, caps, goggles etc. Earplugs shall be provided to staff in areas where there is continuous noise, like AC plant.
22. Protection from stray dogs and other animals shall be ensured in the hospital campus
23. Rubber matting shall be placed on the floors below electric panels
24. Seepage shall not be allowed in areas where electric panels or wires are present
25. Terrace should have side walls of at least 4 feet height
26. The beds shall have provision for providing side guardrails.
155
27.There should be no losing of electrical wiring. All electrical wiring shall be concealed and kept intact
6. Surgical safety
1. There are two independent identifiers for each patient. Name of patient with some other independent identifier.
2. Identification bands for patients should be considered in cases where patient cannot be relied upon to give correct information on his own identity. E.g. pediatric, disoriented, altered consciousness, etc.
3. Use of surgical safety check list based on WHO Criteria is used consistently for each procedure and surgical intervention. The Checklist should divide the operation into three phases, each corresponding to a specific time period in the normal flow of a procedure
a. the period before induction of anesthesia,
b. the period after induction and before surgical incision
c. the period during or immediately after wound closure but before
removing the patient from the operating room.
4. In each phase the checklist task must be completed before proceeding forward.
7. Infection control:
1. Biological safety assessment is done for all areas of patient care and risks defined for the same.
a. Needle Stick Injury and related Transmissions
b. Patient to staff, patient to patient and staff to patient risk of transmission
of diseases is addressed and preventive measures are instituted.
c. Procedure site and surgical site infections are monitored.
2. Preventive measures and remedies for correction are kept available wherever such risk exists.
3. Hand washing practices as per WHO recommended criteria are followed and monitored regularly.
4. Facility and consumables for hand washing are available tat convenient locations in the healthcare facility.
5. Adequate equipment and disposables related to personal safety for infection transmission are available to staff and patients in the organization. E.g. equipment like fogging machine, UV sterilizers, Insect Killer Machines and consumables such as Gloves, hand washing materials/ hand gels, surgical Masks, N95 Masks, industrial gloves, etc.
4. Biomedical waste:
1. Biomedical waste is collected, segregated, packed, transported and disposed according to the regulatory guidelines.
2. Biological Waste Management is monitored on regular basis.
3. Biomedical waste disposal is a part of infection control activities.
7. First aid & basic life support
156
1. At all times there is a staff member who is adequately qualified and is trained in giving at least Basic Life Support System.
2. Adequate qualifications will include qualified nurse or doctor from any specialization who has undergone training on Basic Life Support.
3. There will be a full resuscitation set maintained for use exclusively during such events, irrespective of existence of similar equipment anywhere else in the hospital.
8. Disaster preparedness: Yes for all hospitals of all sizes.
1. Healthcare organization must identify various possible disasters and prepare for
the same by stocking necessary consumables, training adequate staff and
conducting drills regularly.
2. Keeping equipment in a state of readiness for use during such events.
3. Separate stock is maintained as per the risk perceived for the anticipated disorder(s).
4. Keeping a back-up of consumables at all times in usable condition for use during disaster.
5. Personnel are trained for disaster management
6. Disaster drills are carried out at least once in six months for various disaster
anticipated.
7. Anticipated list of disasters can include and is not restricted to any of:
a. Fire
b. Terrorist attack
c. Invasion of swarms of insects and pests.
d. Earthquake.
e. Civil disorders effecting the Organization.
f. Sudden failure of supply of electricity. (Disaster)
7. Fire – Safety Measures
As for safety against fire accidents, fire extinguishers of various powder gas & water type have to be installed & maintained periodically. Fire alarm system equipments have to be fixed in inpatient department, OP Department Lab block & Pharmacy and kept in good condition so as to effectively use them in case of fire accident. All staff members should be given one day training on operation of Fire extinguisher annually.
M.1 Clinical Records (including consents)
Sr. No
Records
1.
OPD/ IPD Records
2.
Treatment Orders
3.
Medication Records
4.
Procedure Records
5.
Nursing Monitoring Records
6.
Nursing Treatment Records
157
7.
Reports of investigations
8.
Consents: General Consent at admission, Procedure consents
M.2 Discharge
2. Discharge Summary should have following details:
a. Primary data of Name, UID, Gender, Age, Address with PIN code, Marital
Status, Contact Number, Type of Diet (Veg, Non-veg), OP/ IP Number, Date of
visit for OP/ admission for IP, Treating Doctor, Discharge date & Reason
b. Primary Complaint of the guest
c. History of Primary Complaint:
d. History of allergies
e. Salient Examination Findings
f. Pain Relief Advice
g. Nutritional Advice
h. Diagnosis – Final
i. Preventive Aspects
j. Treatment Given
k. Details of procedures performed
l. Treatment advised
m. Contact number in case of emergency
158
Teaching Hospitals
All teaching hospitals should comply the notification of Central Council of Indian Medicine Notification, New Delhi Notification 13-2-2013 – Indian Medicine Central Council (Minimum standard Requirements of Siddha Colleges and attached hospitals) Regulations, 2013
159
N. References/Bibliography Reference
1. Essential Drug List – Siddha Medicine, Department of AYUSH, March 2013
2. Indian Medical Association – Government of India- Quality Council of India
Survey Report & Recommendations Of Clinical Establishments – 2013
3. The Clinical Establishments (Registration and Regulation) Act, 2010
4. Central Council of Indian Medicine Notification, New Delhi Notification 13-2-
2013 – Indian Medicine Central Council (Minimum standard Requirements of
Siddha Colleges and attached hospitals) Regulations, 2013
5. Central Council of Indian Medicine Notification, New Delhi Notification 2-5-2013
– Indian Medicine Central Council (Minimum standards of Education in Indian
Medicine) Amendment Regulations 2013.
6. National Accreditation Board for Hospitals & Healthcare Providers (NABH),
General Information Brochure,2010
7. WHO – Development of Standard Siddha Terminologies
8. Recommendations on Electronic Medical Records Standards in India – Ministry
of Health and Family Welfare, April 2013
O. Abbreviations
1. ATM- Aruvai &Thol Maruthuvam
2. B.S.M.S.- Bachelor of Siddha Medicine and Surgery 3. CR – Consultation Room
4. DS – Deputy Superintendent
5. FNA -Female Nursing Assistant
6. FSK -Furniture stock keeping
7. HS- Hospital Superintendent
8. IPD- In Patient Department
9. M.D(S)- Doctor of Medicine(Siddha)
10. MNA – Male Nursing Assistant
11. MSK – Medical stock keeping
12. Minor OT – Minor Operation Theatre. 13. MOT –Minor Operation Theatre
14. Min – Minimum
15. OPD- Out Patient Department
16. SPM- Sirappu Maruthuvam
17. SMM-Sool Magalir Maruthuvam
18. SR – Service Room
19. RMO-Residential Medical Officer
160
MINIMUM STANDARDS FOR
CLINICAL ESTABLISHMENTS OF
HOMOEOPATHY
161
CONTENTS
SL TITLE PAGE A Introduction 164
A.1 General 164
A.2 Scope 164
B. Functions 166
B.1 Core functions (Clinical services) 166
B.2 Auxiliary Functions (support services for ex – diagnostic) 167
C. Physical Facilities 169
C.1 Space requirement 169
C.1.1 Minimum area 169
C.1.2 Functional space 171
C.1.3 Dimensions of the sub areas 174
C.1.4 Basic signage 174
C.1.5 Others 175
C.2 Furniture & Fixtures 177
C.2.1 Furniture/Fixture Requirements 177
C.2.2 Sundry Articles 180
C.2.3 Others 180
C.3 Engineering Services Requirements 181
C.3.1 Electrical Requirements 181
C.3.2 Plumbing Requirements 181
C.3.3 Civil Requirements 182
C.3.4 HVAC / AC / Ventilation / Cross Ventilation Requirements 182
C.3.5 Others 182
C.4 Public Utilities 182
C.4.1 Potable drinking water 182
C.4.2 Sanitary Requirements 182
D. Equipment /instruments 183
D.1 Therapeutic equipment 183
D.2 Surgical equipment 185
D.3 Diagnostic equipment 187
D.4 Emergency equipment 189
D.5 Sterilizing Equipment 189
E. Manpower 190
E.1 Medical practitioners 191
E.2 Therapists 191
E.3 Paramedics 191
E.4 Nurses 193
E.5 Administrative staff 193
F. Drugs 194
162
F.1
Anaesthetic drugs
194
F.2
Emergency drugs
194
F.3
General Drugs
195
G.
Consumables
196
G.1
Surgical
196
G.2
Dressing Material
196
G.3
Disinfectants
197
G.4
Tubing
197
G.5
Linen
197
G.6
Stationery
198
G.7
Adhesives and gels
198
G.8
Others
198
H.
Licenses
199
I.
Basic Processes
201
I.1
Registration
201
I.2
Assessment
201
I.3
Infection Control
201
I.4
Safety considerations
202
I.5
Clinical Treatment Records
204
I.6
Discharge
205
163
A Introduction
A.1 General
In India, unlike allopathic hospitals, stand alone homoeopathic hospitals are almost nonexistent. Homoeopathic hospitals are attached with homoeopathic teaching institutions in India. Individual private clinics and/or Government run homoeopathic dispensaries and polyclinics are situated as has been shown in the survey conducted by the India Medical Association. These homoeopathic teaching institutions along with the attached hospitals are guided by the Central Council of Homoeopathy Minimum Standards Requirement Act 2013. The Minimum standard requirement for different homoeopathic hospitals shall be, inter alia, as per the Central Council of Homoeopathy Minimum Standards Requirement Act 2013. Number of beds available in attached homoeopathic hospitals shall be proportionate to the intake capacity of the Homoeopathic College.
A.2 Scope
This includes the services being provided by the facility to which the standards will be applicable. Homoeopathic health care establishments shall be classified as under
1. Individual Homoeopathic Clinic,
2. 10 Bed Homoeopathic Hospital,
3. 25 bed Homoeopathic Hospital,
4. 50 Bed Homoeopathic Hospital,
5. 100 Bed Homoeopathic Hospital,
6. More than 100 Bed Homoeopathic Hospitals, and
7. Homoeopathic Teaching Hospitals.
These shall be within the ambit of the Clinical Establishments (Central Government) Rules 2012. The clinical establishment shall register, under the respective State Govt. or Union Territory Administration in compliance to the Clinical Establishments (Central Government) Rules 2012, through standard application form prior to their establishment. Respective State Govt. or Union Territory Administration shall provide the required registration and permission for continuation of the establishment on fulfillment of the terms and conditions as laid down in the Rules.
164
Type of Health Care Facility
Scope of Services
Clinic
Outdoor care facility managed by a single Homoeopathy medical practitioner or a group of Homoeopathy practitioners with or without a day care facility. No overnight stay or care is provided here. The average patient reporting to such clinic shall be up to 50 patients per day per clinic.
10 bed Homoeopathic Hospital
Health Care facility with 1 to 10 beds for indoor care and ability to monitor and treat patients requiring an overnight stay. Care is provided by Homoeopathy physician trained in the concerned system of medicine having graduate or preferably postgraduate qualifications.
11to25bed Homoeopathic Hospital
Health Care facility with 11 to 25 beds for indoor care and ability to monitor and treat patients requiring an overnight stay. Care is provided by Homoeopathy physician trained in the concerned system of medicine having graduate or preferably postgraduate qualifications.
26 to 50 Beds
Health Care facility with 26 to 50 beds for indoor care and ability to monitor and treat patients requiring an overnight stay. Care is provided by Homoeopathy physician trained in the concerned system of medicine having graduate or preferably postgraduate qualifications.
51 to 100 Beds
Health Care facility with 51 to 100 beds for indoor care and ability to monitor and treat patients requiring an overnight stay. Care is provided by Homoeopathy physician trained in the concerned system of medicine having graduate or preferably postgraduate qualifications.
More than 100 bed Homoeopathic Hospitals
Health Care facility with more than 100 beds for indoor care and ability to monitor and treat patients requiring an overnight stay. Care is provided by Homoeopathy physician trained in the concerned system of medicine having graduate or preferably postgraduate qualifications.
Teaching Homoeopathic Hospitals
Health Care facility provided through hospitals attached with homoeopathic medical colleges for indoor care and ability to monitor and treat patients requiring an overnight stay. Care is provided by Homoeopathy physician and faculty members of the medical college trained in the concerned system of medicine having graduate or preferably postgraduate qualifications.
Homoeopathic hospitals having 20 beds and above shall be considered as teaching homoeopathy hospitals and shall be in compliance of the Homoeopathy Central Council (Minimum Standards Requirement of Homoeopathic Colleges and attached Hospitals) Regulations 2013, vide The Gazette of India, (Extra Ordinary) dated 08-03-013.
165
B. Functions
This section includes the basic services provided by facilities. It is subdivided into two parts B.1 Core functions (Clinical services)
(Clinics & Outdoor Patients facilities of health care organizations of 1 to 10, 11 to 25, 26 to 50, 51 to 100, more than 100 beds & teaching homoeopathic hospitals)
Upto10Bed
11to25bed
26 to 50 beds
51 to 100 beds
Teaching Hospitals
Minimum Clinical OPD Services to be provided
1
Organon of Medicine
Organon of Medicine
Community Medicine
Community Medicine
Community Medicine
2
Homoeopathic Materia Medica
Homoeopathic Materia Medica
Surgery
Surgery
Surgery
3
Repertory;
Repertory;
Obstetrics & gynecology
Obstetrics & gynecology
Obstetrics & gynecology
4
Practice of Medicine
Pediatric
Pediatric
Pediatric
5
Pediatrics
Dental (optional)
Dental (optional)
Dental (optional)
6
Obstetrics & gynecology
Organon of Medicine
Organon of Medicine
Organon of Medicine
7
Homoeopathic Materia Medica
Homoeopathic Materia Medica
Homoeopathic Materia Medica
8
Repertory;
Repertory;
Repertory;
9
Homoeopathic pharmacy
Homoeopathic pharmacy;
Homoeopathic pharmacy;
10
Practices of Medicine
Practices of Medicine;
Practices of Medicine;
11
Pediatrics
Pediatrics
Pediatrics;
12
Psychiatry
Psychiatry
Psychiatry
Indoor patients facilities
In-Patient Department of the Hospital shall have separate Male and Female wards. Distribution of beds shall be as under: –
i. General Medicine – 50% (for acute patients – 10% and for chronic patients 40%)
ii. Pediatrics – 10%
iii. Surgery – 20%
iv. Obstetrics & Gynecology – 20
166
The indoor department of the hospital shall have separate male and female wards and distribution of beds at the rate of 64 sq. feet (8 ft x 8 ft) area per bed per ward as under –
Upto10bed
11to25bed
26 to50bed
51 to100 bed
Teaching Hospitals
Minimum Clinical Services to be provided in IPD
Organon of Medicine
Organon of Medicine
Community Medicine (optional)
Community Medicine (optional)
Community Medicine (optional)
Homoeopathic Materia Medica
Homoeopathic Materia Medica
Surgery
Surgery
Surgery
Repertory;
Repertory;
Obstetrics & gynecology
Obstetrics & gynecology
Obstetrics & gynecology
Practice of Medicine
Pediatric
Pediatric
Pediatric
Pediatrics
Dental
Dental
Dental
Obstetrics & gynecology
Organon of Medicine with Homoeopathic Philosophy;
Organon of Medicine with Homoeopathic Philosophy;
Organon of Medicine with Homoeopathic Philosophy;
Homoeopathic Materia Medica including applied aspects;
Homoeopathic Materia Medica including applied aspects;
Homoeopathic Materia Medica including applied aspects;
Repertory;
Repertory;
Repertory;
Homoeopathic pharmacy;
Homoeopathic pharmacy;
Homoeopathic pharmacy;
Practices of Medicine;
Practices of Medicine;
Practices of Medicine;
Psychiatry.
Psychiatry.
Psychiatry.
Operationalization of beds of Psychiatry ward shall be subjected to availability of full time psychiatrist and trained nurse required for the purpose.
B.2 Auxiliary Functions (support services for eg: diagnostics) (Central Laboratory for clinical diagnosis and investigations).
5. There shall be a central laboratory in the hospital complex with proper infrastructure and work force for carrying out routine, pathological, biochemical and hematological investigations on the patients referred from outdoor and indoor departments of the hospital.
6. There shall be a central imaging unit in the hospital complex with proper infrastructure and work force for carrying out routine, imaging investigations on the patients referred from outdoor and indoor departments of the hospital.
167
Support Services:
1. Accounting
2. Ambulance services
3. Billing
4. Dietary services/ Canteen
5. Essential commodities like water supply, electric supply etc.
6. Finance
7. Financial accounting and auditing
8. Housekeeping and Sanitation
9. Inventory Management
10. Laundry services
11. Medical records
12. Medicine preparation area
13. Medico legal records
14. Office Management (Provision should be made for computerized medical records
with anti-virus facilities whereas alternate records should also be maintained)
15. Personnel Department
16. Pharmacy/ dispensary
17. Purchase
18. Reception,
19. Security services
20. Stores
21. Waste management
168
C. Physical Facilities
C.1 Space requirement
This entails the minimum space required for carrying out the basic functions of the facility which includes:
Homoeopathic hospitals having 20 beds and above shall be considered as teaching homoeopathy hospitals and shall be in compliance of the Homoeopathy Central Council (Minimum Standards Requirement of Homoeopathic Colleges and attached Hospitals) Regulations 2013, vide The Gazette of India, (Extra Ordinary) dated 08-03-2013.
C.1.1 Minimum area required for establishing the facility
Type of Health Care Organization
Requirements
Stand alone building
Part of another building
Minimum built up area
Clinic
As permitted Development control Floor Space Index, regulations, etc.
under rules, Local
Minimum area should be adequate to accommodate doctors table, consultation chair, two stools/ chairs, examination bed of the size 6 ft X 2.5 ft., privacy screen around examination area while having free mobility.
150 sq feet per clinic with temporary partition for patient waiting.
1to10bed
Local
related
structures,
etc. will be followed.
regulations building occupancy,
to
350 square meters.
11to25
765 square meters.
26to50
1530 square meters.
51 to 100
3060 square meters.
Teaching Hospitals
5000 square meters.
169
11to25 bed
26to50 51to100 bed bed
50
100 200
200
350 500
350
750 2000
Optional (100)
100 100
30
30 30
50
50 50
Optional
30 30
Optional
50 50
45
45 45
50
55 55
765
1530 3060
SL No.
1
2
3
4
5 6 7 8 9 10
Break up of built up area
Minimum area in square meters
1 to 10 bed
Hospital Administration Block
Superintendent Room
Rooms for Senior Medical
Officer 20 300 Staff nurse
Description of the Rooms
Teaching Hospital
Reception & Registration Counters
Out Patient Departments Medicine
Obs & Gyn Pediatrics Dressing rooms Dispensary
Store
In Patient Department
General Medicine ward (male & female separate)
Pediatrics
Surgery ward (male & female separate)
Obstetrics & Gynaecology
Toilets and Bath rooms (male & female separate)
Doctors duty room
Nursing Station
Operation theater Unit Operation theater Preparation room
Post operative recovery room Space for sterile items
Labor room
Rooms for surgeon/obstetrician/Assistant
Nursing staff room
Physiotherapy & yoga Unit Central Clinical Laboratory Radiology & Sonology
50 500
200 3000
optional 250
30 50
30 150 Optional 100
Kitchen Optional 250
Medicine Stores
General Stores
Total
10 200
10 200
350 5000
170
C.1.2 Functional space: planning of the facility like reception area, waiting area etc.
25.Consultation & examination room
a. Minimum 10 ft. x 10 ft.
b. Consultation room should be adequate to accommodate:
i. Doctors table,
ii. Consultation chair, iii. Two stools/ chairs,
iv. Examination bed of the size 6 ft X 2.5 ft.,
v. Privacy screen around examination area while having free mobility
26.Pharmacy/Dispensary Room:
a. The pharmacy should be located in an area conveniently accessible.
b. Temperature & humidity to be maintained as per the requirement of the
stored medications.
c. The size should be adequate to contain 5 percent of the total clinical visits
to the OPD in one session for hospitals with more than 50 beds.
d. Pharmacy should have adequate medicine storage and dispensing facility
for indoor and outdoor patients.
e. In view of the alcohol use and storage in homoeopathic pharmacy, it
should be adequately equipped with fire safety norms.
27.Entrance hall with reception area, enquiry counter, cash counter and record area
a. Preferably 100 sq. ft per 25 beds
28. Waiting area in entire organization
a. Preferably 100 sq. ft per 25 beds i.e. 10% seats of average number of patients visiting daily to hospital.
b. Waiting hall shall have the facility for toilet and drinking water.
c. Information like hospital timings, dos and don’ts in the hospital, various types of services available and utility fees shall be displayed in the waiting
hall.
29.Kitchen area: Applicable only if food is cooked in the hospital. Providing food is mandatory for hospitals of size over 100 beds.
a. Kitchen area should be sufficient size to prepare food for inpatients as per diet advised by the physician
b. Kitchen layout and functioning should follow the flow of materials as: EntrywashedcuttingcookingloadingTo Serve
c. Utensil washing area is separate from the cooking area.
30.Medicine preparation area: Applicable for hospitals of size over 50 beds.
a. Preparation area should be of minimum 50 sq. ft: only if medications are prepared in the hospital.
31.Medical Stores specs:
a. The medical store may be part of pharmacy or separate and secured.
b. Area should be clean, well ventilated, well lit, without any dampness or
fungal growth on walls.
171
c. In view of the alcohol use and storage in homoeopathic pharmacy, it should be adequately equipped with fire safety norms.
d. Homoeopathy medicines shall be stored separately as per the HPI guidelines in a separate store (other than general store).
32.RMO Quarters:
a. Minimum 1 room with attached bathroom & WC, per 2 doctors with separate rooms for male & females with separated sleeping facility with ceiling fan, drinking water facility, intercom, mattress, pillows, blankets, bed sheets. Cupboards/ wardrobes.
33.Nursing station/ duty room (Nurses):
a. One nursing station/room per 15 beds.
b. Applicable for clinics only if there is a day care ward.
c. Nursing stations should be spacious enough to accommodate a table,
requisite chairs, working platform, medicine racks, a work counter, sinks,
dress table, screen, pedal operated trash bins.
d. Station should accommodate all nurses on duty at any time.
34.Clinical laboratory specifications:
a. Laboratory services can be outsourced or can be optional for hospitals upto 100 beds.
b. Laboratory services are mandatory for hospitals above 100 beds for quick diagnosis of blood, urine, etc., a small sample collection room facility shall be provided.
c. Separate Reporting Room for doctors should be there.
d. Must have proper facility for management biomedical waste.
35.Radiology section:
Role of imaging department should be radio-diagnosis and ultrasound along with hire facilities depending on the bed strength.
a. The department should be located at a place which is accessible to both OPD and wards and also to operation theatre department.
b. The size of the room should depend on the type of instrument installed.
c. It should confirm to AERB requirements.
d. The room should have a sub-waiting area with toilet facility and a change
room facility, if required.
e. Film developing and processing (dark room) shall be provided in the
department for loading, unloading, developing and processing of X-ray
films.
f. Separate Reporting Room for doctors should be provided.
36.Laundry (optional)
a. Laundry services can be outsourced or can be optional.
b. If it is provided in house, it should have necessary facilities for drying,
pressing and cleaned linens.
c. If outsourced, disinfection of linen is carried out by the hospital before
handing over the linen to the out-sourced organization.
172
37.Emergency Room specifications:
a. Emergency room should be spacious enough to accommodate a table, requisite chairs, working platform, medicine racks, a work counter, sinks, dress table, screen, pedal operated trash bins.
b. Station should accommodate all nurses & doctors on duty at any time.
c. Room should allow free movement of wheel chair or trolley.
d. Emergency Room should preferably have different entry than the hospital
entry.
e. Access to Emergency Room should have a ramp for wheel chairs and
stretchers.
38. House-Keeping:
a. Housekeeping services should be made available for effective cleanliness. b. Housekeeping services can be outsourced.
c. Designated areas within functional areas for housekeeping materials has
to be in hospital more than 50 beds
39.Security Services:
a. There is a designated location for each security staff on duty.
40.Medical record-room:
a. Medical record-room should be of adequate size as per the load of the documents of the hospital.
b. Tamperproof material and locking facility Cabinets/ cupboards/ Boxes will be used.
c. Fire extinguishers of correct type should be made available nearby all locations.
41.Store rooms:
a. Store room should be lockable & of adequate size with exhaust fan.
b. Area should be clean, well ventilated, well lit, without any dampness or
fungal growth on walls.
42. Wards:
a. Treatment areas for male and female patients shall be segregated if managed as wards and there should be privacy for individual patients. Alternatively individual or sharing rooms can be used to segregate patients of different gender.
b. The ward planning will address minimization of the work for the nursing staff and shall provide basic amenities to the patients located within an area or unit.
c. Ward unit will include nursing station, preferably a treatment/ procedure room, nursing store and toilets as per the norms.
d. At the minimum one nursing station per ward of upto 45 beds will be provided.
e. There should be minimum 70 ft area per bed with 7 feet distance between the mid-points of adjoining beds and at least 3 feet distance between the beds and atleast 8” distance between the bed and the wall.
173
f. Width of the door to be at least 4 feet.
g. Permanent, semi-permanent or temporary partition should be present
between two beds.
h. Ward store area with lockable wall or steel cupboard(s).
43.Duty rooms for doctors
a. To accommodate 1 bed of 6 feet X 3 feet and a side table.
b. Separate beds if sharing for same gender.
c. Separate rooms for separate genders will be provided.
44.Duty rooms for nurses:
a. To accommodate 1 bed of 6 feet X 3 feet and a side table.
b. Separate beds if sharing for same gender.
c. Separate rooms for separate genders will be provided.
45.Dirty utility room:
a. Separate area of minimum 15 sq. feet.
C.1.3 Dimensions of the sub areas of the facility, including the flow of the processes which in turn will give a layout of the department /unit.
Specifications of the Operation Theater/ Minor OT
(if surgical services are provided in hospital having more than 100 beds):
1. OT/ procedure room should have sterile zone of at least 10 ft X 10 ft; Size is exclusive of clean zone, independent enclosure to accommodate equipment & maintaining adequate privacy.
2. OT is mandatory if surgical procedures are provided in any hospital.
3. Waiting area: Adequate number of seats/ chairs with respect to the bed strength
and load of the patients will be provided.
4. Consultation room with examination room: adequate to accommodate Doctors
table, consultation chair, two stools/ chairs, examination bed of minimum size of 6
ft. X 2.5 ft., privacy screen around examination area.
5. Sterilization room: adequate to accommodate sterilization equipment & sterilized
material.
6. Separate Recovery room for regimental therapy is mandatory only in health care
units which provide stand-alone services. Otherwise ward beds of the facility can be
utilized.
7. Separate disposal zone for storage of waste as per bio-medical waste management
rules.
C.1.4 Basic signage
1. A signage within or outside the facility should be made available containing the following information. The information shall be in compliance of the Clinical Establishments (Central Govt.) Rules 2012.
2. All signage meant for patients and visitors shall be bilingual – Local language and Hindi / English.
174
C.1.4.1 Name of the care provider with registration number,
1. Name of organization.
2. Display of Registration under Clinical Establishments Act.
C.1.4.2 Fee structure,
1. Display of tariff list at OPD, Emergency etc.
2. Display of citizen charter in OPD and emergency
C.1.4.3 Timings of the facility
1. Display of OPD timings with names and respective specializations of consultants in OPD.
C.1.4.4 Services provided
1. Directional signage at main entrance towards emergency and OPD
2. Directional signage for patients for utilities and conveniences like toilets,
drinking water, telephone booths, shops
3. Directional signage within the hospital building for all departments within
the building
4. Display of department / area name on the entrance of each area / room /
counter
5. Display of hospital layout at various entrances in the hospital
6. Display of hospital’s scope of services at OPD, Emergency and at Campus
entrance
7. Floor Plan With Location Of Departments
8. Plan of Facility
9. usages: departments, OPD & IP room & wards, waiting areas,
C.1.5 Others
1. Display of all radiation hazard signage in radiation areas (if applicable).
2. Display of Biomedical waste segregation at all location where BMW bins are
kept
3. Display of danger signage at all electric panels and other dangerous areas
4. Display of General instructions like ‘No Smoking’, ‘Keep Silence’, ‘Use
dustbin’, etc. at various patient and visitor areas in the hospital
5. Display of hand–washing techniques compliant with WHO guidelines at all
hand wash basins
6. Display of how to use fire extinguisher at all point where fire extinguisher is
installed
7. Display of important phone contact numbers of hospital authorities
8. Displays required by regulations like PCPNDT, Lifts, Fire, etc.
9. Display of Material Safety Data Sheet at all locations where Hazardous
Materials are stored
10. Display of patient rights and responsibilities in OPD, emergency and wards
11. Display of safety instructions in areas where any kind of safety hazard may
be expected. This includes areas like transformers, Cylinder storage, LPG
storage etc.
12.Emergency exit signage (preferably in auto illumination material, like
radium)
13. Fire Protection
14. Hazards- electrical, fall, pipe locations, prohibited areas
175
15. Notice board for general information to staff 16. Notice board in front of all OPD and Wards. 17. Notice board in Operation theatre
18. Routes for all areas
19. Signage for parking. (Signage for ambulance parking shall be separately mentioned)
20. Safety signage will be displays as per the requirements of respective Indian Standards: Ex. Fire Protection Safety Signs IS 12349:1988
176
C.2 Furniture & Fixtures:
This will entail the details about the furniture and sundry items commensurate to the service delivery requirements.
C.2.1 Furniture/Fixture Requirements:
1: Furniture/Fixture Requirements for Outpatient Department (OPD): (PER CONSULTATION ROOM)
Name of the Equipment
1to10 bed
11to25 bed
26to50 bed
51 to 100 bed
Teaching Hospital
Room with well-lighted and ventilated and equipped with a chair and a table for doctor
1
1
1
1
1
X-ray viewer
1
1
1
1
1
Two chairs for patients & attendants
1 set
1 set
1 set
1 set
1 set
An examination table of 6 ft. X 2.5 ft. With privacy screen
1
1
1
1
1
Blood pressure apparatus,
1
1
1
1
1
Stethoscope
1
1
1
1
1
Torch
1
1
1
1
1
Thermometer
1
1
1
1
1
Weighing machine
1
1
1
1
1
Essential diagnostic tools required for examination of patients as per the scope of services offered by the hospital.
As per requirement
Light source which gives light colour and temperature similar to solar light, Light intensity of at least 500 lux at the point of examination.
As per requirement
Computers, (if required)
1 per consultation room
Telephone equipment
As per requirement
Air conditioning
As per requirement
Adequate lockable storage space
As per requirement
Foot stools
1 per consultation room
177
2: Furniture/Fixture Requirements for In-Patient department (IPD):
1to10 bed
11to25 bed
26to50 bed
51 to 100 bed
Teaching Hospital
2
4
8
15
25
6
12
24
24
35
2
4
8
20
30
1 per floor
1 per 5 patients
1 per ward or full length curtains between the beds
6
12
24
24
24
As per requirement
1 per ward
1 per ward
1 per ward
1 per ward
1 per ward
As needed
As needed
3
3
10
20
25
2
4
8
10
20
3
6
12
15
35
4
8
20
30
50
1 per floor
2
4
4
8
15
ABC 1 per ward/ floor based on layout
8
16
25
25
35
1 Per Area/ Ward
1 per ward
50
100
300
500
500
5
10
30
50
75
2 per ward
2 per ward
2 per ward
10
20
50
100
150
2 per ward
20
40
50
50
75
Adequate
One per procedure roo
1 per ward
4
8
20
20
50
3
6
10
10
30
20% of total beds
1 per bed
1 per bed
1 per ward/ floor a per the profile of patients & layout of facility
Sr. Name of the Equipment No.
Ade1q.uate wall or steel Cupboards
2. Arm Board Adult
3. Back rest
4. Bain Marie trolley stainless steel 1
per floor
5. Bed side cabinets
6. Bed side Screen
7. Bucket Plastic
8. Ceiling Fans
9. Clock
10. Containers for kitchen
11. Doctor’s chair for OP & ward,
12. Doctor’s or Office table
13. Dressing trolley-1 per floor/ ward
depending on layout
14. Dust bins in each ward & consultation
room
15. Duty table for nurses
16. Emergency resuscitation kit
17. Enema Set
18. Fire extinguisher –
19. Foot stools
20. Fridge
21. Heavy duty Torch light
22. Hospital Cots
23. Hospital Cots Pediatric
24. Hot Water Bags
25. Ice bags
26. Hot Water geyser
27. I V Stands – 2 per 10 beds
28. Intercom System
29. Kidney Trays1 per 5 beds
30. Kitchen utensils
31. Massage table of 7ft. x 2.5ft (wood or
fiber) if service is provided
32. Medicine trolley
33. Office chairs
34. Office Table
35. patient Beds with side rails
36. Patient call Bell System
37. Patient locker
38. Patients examination table– 1 per ward/ floor a per the profile of patients & layout of facility
178
39.
Patients side table
1 per bed
40.
Pediatric cots with railings as per scope of services
as per scope of services
41.
Steel or Wooden cup board
8
16
20
25
50
42.
Steel rack
5
10
20
40
50
43.
Stool 1Per Bed
8
8
15
25
40
44.
Stools revolving – 1 per ward
2 per ward
2 per ward
2 per ward
2 per ward
2 per ward
45.
Stretcher/ Patient trolley – 1 per ward
1 per ward
1 per ward
1 per ward
1 per ward
1 per ward
46.
Urinal Male and Female
10
20
50
100
150
47.
waiting chairs / benches for patients relatives
50% of the bed strength
48.
Weighing Machine
1 per ward
49.
Wheel chair
2 per 50 beds
50.
X-ray viewer
one per ward
3: Furniture/Fixture Requirements
SN
Name of the Equipment
1to10 bed
11to25 bed
26to50 bed
51 to 100 bed
Teaching Hospital
1
Arm chair
One per service room
2
Examination table
Minimum 1
3
Focus lamp
Minimum 1 per service room
4
Footstool
One per service room
5
Gas/Stove
One per service room
6
Good light source
Minimum 1 per service room
7
hamox stretchers / Stretchers with wheels
One per service room
8
Heating facilities
One per service room
9
Hot water bath
One per service room
10
IV stands
One per service room
11
OT table / Lithotomy Table with Side Railings
Minimum one
12
Plastic aprons, gloves and mask
One per service room
13
Revolving stools
Minimum 1 per service room
14
Stool
One per service room
15
Sufficient light and ventilation
As per requirement
16
Surgical trolley
Minimum 1
17
Torch
Minimum 1 per service room
179
18
Wheel chairs
One per service room
C.2.2 Sundry Articles Requirement
Furniture/Fixture Requirements
Sr. No.
Name of the Equipment
1to10 bed
11to25bed
26to50 bed
51 to 100 bed
Teaching Hospital
1.
Air conditioners Central A/C for OT
Optional
Optional
Minimum 1
Minimum 1
Minimum 1
2.
Ambulance
Optional
Optional
Optional
Minimum 1
Minimum 1
3.
Ceiling / wall Fans
As needed
4.
Clock
1 per ward
5.
Computer with modem with UPS, printer with internet connection
As needed
6.
Coolers
As needed
7.
Drinking Water purifier
As needed
8.
Emergency lamp
2 Per Area/ Ward
9.
Emergency trauma set
2 per ward
10.
Exhaust Fan
As needed
11.
Fire extinguishers
As needed
12.
Geyser
1 per ward
13.
Refrigerator
1 per ward
14.
Storage Geyser
1 per ward
15.
Tables & Chairs
As needed
16.
Telephone/ cell phone
1 per ward
17.
Tube lights
As needed
18.
Vacuum cleaner
As needed
C.2.3 Others
Furniture/Fixture Requirements Administration
Sr. No.
Name of the Equipment
1to10 bed
11to25 bed
26to50 bed
51 to 100 bed
Teaching Hospital
Computer with Modem 1.
with UPS, Printer with Internet Connection
As needed
2.
Photocopier Machine
As needed
As needed
1 per ward
1 per ward
1 per ward
3.
Intercom (10 lines)
As needed
4.
Fax Machine
–
As needed
As needed
As needed
As needed
5.
Telephone
One per organization
Two per organizati on
6.
Public Address System
–
Covering Indoor and OPD Areas
180
4.
5.
6.
C. 3 Engineering Services Requirements
This will include detailed information about basic requirements including
C.3.1 Electrical Requirements
1. At least 3 hours backup or generator for critical areas
2. Primary electrical Supply is available as provided by the local utility
provider. Lighting back up for at least 1 hour covering all functional areas
must be available during the functioning time.
3. Primary electrical Supply as supplied by utility provider. Emergency backup
for at least 3 hours backup for electricity & for lighting and critical equipment must be available during the functioning time. Take over time must be less than 30 seconds. Electric supply to lighting will be backed up with UPS/ Inverter/ Battery.
4. The illumination in the hospital is provided as per the prescribed standards.
5. Shadow less lights should be provided in operation theatres and delivery
rooms.
6. Emergency portable light units should be provided in the wards and
departments.
C.3.2 Plumbing Requirements Number of Wash basins
i. 1 for every 20 persons or part there
ii. Doctor, staff, patients and visitors have an access to wash basin(s) 1
for every 50 persons or part there.
iii. Dirty utility & surgical / procedural hand wash basin will be separate
from general use & one each.
Number of Water closets
iii. 1 for every 20 beds or part thereof.
iv. Doctor, staff, patients and visitors have an access to wash closet(s) 20
beds or part thereof.
For in-patient department
a. No. of Wash basins
i. 1 for every 12 beds or part thereof
ii. Doctor, staff, patients and visitors have an access to wash basin(s);
iii. Procedure hand wash basins are separate and located close to procedure
area. 1 for every 12 beds or part thereof.
b. No. of Water closets
i. 1 for every 6 beds or part thereof
ii. Separate water closets are available for use for outpatient
and in-patient areas.
iii. For in-patient areas the water closets are provided in the
ratio of 1 per 6 beds and are located close to patient care
areas.
c. No. of bathrooms
d. WC
i. Minimum 1 bathroom per 6 beds/ one for each ward rooms
ii. Minimum 1 bathroom per 6 beds/ one for each therapy
rooms
181
i. Minimum 1 WC per 6 beds/ one for each Male & Female wards ii. Average size of toilet : 810 mm X 1800mm with grab bars
iii. Minimum 1 WC per 6 beds/ one for each Male & Female wards
iv. At least one wheel chair friendly toilet of dimensions 2200mm X
1800mm must be provided.
C.3.3 Civil Requirements
1. Space between 2 rows of beds in a ward should be minimum 5 ft.
2. Distance between 2 beds should be minimum 3.5 ft. if more than one bed is present 3. If clinic has beds then: measured between the facing borders of adjoining beds
there shall be at least 3 feet of distance if the beds are mobile and provided with
functional wheels and at least 4 feet if beds do not have functional wheels. 4. If there are no beds then this requirement is not applicable.
5. Size of hospital bed should be minimum 6’ x 3’
6. Area per bed should be Minimum 50 sq. ft. / bed
C.3.4 HVAC / AC / Ventilation / Cross Ventilation Requirements
1. Air-conditioning and Room Heating in operation theatre and neo-natal units should be provided.
2. The ventilation in the hospital may be achieved by either natural supply or by mechanical exhaust of air.
3. Cross ventilation/ Mechanical ventilation by fans and or exhausts to achieve comfortable environment without noxious odours.
C.3.5 Others
1. Air coolers or hot air convectors may be provided for the comfort of patients and staff depending on the local needs.
C.4 Public Utilities
C.4.1 Safe drinking water
1. Round the clock availability of safe drinking water for patients, staff and visitors.
2. Hospital should be provided with water coolers and refrigerator in wards and departments depending upon the local needs.
C.4.2 Sanitary Requirements
1. Arrangement should be made for round the clock piped water supply along with an overhead water storage tank with pumping and boosting arrangements.
2. Approximately 10000 liters of potable water per day is required for a 100 bedded hospital.
3. Separate provision for firefighting should be available.
4. Water softening plant should be considered where hardness of water is a
major problem.
182
Drainage and Sanitation
1.
2.
The construction and maintenance of drainage and sanitation system for waste water, surface water, sub-soil water and sewerage shall be in accordance with the prescribed standards. Prescribed standards and local guidelines shall be followed.
Waste Disposal System: As Rules, 2016
per the Bio-Medical Waste Management
D. Equipments /instruments
This includes the type, number, minimum specification & functionality of equipments required in the facility under the following headings
D.1 Therapeutic equipments
1: Outpatient Department (OPD)
1: Equipment /Instruments Requirements for Outpatient department (OPD) (PER CONSULTATION ROOM)
Sr. No.
Name of the Equipment
Clinic
1to10 bed
11to25 bed
26to50 bed
51 to 100 bed
Teaching Hospital
A chair and a table for doctor
1.
1
1
1
1
1
1
2.
X-ray viewer
1
1
1
1
1
1
3.
An examination table of 6 ft. X 2.5 ft. with privacy screen
1
1
1
1
1
1
4.
Blood pressure apparatus
1
1
1
1
1
1
5.
Stethoscope
1
1
1
1
1
1
6.
Torch
1
1
1
1
1
1
7.
Thermometer
1
1
1
1
1
1
8.
Weighing machine.
1
1
1
1
1
1
9.
Essential diagnostic tools required for examination of patients as per the scope of services offered by the hospital.
As per requirement
10.
Light source which gives light colour and temperature similar to solar light,
Light intensity of at least 500 lux at the point of examination.
As per requirement
11.
ENT SET
1
1
1
1
1
1
183
2: In-Patient department (IPD)
2:Equipments /instruments for In-Patient department (IPD):
Sr. Name of the Equipment No.
Autoclave Drums Back rest
Bain marie trolley stainless steel :1 per floor Bed pans:
1 per 5 patients Biomedical waste colour coded bins
Cheatle forceps assorted sizes
Clock
10. Containers for kitchen
11. Dressing trolley
12. Dust bins in each ward & consultation room
13. Emergency resuscitation
kit
14. Enema Set
15. Fridge
16. Heavy duty Torch light –
1 per ward
17. Hot Water Bags :
2 per ward
18. IVStands-2per10beds
19. Infra-Red lamp
20. Instrument tray –
minimum 1 per ward
21. Instrument trolley – 1 per
ward
22. Intercom System
23. Kidney Trays-1 per 5 beds
24. Medicine trolley
25. Needle cutter – 3 per ward
26. Non mercury Thermometer clinical – 1
per ward
27. O2 cylinder with spanner
– 1 per ward
28. Patients examination
table– 1 per ward/ floor a per the profile of patients & layout of facility
29. Sphygmomanometers- Stand Type 1& Portable
(aneroid or Digital) Type
X 1 – 1 per ward
30. Stretcher/ Patient trolley
1to10bed
11to25bed
26to50 bed
51 to 100 bed
Teaching hospital
10
3
6
6
6
3
12
6
24
50
6
24
9
12
25
50
2
4
8
20
1
2
4
8
15
10
20
50
100
200
One set each per floor
8
50
5
16
25
1 per ward
As required
1 per floor/ ward depending on layout
1 per ward
1 per floor
As required
As required
1 per ward
As required
1 per ward
1 per ward
1 per floor
2 per ward
As required
2 per 10 beds
As required
1 per ward
3
5
10
10
minimum 1 per ward
2 per ward
minimum 1 per ward
As required
2 per 10 beds
10
1 per 5 beds
minimum 1 per ward
minimum 1 per ward
3 per ward
1 per ward
1 per ward
1 per ward
1 per ward
1 per ward
Ambu bags
1.
2. Arm Board Adult
3.
4.
5.
6. 7. 8. 9.
184
– 1 per ward
31.
Weighing Machine – 1 per ward
1 per ward
32.
X-ray viewer – one per ward
1 per ward
D.2 Surgical equipment Sr. No.
2. 3.
4.
6.
7. 8.
9. 10. 11. 12. 13. 14.
15.
16. 17. 18. 19. 20. 21. 22.
23. 24.
25. 26. 27.
28. 29. 30.
31. 32.
1: Operation Theater 1:Equipment Requirements for Operation Theater
Name of the Equipment
Auto Clave HP Vertical (2 bin)
Bladder sound (Urethral
5.
dilators) of different sizes
11to25 bed
1*
1*
26to50 bed
51 to 100 bed
1*
Teaching hospital
Anterior vaginal wall
Adequate
Adequate
Adequate
Adequate
1.
retractor
Adequate
Adequate
Adequate
Adequate
Artery forceps
1*
1*
Autoclave equipment for sterilization/Sterilizer
1*
1*
1*
1*
1*
1*
1*
Crash Cart with lifesaving
1*
1*
1*
1*
drugs and Resuscitation Kit
Cusco’s Speculum
Diathermy Machine (Electric Cautery)
Focus lamp Ordinary
As needed
As needed
1*
As needed
As needed
As needed
As needed
As needed
1*
As needed
Disposable syringes (5-10cc)
As needed
As needed
As needed
As needed
Enema Pot
1*
1*
1*
1*
1*
1*
As needed
As needed
As needed
As needed
Foley’s Catheter
General Surgical Instrument Set Piles, Fistula, Fissure
1*
1*
1*
1*
1*
1*
Formaline dispenser
1*
1*
Instrument Trays of various Sizes
Adequate
Adequate
Adequate
Adequate
Knife and scissor1 each
As needed
As needed
As needed
As needed
Instrument Trolley
IV stands
As needed
As needed
As needed
As needed
As needed
As needed
As needed
As needed
Kidney tray
As needed
As needed
As needed
As needed
Magill’s forceps (two sizes)
Adequate
Adequate
Adequate
Adequate
L. P. Tray
Adequate
Adequate
Adequate
Adequate
Metallic or disposable insemination cannula
Adequate
Adequate
Adequate
Adequate
Operation table Hydraulic Minor with stand
1*
1*
1*
1*
OT Spot light (Shadow less ceiling fitted/ stand mounted)
Shadow less lamp ceiling type major / minor
Sims speculum in small, medium & large size
1
1*
1*
2
1*
1*
1*
1*
1*
1*
Oxygen Cylinder
Plastic aprons, gloves and mask
Adequate
1*
Adequate
1*
Adequate
1*
1*
Oxygen Mask with Circuit
Adequate
1
Shadow less Lamp stand model
1*
1*
Adequate
1*
1*
Adequate
Adequate
Adequate
Sphygmomanometer
1*
1*
1*
1*
Sterile cotton
As needed
185
33.
Sterile gloves
As needed
34.
Steriliser Small (Instruments)
As needed
35.
Sterilizer big (Instrument)
As needed
36.
Sterilizer Medium (Instrument)
1*
1*
1*
1*
37.
Stethoscope
1*
1*
1*
1*
38.
Suction Apparatus – Electrical
1*
1*
1*
1*
39.
Suturing Set
1*
1*
1*
1*
40.
Swab holders
1*
1*
1*
1*
41.
Thermometer
1*
1*
1*
1*
42.
Tongue depressors
1*
1*
1*
1*
43.
Toothed forceps
1*
1*
1*
1*
44.
two long (8 inch)& two short (6 inch) Artery forceps
1*
1*
1*
1*
45.
two Uterine sound
1*
1*
1*
1*
46.
Urethral Dilator Set
1*
1*
1*
1*
47.
Vaginal Examination set
1*
1*
1*
1*
48.
Vulsellum
1*
1*
1*
1*
1*: this is the minimum number required. 2: Anesthesia
Equipment Requirements for Anesthesia
Sr. No.
Name of the Equipment
11to25bed
26to50 bed
51 to 100 bed
Teaching hospital
1.
Airway female & male
Adequate
Adequate
Adequate
Adequate
2.
Anesthesia Trolley / Boyle’s Apparatus
Minimum 1 if anesthesia is given
1*
1*
1*
3.
Anesthetic- laryngoscope Magill’s with four blades
2*
2*
2*
2*
4.
CO2 cylinder for laparoscope
1*
1*
1*
1*
5.
Connector set of six for ETT
1*
1*
1*
1*
6.
Defibrillator/ AED
1*
1*
1*
1*
7.
Endotracheal tube sets
1*
1*
1*
1*
8.
Magill’s forceps (two sizes)
1*
1*
1*
1*
9.
Mouth prop
1*
1*
1*
1*
10.
Multi-parameter Monitor
1*
1*
1*
1*
11.
N2O Cylinder for Boyles
1*
1*
1*
1*
12.
O2 cylinder for Boyles
1*
1*
1*
1*
13.
Tongue depressors
Adequate
Adequate
Adequate
Adequate
14.
Tubes connecting for ETT
Adequate
Adequate
Adequate
Adequate
*minimum number required
186
D.3 Diagnostic equipment
1: Imaging Equipment
1. Imaging Equipment
Sr. No.
Name of the Equipment
11to25bed
26to50 bed
51 to 100 bed
Teaching hospital
300 M.A. X-ray machine
1.
Optional
Optional
Optional
Optional
2.
Ultra Sonogram (Obs. & Gyne. department should be having a separate ultra-sound machine of its own)
Optional
Optional
Optional
Minimum 1
3.
Echocardiogram
Optional
Optional
Optional
Optional
If X-Ray machine exists, there should be a minimum of one of each of the following items:
4.
X-ray developing tank
1
1
1
1
5.
Safe light X-ray dark room
1
1
1
1
6.
Cassettes X-ray
1
1
1
1
7.
Lead apron
1
1
1
1
8.
Intensifying screen X-ray
1
1
1
1
9.
Thyroid shield
1
1
1
1
10.
TLD batches
1
1
1
1
11.
Gonadal guard
1
1
1
1
12.
X-ray lobby single
1
1
1
1
187
1
* is the minimum number required
2: Laboratory Equipments
Sr. No.
Name of the Equipment
11to25bed
26to50 bed
51 to 100 bed
Teaching hospital
.
Alarm clock
1 Per Area/ Ward
2.
Automatic cell counter
Optional
Optional
1*
1*
3.
Auto analyzer/ Semi auto analyzer
Optional
Optional
Optional
Optional
4.
Binocular Microscope
1*
1*
1*
1*
5.
Chemical Balances
1*
1*
1*
1*
6.
Counting chamber
1*
1*
1*
1*
7.
Electric Colorimeter
1*
1*
1*
1*
8.
Electric centrifuge, table top
1*
1*
1*
1*
9.
ESR stand with tubes
1*
1*
1*
1*
10.
flame photometer
1*
1*
1*
1*
11.
Glucometer
1 Per Area/ Ward
12.
Haemoglobinometer
1*
1*
1*
1*
13.
Hot air oven
As needed
As needed
As needed
As needed
14.
Hot plates
As needed
As needed
As needed
As needed
15.
Lab Incubator
As needed
As needed
As needed
As needed
16.
Laboratory Auto Claves
As needed
As needed
As needed
As needed
17.
Micro pipette of different volumes
As needed
As needed
As needed
As needed
18.
PH meter
As needed
As needed
As needed
As needed
19.
Refrigerator
1*
1*
1*
1*
20.
Rotor / Shaker
1*
1*
1*
1*
21.
Simple balances
1*
1*
1*
1*
22.
Spirit lamp
1*
1*
1*
1*
23.
TCDC count apparatus
As needed
As needed
As needed
As needed
24.
Test tube holders
As needed
As needed
As needed
As needed
25.
Test tube rack
As needed
As needed
As needed
As needed
26.
Test tube stands
As needed
As needed
As needed
As needed
27.
Timer stop watch
As needed
As needed
As needed
As needed
28.
Water bath
As needed
As needed
As needed
As needed
188
D.4 Emergency equipments
Sr. No.
Name of the Equipment
11to25 bed
26to50 bed
51 to 100 bed
Teaching hospital
1.
Emergency equipment box for first aid & BLSS
Minimum 1
Minimum 1
Minimum 1
Minimum 1
2.
Crash-Card trolley:1
Minimum 1
Minimum 1
Minimum 1
Minimum 1
3.
Portable defibrillator:1
Optional
Optional
Minimum 1
Minimum 1
4.
Disposable syringes
As needed
As needed
As needed
As needed
5.
Ambu Bag:1
Minimum 1
Minimum 1
Minimum 1
Minimum 1
6.
Laryngoscope with cell
Minimum 1
Minimum 1
Minimum 1
Minimum 1
7.
Sealed battery cell
Minimum 1
Minimum 1
Minimum 1
Minimum 1
8.
Endotracheal tubes
As needed
As needed
As needed
As needed
9.
Monitor
As needed
As needed
As needed
As needed
D.5 Sterilizing Equipments
Essential Drugs List –
The essential drug list for all the Homoeopathic clinical Establishments established under the Clinical Establishments Rules 2012 (Central Govt.) shall be in compliance of the EDL – Homoeopathy, March 2013, Dept. of AYUSH, Govt. of India.
Sterilizing Equipments
Sr. No.
Name of the Equipment
1to10bed
11to25 bed
26to50 bed
51 to 100 bed
Teaching hospital
1.
Auto Clave HP Vertical (2 bin)
As needed
Minimum 1
Minimum 1
Minimum 1
Minimum 1
2.
Autoclave equipment (drums or trays) for sterilization/Sterilizer
Adequate
Adequate
Adequate
Adequate
Adequate
189
E. Manpower
This includes the Designation, minimum qualification & number of people required in the facility.
Minimum strength of staff of hospital attached to a homoeopathic college
Sl
No Name of the Post
1 Medical Superintendent
2 Dy. Medical Superintendent
2 Senior Medical officer
3 Medical Officer
4 Resident Medical Officer
5 Surgeon (General Surgery)**
6 Anesthetist*
7 Obstetrician/Gynaecologist**
8 Radiologist*
9 Pathologist/ Biochemist**
10 House Physician (Resident)***
11 Dispenser
12 Laboratory Technician
13 X-ray Technician/Radiographer
14Dresser
15 X-ray Attendant
16 Nursing Staff In-charge
17 Nursing Staff
18 Ward Boys/Ayas
19 Store Keeper
For For For For 51 to
20 25 50 100 beds beds beds beds
For More 100 than to 200 200 beds beds
1 1 2 3 3 5 5 7 3 5 2 2 1 1
2 2 1 1
3 5 12 20 5 8 5 7 3 5
1 1
1 1
2 2
1 1
1 1
On On Call Call
1 1
On On Call Call
1 1
2 2
1 1
1 1
1 1
1 1
1 1
2 4
2 2
1 1
On On Call Call
1 1
On On Call Call
1 2 5 8 2 3 1 2
On On Call Call
1 1 111135
On On 1 1 Call Call
1 1 1 1 2 3 7 9 3 4 7 9 1 1 1 1
3 3
3 5 12 15 15 18 3 3
190
Registration Clerk/Telephone Operator
21 Yoga Expert
22 Physiotherapist
23 Dietician (Part Time)
20
1
On Call
On Call
1
1
On Call
On Call
1
1
1
1
1
1
1
1
1
3
1
1
1
3
1
1
1
24
Every Homoeopathic Hospital shall engage adequate secretarial and Accounts staff for running the hospital smoothly.
25
Auxiliary staff like Lab Attendant, Dark Room Attendant shall be as per requirement.
26
The College and Hospital authorities shall make arrangements either by adequate staff of its own or through a contractor for looking after the jobs like cleanliness, laundry, hospital catering, gardening and watch and ward duties in the premises of the hospital.
Hospital reception, Out-Patient Department registration, In-Patient
27 Department registration, Medical record room, Accounts section shall be
properly manned and preferably computerised.
E.1 Medical practitioners
5. Category: Doctors
6. Minimum Qualifications: Degree/ Post Graduate Degree from recognized university by
Central of Homoeopathy
7. Registration: (if applicable): with State or central council of Homoeopathy
8. Trained / skilled: Trained
E.2 Therapists:
9. Category: Therapists:
10. Minimum Qualifications (5 1⁄2 years BHMS Degree from recognized University
by Central Council of Homoeopathy)
11.Registration with the Central Council of Homoeopathy (if applicable): State
Board /council of Homoeopathy 12.Trained / skilled: Trained
E.3 Paramedics
9. Category: Paramedics
10. Minimum Qualifications (diploma/degree from recognized university by Central
Government or State government of Indian Medicine.)
11. Registration with the concerned council(if applicable): state or central council of
Indian Medicine
12. Trained / skilled: Trained
191
Sr. no
Paramedics
Minimum qualification
1to10 bed
11to25 bed
26to50 bed
51 to 100 bed
Teaching hospital
1.
Clerk for Billing
Minimum qualification- 12th Standard passed.
_
1
1
2
2
2.
Cook
(if food is cooked in-house)
Experience of working in mass kitchen for at least 1 year at senior cook or at in charge level.
As per requirement
3.
Driver (Only in case hospital has its own vehicle for patient or ambulance services)
Driver’s License for the category of vehicle
With State Road Transport Office.
If driving an ambulance, specific training is required.
As per requirement
4.
ECG Technician (if ECG services are provided in- house)
1 year experience of taking ECG
–
1
1
3
3
5.
Electrician
If exists, Diploma in Electrical Engineering
–
1
2
2
3
6.
Hospital worker (OP/ward +OT)
Eight standard complete
5
5
10
20
7.
Housekeeping Staff
Ability to read national or local language
1
1
As per requirement
8.
Kitchen Servant (if food is cooked in-house)
–
As per requirement
9.
Laboratory Attendant (Hospital Worker) (if lab is in-house)
Ability to read national or local language
_
1
2
3
5
10.
Laboratory Technician (if Lab is in- house)
Qualified Laboratory Technician
_
2
3
3
5
11.
Maintenance person
If exists, Diploma in Electrical Engineering
_
1
1
2
3
12.
Medical Records Officer / Technician
Minimum qualification- 12th Standard passed
_
1
1
1
3
13.
OT Assistant (if surgical services are provided)
Minimum qualification- 12th Standard passed
1
2
2
3
10
14.
Peon
Eight standard completed
_
1
2
3
10
15.
Pharmacist
(if pharmacy is in- house)
Diploma in Homeopathy Pharmacy (D.Pharma) Bachelor in Homeopathy Pharmacy (B.Pharma) Master in Homeopathy Pharmacy (M.Pharma)
–
2
4
6
8
16.
Physiotherapist
Qualified PT
_
1
1
1
2
192
17.
Plumber
–
_
1
1
3
3
18.
Radiographer (if Imaging is in- house)
Qualified Radiographer
1
1
3
3
19.
Sanitary Worker
–
5
5
10
15
20.
store keeper/ Manager
Minimum qualification- 12th Standard passed
_
_
1
3
3
21.
Therapy Attendant Minimum 1
Eight standard completed
As per requirement
22.
Ward Ayah Minimum 1 per ward/ floor
Eight standard completed
As per requirement
23.
Ward boy Minimum 1 per ward/ floor
Eight standard completed
As per requirement
24.
Dispenser
Eight standard completed
–
1
2
3
5
25.
Dresser
Eight standard completed
–
1
1
2
3
E.4 Nurses: Nurses to Beds Ratio: 1 per 10 beds
9. Category: Nursing
10. Minimum Qualifications: GNM or BSc or MSc Nursing
11. Registration: State Nursing Council of where hospital is located 12. Trained / skilled: Trained
Sr. no
Nursing Staff
1to10 bed
11to25bed
26to50bed
51 to 100 bed
Teaching hospital
1.
Staff Nurse
1
1 for every 10 beds in IPD and 2 for OPD attendance up to 150 patients and 1 extra each for additional 100 patients.
1 for every 10 beds in IPD and 2 for OPD attendance up to 150 patients and 1 extra each for additional 100 patients.
1 for every 10 beds in IPD and 2 for OPD attendance up to 150 patients and 1 extra each for additional 100 patients.
1 for every 10 beds in IPD and 2 for OPD attendance up to 150 patients and 1 extra each for additional 100 patients.
2.
Matron
–
1
1
2
2
E.5 Administrative staff: The number would vary as per requirement and may be outsourced.
Administrative staff
Sr. no
Administrative staff
1to10 bed
11to25 bed
26to50bed
51 to 100 bed
Teaching hospital
1.
Office Superintendent/ Hospital Administrator
–
1
1
1
1
2.
Accountant
–
2
2
3
5
3.
Computer Operator
–
6
6
10
15
4.
Security Staff*
–
2
4
6
10
193
F. Drugs
This segment includes the minimum essential drug which needs to be maintained in the facility.
F.1 Anesthetics drugs
Category: Anesthetics drugs
Sr. no.
Name of the Drug
Strength
Minimum Quantity
1.1 General Anesthesia (to be given only by a qualified Allopathy anesthetist)
1.
Ether,
As per requirement
2.
Halothane
As per requirement
3.
Isoflurane*
As per requirement
4.
Ketamine Hydrochloride Injection
10 mg / ml, 50 mg / ml
As per requirement
5.
Nitrous Oxide
medical grade
As per requirement
6.
Oxygen
medical grade
As per requirement
7.
Injection Thiopentone Sodium
0.5 g, 1 g powder
As per requirement
1.2 Local Anesthesia
8.
Injection Bupivacaine Hydrochloride
0.25%,0.5% 0.5% + 7.5% Glucose
As per requirement
9.
Spray Ethyl Chloride
1%
As per requirement
10.
Injection Lignocaine
Topical Forms 2-5%
As per requirement
11.
Hydrochloride 1-2% Spinal 5% + 7.5% Glucose
As per requirement
12.
Injection Lignocaine Hydrochloride + Adrenaline
1%, 2% +Adrenaline 1:200,000 In vial 1.3
As per requirement
1.3 Preoperative Medication and Sedation for Short Term Procedures
13.
Injection Atropine Sulphate
0.6 mg / ml
As per requirement
14.
Injection Diazepam
5 mg Injection 5 mg / ml
As per requirement
15.
any other medication as decided by the concerned anesthetist
As per requirement
F.2 Emergency drugs
Category: Emergency Drugs
Sr. no.
Name of the Drug
Strength
Minimum Quantity
1.
Inj. Adrenaline
As per I.P.
Minimum 10 Ampoules/ Vials
2.
Inj. Atropine
As per I.P.
Minimum 10 Ampoules/ Vials
3.
Inj. Calcium Carbonate
As per I.P.
Minimum 10 Ampoules/ Vials
4.
Inj. Dopamine
As per I.P.
Minimum 10 Ampoules/ Vials
5.
Inj. Dobutamine
As per I.P.
Minimum 10 Ampoules/ Vials
6.
Inj. Nitroglycerine
As per I.P.
Minimum 10 Ampoules/ Vials
7.
Inj. Sodium Bicarbonate
As per I.P.
Minimum 10 Ampoules/ Vials
8.
Inj. Hydrocortisone
As per I.P.
Minimum 10 Ampoules/ Vials
9.
Inhaler Beclomethasone (250 micro/dose)
As per I.P.
Minimum 10 Ampoules/ Vials
10.
Inhaler Salbutamol (200 micrograms)
As per I.P.
Minimum 10 Ampoules/ Vials
11.
Inj. Frusemide
As per I.P.
Minimum 10 Ampoules/ Vials
12.
Inj. Diazepam/Midazolam
As per I.P.
Minimum 10 Ampoules/ Vials
13.
Inj. Deriphyllin
As per I.P.
Minimum 10 Ampoules/ Vials
194
14.
Inj. Phenytoin sodium
As per I.P.
Minimum 10 Ampoules/ Vials
15.
Inj. Avil
As per I.P.
Minimum 10 Ampoules/ Vials
16.
Inj. Ondansetrone
As per I.P.
Minimum 10 Ampoules/ Vials
17.
Inj. KCl
As per I.P.
Minimum 10 Ampoules/ Vials
18.
Inj. Lignocaine 2%
As per I.P.
Minimum 10 Ampoules/ Vials
19.
Inj. Amiadarone
As per I.P.
Minimum 10 Ampoules/ Vials
20.
Inj. Magnesium sulphate
As per I.P.
Minimum 10 Ampoules/ Vials
21.
Inj. Mannitol
As per I.P.
Minimum 10 Ampoules/ Vials
22.
Inj. Morphine/Inj. Pethidine
As per I.P.
Minimum 10 Ampoules/ Vials
23.
Inj. Noradrenaline bititrate
As per I.P.
Minimum 10 Ampoules/ Vials
24.
Inj. Fentanyl
As per I.P.
Minimum 10 Ampoules/ Vials
25.
water for Injection
As per I.P.
Minimum 10 Ampoules/ Vials
26.
Inj. Sodium Valporate
As per I.P.
Minimum 10 Ampoules/ Vials
27.
Inj. Voveran
As per I.P.
Minimum 10 Ampoules/ Vials
28.
Inj. Paracetamol
As per I.P.
Minimum 10 Ampoules/ Vials
29.
Mannitol Injection
As per I.P.
Minimum 10 Ampoules/ Vials
30.
Metoprolol Injection
As per I.P.
Minimum 10 Ampoules/ Vials
31.
N/2 saline Injection
As per I.P.
Minimum 10 Ampoules/ Vials
32.
Oxygen Inhalation
As per I.P.
Minimum 10 Ampoules/ Vials
33.
Oxytocin Injection
As per I.P.
Minimum 10 Ampoules/ Vials
F.3 General Drugs:
The list of essential drugs to be procured for any homoeopathic hospital shall be
in compliance of the Govt. of India Essential Drug List (EDL) – Homoeopathy – 2013
195
G. Consumables
This includes the minimum quantity of the commonly used consumables in the facility which should be made available.
G.1 Surgical
Sr. no.
Surgical Consumables
Sr. no.
Surgical Consumables
1.
Bandage rolled
1. Plastic aprons
2.
caps & mask
Prolene
2.
3.
Catgut Chromic a)1 No., 2 No., 1-0 No, 2-0 N0, 8-0
3.
Rubber Mackintosch Sheet in meter
4.
Clinical thermometer
4.
Scalp vein sets no a)19, 20, 21, 22, 23, 24, 25, 26
5.
Developer
5.
Shaving blade –packet of 5
6.
Draw sheets
Small and larg6e. plastic bottle for keeping his to histo-pathological samples
7.
ECG Paper Roll
sterial sheets7.
8.
Ether Anesthetic 500ml
8.
Sterile disposable syringes
9.
Fixer
9. sterile Dressing pads
10.
Gown
10.
Sterile Infusion sets(Plastic)
11.
Halothane
11.
Sterile Surgical rubber gloves
12.
HIV Kits if necessary
12. Surgical Disposable
13.
Hypodermic Needle (Pkt of 10 needle) No.19, 20, 21, 22, 23, 24, 25, 26
13.
Surgical Gloves a)6 “, 6.1/2″, 7″, 7.5″
14.
Indicator tape for sterilization by pressure autoclave
Surgical mark1i4n.g pens/permanent marker ink pen
15.
Isopropyl Alcohol swab
15. Sutupak 1,1/0,2,2/0
16.
IV Cannula
16.
Syringes 2ml,5ml,10ml, 20ml
17.
Leg drape
17. tongue depressor
18.
Mackintosh
18. Ultrasound scan film
19.
Mask
Vicryl No.1 19.
20.
Non Sterile Surgical rubber gloves
X Ray film 502fi0lm. packet(in Pkt) size, 6.1/2×8.1/2″, 8″x10″, 10″x12′, 12″x15”
G.2 Dressing Material
Sr. no
Dressing Material
Sr. no
Dressing Material
1.
Absorbent cotton I.P 500gm Net
7
Bandages
2.
Adhesive plaster 7.5cm x 5mtr
8
Gamjee Pad and Rolls
3.
Adhesive tape
9
Rolled Bandage a)6cm,10cm,15cm
4.
Antiseptic cream
10
Sterile & non sterile Gloves of different sizes
5.
Antiseptic solution
11
Sterile cotton, gamjee pads, gauze pieces
6.
Bandage cloth(100cmx20mm)
12
Surgical Gauze (50cmx18m)
7.
13
Suture removal
196
G.3 Disinfectants: As applicable in adequate quantity
Sr. no
Disinfectants
1.
Hypochlorite 4%-6%
2.
Ortho-phthalaldehyde (OPA)
3.
70% ethanol plus10ppm Bitrex
4.
Formaldehyde solutions (1%–2%)
5.
Glutaraldehyde
6.
Hydrogen peroxide
7.
Quaternary ammonium compounds
8.
Phenolic germicides
G.4 Tubing
G.5 Linen
Sr. no
Tubing
1.
Connecting tubing’s for endotracheal suction
2.
Connecting tubing’s for oxygen delivery
3.
Oxygen catheters
4.
Oxygen masks
5.
Suction catheters
6.
Foley catheters
Sr. no
Linen
1to10 bed
11to25 bed
26to50 bed
51 to 100 bed
Teaching hospital
1.
Abdominal sheets for OT
–
30
30
30
30
2.
Abdominal sheets for OT
–
6
10
25
25
3.
Apron for cook
–
As per requirement
4.
Bed sheets
–
200
300
400
500
5.
Bedspreads
–
300
400
400
500
6.
Blankets
–
one per bed
7.
Curtain cloth windows and doors
As per requirement
8.
Doctor’s overcoat
one per doctor
9.
Draw sheet for wards & OT
Two per bed
10.
Hospital worker OT coat
one per worker
one per worker
one per worker
one per worker
11.
Leggings
as per patient load
12.
Mackintosh sheet (in meters)
one per bed
13.
Mats (Nylon)
one per bed
14.
Mattress (foam) adults
one per bed
15.
Pediatric Mattress
one per bed
16.
Patient house coat (for female)
Two per bed
197
17.
Patients pajama (for male) shirts
Two per bed
18.
towels
Two per bed
19.
Perineal sheets for OT
as per patient load
20.
Pillow covers
Two per bed
21.
Pillows
Two per bed
22.
Table cloth
adequate quantity
23.
Uniform / Apron
As per requirement
G.6 Stationery
1
Consent Forms
2
Continuation Sheets for IPD
3
Continuation sheets for OPD
4
Death Certificate Books
5
Diet Cards
6
Diet Sheets
7
Discharge cards
8
Gynecological and Obst. Case sheets
9
Indoor Admission Form & Case Sheets
10
Intake Output Charts
11
Medical Case Sheets
12
Medico-Legal Forms
13
Repertorisation chart
14
Nursing Monitoring Forms
15
OPD Forms
16
Pathological Books
17
Registers
18
Registration Card
19
Sentinel Event Form
20
Supplementary Sheets
21
Surgical Case Sheets
22
Temperature Charts
23
Treatment Cards
24
White Papers
25
X-ray Forms
G.7 Adhesives and gels: NA G.8 Other: NA
198
H. Licenses
This includes the minimum statutory compliance applicable as per the Central or State Government along with licensing body.
SN
Name of the Act
Department/ Area
Licensing body
1
Registration under Shops and Establishment Act
Organization
Jurisdictional Authorities like Panchayat/ Nagarpalika/ Mahanagarpalika/ Municipality/ Municipal Corporation
2
Registration under Clinical Establishment Act
Organization
Jurisdictional Authorities like Panchayat/ Nagarpalika/ Mahanagarpalika/ Municipality/ Municipal Corporation
3
AERB clearances for CT/ MRI/ X ray & Radiation
Imaging
Atomic Energy Regulatory Board
4
Agreement for Common Biomedical Waste Collection, Transportation, Treatment, Storage and Disposal Facility
Organization
Local Pollution Control Board
5
Registration under Air (prevention and control of pollution) Act, 1981.
Organization
Local Pollution Control Board
6
Approval of Radiation Safety Officer
Imaging
Atomic Energy Regulatory Board
7
Boiler license under Indian Boiler Act, 1923
Boiler
Concerned regulatory Body
8
Building Permit (From the Municipality).
To be obtained from
Jurisdictional Revenue Authorities like Panchayat/ Nagarpalika/ Mahanagarpalika/ Municipality/ Municipal Corporation
9
Certificate for Narcotics & Psychotropic Substances
Pharmacy and / Hospital
Drug Controller
10
Certificate of Registration under society act 1860
Organization
Registrar of societies/ Charity Commissioners office
11
Certificate u/s 80-G of IT Act
Organization
If applicable.
12
Class clearance certificate issued to manufacturer/ importer of mobile X ray equipment
Imaging
AERB Class Clearance issued to Manufacturer/ dealer of imaging equipment
13
Commissioning approval of Linear Accelerator
Radiation Therapy
AERB
14
ESIS registration in case of >20 employees
Organization
Employee State Insurance Company
15
Excise permit to store Spirit.
Organization
Excise department
16
Generator Exhaust air Quality Report
Generator
Authorized Air Testing Laboratory
17
License to sale or distribute drugs Form 20, 21, 21C
Pharmacy
FDA
18
License for procurement & storage & dispensing of Alcohol
Pharmacy
Excise Dept.
199
19
License for lift
Lift
Mobile Electric Vehicles Department
20
License to play music for public use
Organization
Indian
21
No objection certificate from the Chief Fire Officer.
Organization
Fire Department
22
Obtaining clearances for weighing equipments in all the hospital units under The Standards of Weights and Measures Act, 1976.
Weights and measures
Department of Weights and Measures
23
Occupation Certificate
To be obtained from
Jurisdictional Revenue Authorities like Panchayat/ Nagarpalika/ Mahanagarpalika/ Municipality/ Municipal Corporation
24
PC PNDT Act, 1996.
Sonography
Health Department of Regulatory Body assigned with the responsibility
25
Registration of births and deaths Act, 1969.
Organization
Health Department of Regulatory Body assigned with the responsibility
26
SMPV License for Storage of Liquid Oxygen, Form III (License to compressed gas in pressure vessel or vessels)
Medical Gases in Pressurized Vessels
Licensing Authority
27
TAN Number
Organization
Income Tax Department
28
PAN Number
Organization
Income Tax Department
29
Vehicle Registration certificates for Ambulance
Ambulance and Vehicles owned by the organization
Road Traffic Authority
30
Water Prevention and control of pollution Act
Organization
Pollution Control Board
200
I. Basic Processes
I.1 Registration (This will help in developing a database at State / Central level)
1. Name,
2. Age,
3. Gender ,
4. Address with PIN code, 5. Marital Status,
6. Contact Number
7. Type of Diet (Veg, Non-veg),
8. OP/ IP Number,
9. Date & Time of visit for OP/ admission for IP, 10. Name of Treating Doctor
I.2 Assessment
1. Primary Complaint of the guest:
2. History of Primary Complaint:
3. History of Medication:
4. History of Implants/ Pacemaker/ Surgery:
5. Past History
6. History of allergies
7. Diet and Lifestyle History
8. Family History
9. Personal History
10. Homoeopathic Characteristics and Observations (Generalities)
11. General Examination
12. Systemic Examination
13. Physical Examination
14. Nutritional Assessment
15. Diagnosis Provisional / Final
16. Repertorisation and Repertorial Totality
17. Miasmatic assessment
18. Totality of Symptoms
19. Final Prescription (after consultation of Materia Medica)
20. Preventive Aspects
21. Plan of Care
22. Treatment
201
I.3 Infection Control
1. Cleaning: to be done with defined solution with dilution as advised by the manufacturer. Defined schedule with full cleaning at least once a day.
2. Disinfectants: Defined solution with dilution as advised by the manufacturer. Defined schedule with full cleaning at least once a day.
3. Advisable to have designated Infection Control Officer for hospital more than 50 beds.
4. Advisable to have designated Infection Control Committee for hospital more than 50 beds.
5. Infection control activities should be monitoring by defined method & schedule.
I.4 Safety considerations
(Surgical safety, infection control, biomedical waste, first aid & basic life support, disaster preparedness)
8. Following physical safety aspects shall be taken care in the hospital
1. AERB safety rules shall be followed in Radiology and other radiation areas.
2. All areas where a physical hazards may occur, like near DG set, transformer, Cylinder storage, electric panels, steep slope etc. shall be provided with safety
signage and safety instructions
3. All balconies and opening on higher floors shall have grills
4. All bottles containing acids or alkalis shall be stored on cupboards at height
below the shoulder level to prevent them from falling while taking out. It shall
never be stored on height above the head level
5. All electric panels shall be enclosed in insulated and nonflammable box and shall
be kept locked
6. All entry doors, windows and furniture shall be maintained in good maintained
condition
7. All equipments, furniture awaiting condemnation shall be stored in separate
condemnation area
8. All stretchers and wheelchairs shall have safety belts for fastening the patient
9. Anti-skid mats shall be placed on entrance of bathrooms
10. Boundary wall of the hospital’s campus shall be of sufficient height with metal
fencing on top. Entire boundary wall shall be kept in intact condition
11. Corridors and passages shall not be blocked by chairs, tables or equipments
12. Displays of ‘floor is wet’ or ‘under repair’ or similar precautions in required areas
and time shall be available with the hospital
13. Doors height shall be at least of 8 feet
14. Electric rooms shall not be used as store room or for any other purpose
15. Emergency exit routes shall be kept clear all the times
16. Hospitals ground shall be properly maintained. There shall be no openings, or
pits in the ground. The surfaces shall be kept even
17. Lab shall be provided with safety equipments like eye wash cups
18. Material safety data sheet shall be available for all hazardous materials
19. No door shall open towards public areas like crowded lobby etc. (the door shall
preferably open towards the inside of room)
202
20.No inflammable materials like, diesel, LPG, acids etc. shall be stored near electrical panel
21.Personal protective gears shall be available everywhere and in adequate quantity. These include gears like, gloves, masks, gowns, boots, caps, goggles etc. Earplugs shall be provided to staff in areas where there is continuous noise, like AC plant.
22. Protection from stray dogs and other animals shall be ensured in the hospital campus
23. Rubber matting shall be placed on the floors below electric panels
24. Seepage shall not be allowed in areas where electric panels or wires are present
25. Terrace should have side walls of at least 4 feet height
26. The beds shall have provision for providing side guardrails.
27.There should be no losing of electrical wiring. All electrical wiring shall be
concealed and kept intact.
9. Surgical safety
1. 2.
3.
4.
10.
1.
2. 3. 4.
There are two independent identifiers for each patient. Name of patient with some other independent identifier.
Identification bands for patients should be considered in cases where patient cannot be relied upon to give correct information on his own identity. E.g. pediatric, disoriented, altered consciousness, etc.
Use of surgical safety check list based on WHO Criteria is used consistently for each procedure and surgical intervention. The Checklist should divide the operation into three phases, each corresponding to a specific time period in the normal flow of a procedure
a. the period before induction of anesthesia,
b. the period after induction and before surgical incision
c. the period during or immediately after wound closure but before
removing the patient from the operating room.
In each phase the checklist task must be completed before proceeding forward.
Infection control:
Biological safety assessment is done for all areas of patient care and risks defined for the same.
a. Needle Stick Injury and related Transmissions
b. Patient to staff, patient to patient and staff to patient risk of transmission
of diseases is addressed and preventive measures are instituted.
c. Procedure site and surgical site infections are monitored.
Preventive measures and remedies for correction are kept available wherever such risk exists.
Hand washing practices as per WHO recommended criteria are followed and monitored regularly.
Facility and consumables for hand washing are available tat convenient locations in the healthcare facility.
203
9.
1. 2. 3.
10.
1.
2. 3.
4.
5. 6.
7.
Individual homoeopathic clinics as well as hospitals must have provision for handling of biomedical wastes in compliance of the Bio-Medical Waste Management Rules 2016. Bio-medical waste shall be segregated in color-coded bags (red, yellow, black, and blue), before storage, treatment, and transportation. All types of waste shall be collected, segregated, packed, transported and disposed according to the regulatory guidelines. Biological Waste Management is to be monitored on regular basis being a part of infection control activities.
First aid & basic life support
At all times there is a staff member who is adequately qualified and is trained in giving at least Basic Life Support System.
Adequate qualifications will include qualified nurse or doctor from any specialization who has undergone training on Basic Life Support.
There will be a full resuscitation set maintained for use exclusively during such events, irrespective of existence of similar equipment anywhere else in the hospital.
Disaster preparedness: Mandatory for all hospitals of all sizes.
Healthcare organization must identify various possible disasters and prepare for the same by stocking necessary consumables, training adequate staff and conducting drills regularly.
Keeping equipment in a state of readiness for use during such events.
Separate stock is maintained as per the risk perceived for the anticipated disaster(s).
Keeping a back-up of consumables at all times in usable condition for use during
disaster.
Personnel are trained for disaster management
Disaster drills are carried out at least once in six months for various disaster anticipated.
Anticipated list of disasters can include and is not restricted to any of:
a. Fire
b. Terrorist attack
c. Invasion of swarms of insects and pests.
d. Earthquake.
e. Civil disorders effecting the Organization.
f. Sudden failure of supply of electricity. (Disaster)
5. Adequate equipment and disposables related to personal safety for infection transmission are available to staff and patients in the organization. E.g. equipment like fogging machine, UV sterilizers, Insect Killer Machines and consumables such as Gloves, hand washing materials/ hand gels, surgical Masks, N95 Masks, industrial gloves, etc.
11.Biomedical waste:
204
I.5 Clinical Records (including consents)
Sr. no
Records
1.
OPD/ IPD Records
2.
Treatment Orders
3.
Medication Records
4.
Procedure Records
5.
Nursing Monitoring Records
6.
Nursing Treatment Records
7.
Reports of investigations
8.
Consents: General Consent at admission, Procedure consents
I.6 Discharge
Discharge Summary should have following details:
1. Primary data of Name, Gender, Age, Address with PIN code, Marital Status, Contact Number, Type of Diet (Veg, Non-veg), OP/ IP Number, Date of visit for OP/ admission for IP, Treating Doctor
2. Primary Complaint of the guest
3. History of Primary Complaint:
4. History of allergies
5. Salient Examination Findings
6. Pain Relief Advice
7. Nutritional Advice
8. Diagnosis – Final
9. Preventive Aspects
10. Treatment Given
11. Details of procedures performed
12. Treatment advised
13. Contact number in case of emergency
Fire safety majors:
Each homoeopathic hospital with indoor facility for 25 beds or more shall have fire safety majors in compliance of the National Building Code of India 2005 relating to the following matters:-
1. Access to building
2. Two Number, Width, Type and Arrangement of exits.
3. Protections of Exits by means of fire check door (s) and or pressurization.
4. Compartmentation.
5. Smoke Management System.
6. Fire Extinguishers.
7. First-Aid Hose Reels.
8. Automatic fire detection and alarming system.
9. MOEFA.
205
10. Public Address System.
11. Automatic Sprinkler System
12. Internal Hydrants and Yard Hydrants.
13. Pumping Arrangements.
14. Captive Water Storage for fire fighting
15. Exit Signage
16. Provision of Lifts (for G+3 storied buildings)
17. Standby power supply
18. Refuge Area
19. Fire Control Room
20. Special Fire Protection Systems for Protection of special Risks
Dispensary of each homoeopathic hospital shall be equipped with adequate no. of fire extinguishers to deal with the highly inflammable alcohol used for preparation of medicine. At least one fire extinguisher must be there for every 10 liters of alcohol stored either in crude or medicinal form.
RECORDS TO BE MAINTAINED BY THE CLINICAL ESTABLISHMENTS
sn Record
1 Out Patient Register
2 In Patient Register
3 Operation theater register
4 Labor room register
5 MTP Register
6 Case Records
7 Medico Legal Register
8 Laboratory Register
9 Radiology & Imaging Register
10 Discharge Summary
11 Medical Certificate in Duplicate
12 Complaint Register
13 Birth Register
14 Death Register
15 Bed Charts/Distributions/
16 RMO Duty Register
17 Total Discharges Register
18 Diet Register
19 Cash and Credit Register
20 Staff Attendance Register
21 Stock & Store Register
22 Maintenance Register
206
MINIMUM STANDARDS FOR
CLINICAL ESTABLISHMENTS OF
YOGA
207
YOGA STANDARDS FOR
CLINICS/ OPDs
1 TO 10 BEDS
11 TO 25 BEDS
26 TO 50 BEDS
51 TO 100 BEDS
100 AND ABOVE BEDS/TEACHING HOSPITALS
208
CONTENTS
Sn TITLE PAGE A Introduction 211
A.1 General 211
A.2 Scope 211
B Functions 211
B.1 Core functions (Clinical services) 211
B.2 Auxiliary Functions (support services for ex – diagnostic) 212
C Physical Facilities 213
C.1 Space requirement 213
C.1.1 Minimum area 213
C.1.2 Functional space 213
C.1.3 Dimensions of the sub areas 215
C.1.4 Basic signage 215
C.1.5 Others 216
C.2 Furniture & Fixtures 216
C.2.1 Furniture/Fixture Requirements 216
C.2.2 Sundry Articles 219
C.2.3 Others 220
C.3 Engineering Services Requirements 220
C.3.1 Electrical Requirements 220
C.3.2 Plumbing Requirements 220
C.3.3 Civil Requirements 221
C.3.4 HVAC / AC / Ventilation / Cross Ventilation Requirements 221
C.3.5 Others 221
C.4 Public Utilities 221
C.4.1 Potable drinking water 221
C.4.2 Sanitary Requirements 221
D Equipment /instruments 222
D.1 Therapeutic equipment 222
D.2 Surgical equipment N.A.
D.3 Diagnostic equipment 224
E Manpower 225
E.1 Medical practitioners 225
E.2 Therapists 225
E.3 Non-Technical staff 226
E.5 Administrative staff 227
G Consumables 227
G.5 Linen 227
G.6 Stationery 228
209
H
Licenses
228
I
Basic Processes
229
I.1
Registration
229
I.2
Assessment
229
I.3
Infection Control
230
I.4
Safety considerations
230
I.5
Clinical Treatment Records
232
I.6
Discharge
232
210
A. Introduction
A.1 General
The standards thus framed are on account of the minimum requirement of this category of healthcare provider. There are no exclusions. They are dependent on the basic functions of the unit/ hospital/ provider. All sections mentioned are mandatory and include both structure and basic processes.
A.2 Scope
This includes the services being provided by the facility to which the standards will be applicable (For example common minimum standards framed for a polyclinic are applicable to a polyclinic only and not to a single specialty hospital)
Scope:
Type of Health Care Facility
Scope of Services
Clinic
Outdoor care facility managed by a single Medical Officer/ Physician or a group of Medical Officer/ Physicians/ Therapists trained in concerned system (Yoga) with or without a day care facility. No overnight stay or care is provided here.
Minimum 10 beds
Health Care facility with 10 beds for indoor care and ability to monitor and treat patients requiring an overnight stay. Care is provided by Medical Officer/ Physician trained in the concerned system (Yoga) having graduate or postgraduate qualifications.
11 to 25 Beds
Health Care facility with 11 to 25 beds for indoor care and ability to monitor and treat patients requiring an overnight stay. Care is provided by Medical Officer/ Physician trained in the concerned system (Yoga) having graduate or postgraduate qualifications.
26 to 50 Beds
Health Care facility with 26 to 50 beds for indoor care and ability to monitor and treat patients requiring an overnight stay. Care is provided by Medical Officer/ Physician trained in the concerned system (Yoga) having graduate or postgraduate qualifications.
51 to 100 Beds
Health Care facility with 51 to 100 beds for indoor care and ability to monitor and treat patients requiring an overnight stay. Care is provided by Medical Officer/ Physician trained in the concerned system (Yoga) having graduate or postgraduate qualifications.
More than 100 Beds
Health Care facility with more than 100 beds for indoor care and ability to monitor and treat patients requiring an overnight stay. Care is provided by Medical Officer/ Physician trained in the concerned system (Yoga) having graduate or post graduate qualifications.
Teaching Hospital
Health Care facility with minimum 100 beds for indoor care and ability to monitor and treat patients requiring an overnight stay. Care is provided by Medical Officer/ Physician trained in the concerned system (Yoga) having graduate or post graduate qualifications.
B. Functions
This section includes the basic services provided by facilities. It is subdivided into two parts
B.1 Core functions (Clinical services)
(Clinics & Outdoor Patients facilities of health care organizations of Minimum 10 beds, 11 to 25, 26 to 50, 51 to 100, More than 100 beds and Teaching Hospital)
S. No.
Services
Clinic
Minimum 10 beds
11to25 beds
26to50 beds
51 to 100 beds
More than 100 beds
Teaching Hospital
Minimum Clinical Services to be provided
1.
Yogic Counseling
2.
Yogic diet
3.
Shatkarma
4.
Nabhi/ Nadi Pareeksha
5.
Yogic Sukshma Vyayama
6.
Yogic Surya Namaskar
7.
Yogasanas
8.
Yoga Nidra
9.
Breathing Practices
211
10.
Bandha
11.
Pranayamas
12.
Mudra
13.
Mantra chanting
14.
Dharana
15.
Practices leading to Dhyana
16.
Dhyana
Indoor patient’s facilities:
The indoor department of the hospital shall have separate male and female wards and distribution of beds at the rate of 65 sq. ft. area per bed ward as under:
S. No.
Services
Minimum 10 beds
11to25 beds
26to50 beds
51 to 100 beds
More than 100 beds
Teaching Hospital
Minimum Clinical Services to be provided
1
Yogic Counseling
2
Yogic diet
3
Shatkarma
4
Nabhi/ Nadi Pareeksha
5
Yogic Sukshma Vyayama
6
Yogic Surya Namaskar
7
Yogasanas
8
Yoga Nidra
9
Breathing Practices
10
Bandha
11
Pranayama
12
Mudra
13
Mantra chanting
14
Dharana
15
Practices leading to Dhyana
16
Dhyana
B.2 Auxiliary Functions (support services for ex – diagnostic) (Central Laboratory for clinical diagnosis and investigations).
1. There shall be a laboratory in the hospital complex of more than 100 beds with proper infrastructure and manpower for carrying out routine, pathological, biochemical and hematological investigations on the patients referred from outdoor and indoor departments of the hospital.
Support Services:
1. Accounting,
2. Ambulance services
3. Billing
4. Dietary services/ Canteen
5. Essential commodities like water supply, electric supply etc.
6. Finance
7. Financial accounting and auditing
8. Housekeeping and Sanitation
9. Inventory Management
10. Laundry services
11. Medical records
212
12. Office Management (Provision should be made for computerized medical records with anti- virus facilities whereas alternate records should also be maintained)
13. Personnel Department 14. Purchase
15. Reception
16. Security services
17. Stores
18. Waste management Housekeeping/ sanitation,
C. Physical Facilities
C.1 Space requirement
This entails the minimum space required for carrying out the basic functions of the facility which includes:
C.1.1 Minimum area required for establishing the facility,
Type of Health Care Organization
Requirements
Stand alone building
Part of another building
Clinic
As permitted under Development control rules, Floor Space Index,
Local regulations, etc.
Minimum area should be adequate to accommodate doctors table, consultation chair, two stools/ chairs, examination bed of the size 6 ft X 2.5 ft., privacy screen around examination area while having free mobility.
1to10bed
As permitted under Development control rules, Floor Space Index,
Local regulations, etc.
Local regulations related to building structures, occupancy, etc. will be followed.
11to25
26to50
51 to 100
101 and above / Teaching Hospitals
C.1.2 Functional space planning of the facility like reception area, waiting area etc.
b. Yoga hall:
1. Space should be available for minimum 30 people to practice Yoga (minimum space
requirement per person would be approximately 20 sq. ft.)
2. The hall should be approximately 600 sq.ft area. As per the bed capacity the no. of Yoga
Halls shall be increased.
3. Separate Yoga Halls are proposed for male & female with attached dressing room, toilet and
bathroom.
4. Shatkarma sthal with clean water facility (hot and cold)
213
5. Dhyan kaksh
c. Yoga Therapy Treatment rooms: Minimum 50 sq.ft area per Treatment room
d. Consultation & Examination room
1. Minimum 10ft. x 8 ft.
2. Consultation room should be adequate to accommodate:
ii. Table for Consultancy
iii. Consultation chair,
iv. Two stools/ chairs,
v. X-Ray viewing screen,
vi. Examination bed of the size 6 ft X 2.0 ft.,
vii. Privacy screen around examination area while having free mobility,
viii. Wash Basin for hand wash
e. Entrance hall with reception area, enquiry counter, cash counter and record area: Preferably 100 sq. ft per 25 beds
f. Waiting area in entire organization: Preferably 100 sq. ft per 25 beds i.e. 10% seats of average number of patients visiting daily to hospital
g. Kitchen/ Canteen area:
1. Providing food is mandatory for hospitals of having indoor facility.
2. Kitchen area should be sufficient size to prepare food for inpatients as per diet advised by
the physician.
3. Kitchen layout and functioning should follow the flow of materials as: Entry> washed>
cutting> cooking> loadingTo Serve.
4. Utensil washing area is separate from the cooking area.
h. Yoga Therapist Quarters:
Minimum 1 room with attached bathroom & WC, per 2 therapist with separate rooms for male & females with separated sleeping facility with ceiling fan, drinking water facility, intercom, mattress, pillows, blankets, bed sheets. Cupboards/ wardrobes.
i. Clinical laboratory specifications:
1. Laboratory services can be outsourced or can be optional for hospitals upto 100 beds.
2. Laboratory services are mandatory for hospitals above 100 beds for quick diagnosis of blood,
urine, etc., a small sample collection room facility shall be provided.
3. Separate Reporting Room for doctors should be there.
j. Laundry (optional)
1. Laundry services can be outsourced or can be optional.
2. If it is provided in house, it should have necessary facilities for drying, pressing and storage
of soiled and cleaned linens.
3. If outsourced, disinfection of linen is carried out by the hospital before handing over the
linen to the out-sourced organization.
k. House-Keeping:
1. Housekeeping services should be made available for effective cleanliness.
2. Housekeeping services can be outsourced.
3. Designated areas within functional areas for housekeeping materials has to be in hospital
more than 30 beds
l. Security Services:
There is a designated location for each security staff on duty.
m. Medical record-room:
1. Medical record-room should be of adequate size as per the load of the documents of the
hospital (Minimum of 50 sq feet).
214
2. Tamperproof material and locking facility Cabinets/ cupboards/ Boxes will be used.
3. Fire extinguishers of correct type should be made available nearby all locations.
n. Store rooms:
1. Store room should be lockable & of adequate size with exhaust fan.
2. Area should be clean, well ventilated, well lit, without any dampness or fungal growth on
walls.
14. Wards:
i. Treatment areas for male and female patients shall be segregated if managed as wards and there should be privacy for individual patients. Alternatively individual or sharing rooms can be used to segregate patients of different gender.
j. The ward planning will address minimization of the work for the nursing staff and shall provide basic amenities to the patients located within an area or unit.
k. Ward unit will include nursing station, preferably a treatment/ procedure room, nursing store and toilets as per the norms.
l. At the minimum one nursing station per ward of upto 45 beds will be provided.
m. There should be minimum 50 ft. area per bed with 7 ft. distance between the mid-points of adjoining beds and at least 3 feet distance between the beds and 8 inch distance between the
bed and the wall.
n. Width of the door to be at least 4 feet.
o. Permanent, semi-permanent or temporary partition should be present between two beds.
p. Ward store area with lockable wall or steel cupboard(s).
15. Duty rooms for Yoga Therapist
a. To accommodate 1 bed of 6 feet X 3 feet and a side table.
b. Separate beds if sharing for same gender.
c. Separate rooms for separate genders will be provided.
16. Duty rooms for nurses:
a. To accommodate 1 bed of 6 feet X 3 feet and a side table.
b. Separate beds if sharing for same gender.
c. Separate rooms for separate genders will be provided.
17. Dirty utility room:
Separate area of minimum 15 sq feet.
C.1.3 Dimensions of the sub areas of the facility, including the flow of the processes which in turn will give a layout of the department /unit.
C.1.4 Basic signage
1. A signage within or outside the facility should be made available containing the following information.
2. All signage meant for patients and visitors shall be bilingual – Local language and Hindi/ English.
C.1.4.1 Name of the care provider with registration number,
1. Name of organization.
2. Display of Registration under Clinical Establishment Act
C.1.4.2 Fee structure
1. Display of tariff list at OPD/ IPD (wherever applicable) etc.
2. Display of citizen charter in OPD/ IPD (wherever applicable)
C.1.4.3 Timings of the facility
1. Display of OPD timings with names and respective specializations of consultants in OPD C.1.4.4 Services provided
215
1. Directional signage at main entrance towards OPD/IPD
2. Directional signage for patients for utilities and conveniences like toilets, drinking water,
telephone booths etc.
3. Directional signage within the hospital building for all departments within the building
4. Display of department / area name on the entrance of each area / room / counter
5. Display of hospital layout at various entrances in the hospital
6. Display of hospital’s scope of services at OPD and at Campus entrance
7. Floor Plan With Location Of Departments
8. Plan of Facility
9. Usages: departments, OPD & IP room & wards, waiting areas,
C.1.5 Others
1. Display of all radiation hazard signage in radiation areas (if applicable).
2. Display of Biomedical waste segregation at all location where BMW bins are kept
3. Display of danger signage at all electric panels and other dangerous areas
4. Display of General instructions like ‘No Smoking’, ‘Keep Silence’, ‘Use dustbin’, etc. at various
patient and visitor areas in the hospital
5. Display of hand–washing techniques compliant with WHO guidelines at all hand wash basins
6. Display of how to use fire extinguisher at all point where fire extinguisher is installed
7. Display of important phone contact numbers of hospital authorities
8. Displays required by regulations like PNDT, Lifts, Fire, etc.
9. Display of Material Safety Data Sheet at all locations where Hazardous Materials are stored
10. Display of patient rights and responsibilities in OPD and wards
11. Display of safety instructions in areas where any kind of safety hazard may be expected. This
includes areas like transformers, Cylinder storage, LPG storage etc.
12. Emergency exit signage (preferably in auto illumination material, like radium)
13. Fire Protection
14. Hazards- electrical, fall, pipe locations, prohibited areas
15. Notice board for general information to staff
16. Notice board in front of all OPD and Wards.
17. Routes for all areas
18. Signage for parking. (Signage for ambulance parking shall be separately mentioned)
19. Safety signage will be displays as per the requirements of respective Indian Standards: Ex. Fire
Protection Safety Signs IS 12349:1988
C.2 Furniture & Fixtures:
This will entail the details about the furniture and sundry items commensurate to the service delivery requirements.
C.2.1 Furniture/Fixture Requirements: 1: Furniture/Fixture Requirements for Outpatient Department (OPD)::
216
clinic
hospital
Sr. No.
Name of the Equipment
Clinic
1 to 10 Beds
11 to 25 Beds
26to50 Beds
51-100 beds
101 beds and above/ Teaching hospitals
A chair and a table for doctor 1.
1 set per consultation room
2.
X-ray viewer
Optional
1 per consultation room
3.
Two chairs for patients & attendants
1 set per consultation room
4.
An examination table of 6 ft. X 2.5 ft. With privacy screen
1 per consultation room
5.
Blood pressure apparatus,
1 per consultation room
6.
Stethoscope
1 per consultation room
7.
Torch,
1 per consultation room
8.
Thermometer
1 per consultation room
9.
Weighing machine.
1 per consultation room
10.
Essential diagnostic tools required for examination of patients as per the scope of services offered by the hospital.
As per requirement
11.
Light source which gives light colour and temperature similar to solar light,
Light intensity of at least 500 lux at the point of examination.
As per requirement
12.
Refrigerator if temperature sensitive medication are stored (if required)
1 per consultation room
13.
Computers, (if required)
1 per consultation room
14.
Telephone equipment
As per requirement
15.
Air conditioning
As per requirement
16.
Lockable storage space
As per requirement
17.
Foot stools
1 per consultation room
Rooms should be well ventilated.
.
2: Furniture/Fixture Requirements for In-Patient Department (IPD):
Sr. No .
Name of the Equipment
Minimum 10 bedded hospital
11-25 bedded hospital
26to50 bedded hospital
51 to 100 bedded hospital
More than 100 bedded hospital
Teaching hospital
Adequate wall or
1.
steel Cupboards
1
2
4
6
8
10
2.
Arm Board Adult
2
4
6
12
16
24
3.
Back rest
2
4
6
12
16
24
4.
Bain Marie trolley stainless steel 1 per
1 per floor
217
floor
Bed side cabinets
1 per 5 patients
1 per ward or full length curtains between the beds
As per requirement
1 per ward As needed
As needed
As per need
As per need
As per need
ABC 1 per ward/ floor based on layout As per need
1 Per Area/ Ward
1 per ward
2 per ward
2 per ward
Adequate
Adequate
Adequate
20% of total beds
1 per bed
1 per bed
– 1 per ward/ floor a per the profile of patients & layout of facility
1 per bed Adequate
24
8
5.
6.
Bed side Screen
6
12
24
7.
Bucket Plastic
Ceiling Fans
8.
Clock 1 per ward
9.
Containers for kitchen
10.
11.
Consultant’s chair for OP & ward,
1
2
3
4
6
Consultant’s or Office table
12.
Dressing trolley-1 per floor/ ward depending on layout
13.
Dust bins in each ward & consultation room
14.
Duty table for Yoga therapists
15.
Fire extinguisher
16.
Foot stools
17.
Fridge
18.
Heavy duty Torchlight
19.
10+2
30+5
50+5
100+10
150+15
Hospital Cots
20.
200+20
Hot Water geyser
21.
Intercom System
22.
Kitchen utensils,
23.
Office chairs
24.
25.
Office Table
patient Beds with side rails
26.
Patient call Bell System
27.
28.
Patient locker
Patients examination table– 1 per ward/ floor a per the profile of patients & layout of facility
29.
Patients side table
30.
Steel or Wooden cup board
31.
218
32.
Steel rack
Adequate
33.
Stool 1Per Bed
As needed
34.
Stools revolving – 1 per ward
2 per ward
35.
Stretcher/ Patient trolley – 1 per ward
1 per ward
36.
waiting chairs / benches for patients relatives
50% of bed strengths
37.
Weighing Machine
1 per ward
38.
Wheel chair
2 per 50 beds
39.
X-ray viewer
one per ward
C.2.2 Sundry Articles Requirement
Furniture/Fixture Requirements
Hospital Fittings & Necessities
Sr. No
Name of the Equipment
Clinic
Minimum 10 bedded Hospital
11- 25 bedded Hospital
26-50 bedded Hospital
51-100 bedded Hospital
More than 100 bedded hospital
Teaching Hospital
1
.
Air conditioners Central A/C
Optional
Minimum 1
2.
Ambulance
Optional
Minimum 1
3.
Ceiling / wall Fans
As needed
4.
Clock
1 per ward
5.
Computer with modem with UPS, printer with internet connection
As needed
6.
Coolers
As per need
7.
Drinking Water purifier
As needed
8.
Emergency lamp
2 Per Area/ Ward
9.
Exhaust Fan
As needed
10.
Fire extinguishers
As needed
11.
Geyser
1 per ward
12.
Refrigerator
1 per ward
13.
Storage Geyser
1 per ward
14.
Tables & Chairs
As needed
15.
Telephone/ cell phone
1 per ward
16.
Tube lights
As needed
219
17.
Vacuum cleaner
As needed
C.2.3 Others
Furniture/Fixture Requirements
Administration
Sr. No.
Name of the Equipment
Clinic
Minimum 10 bedded Hospital
11- 25 bedded Hospital
26to50 bedded Hospital
51-100 bedded Hospital
More than 100 bedded hospital
Teaching Hospital
Computer with 1.
Modem with UPS, Printer with Internet Connection
As needed
2.
Xerox Machine
As needed
1 per ward
3.
Intercom (10 lines)
As needed
4.
Fax Machine
–
As needed
5.
Telephone
One per organization
6.
Public Address System
–
Covering Indoor and OPD Areas
C. 3 Engineering Services Requirements
This will include the detail information about the basic requirements including
C.3.1 Electrical Requirements
7. At least 3 hours backup or generator for critical areas
8. Primary electrical Supply is available as provided by the local utility provider. Lighting back up
for at least 1 hour covering all functional areas must be available during the functioning time.
9. Primary electrical Supply as supplied by utility provider. Emergency backup for at least 3 hours backup for electricity & for lighting and critical equipment must be available during the functioning time. Take over time must be less than 30 seconds. Electric supply to lighting will be backed up with UPS/ Inverter/ Battery.
10.The illumination in the hospital is provided as per the prescribed standards. 11.Shadow less lights should be provided in operation theatres and delivery rooms. 12.Emergency portable light units should be provided in the wards and departments.
C.3.2 Plumbing Requirements
7.
8.
9.
Number of Wash basins
i. 1 for every 20 persons or part there
ii. Consultant, Therapist, staff, patients and visitors have an access to wash basin(s) 1 for every
50 persons or part there.
iii. Dirty utility & surgical / procedural hand wash basin will be separate from general use & one
each.
Number of Water closets
i. 1 for every 20 beds or part thereof.
ii. Consultant, Therapist, staff, patients and visitors have an access to wash closet(s) 20 beds or
part thereof.
For in-patient department
a. No. of Wash basins
1. 1 for every 12 beds or part thereof
220
b.
c.
2. Consultant, Therapist, patients and visitors have an access to wash basin(s);
3. Procedure hand wash basins are separate and located close to procedure area.1 for
every 12 beds or part thereof
No. of Water closets
iv. v. vi.
i. ii.
1 for every 6 beds or part thereof
Separate water closets are available for use for outpatient and in-patient areas.
For in-patient areas the water closets are provided in the ratio of 1 per 6 beds and are located close to patient care areas.
No. of bathrooms
Minimum 1 bathroom per 6 beds/ one for each ward rooms Minimum 1 bathroom per 6 beds/ one for each therapy rooms
d. WC
i. Minimum 1 WC per 6 beds/ one for each Male & Female wards
ii. Average size of toilet : 810 mm X 1800mm with grab bars
iii. Minimum 1 WC per 6 beds/ one for each Male & Female wards
iv. At least one wheel chair friendly toilet of dimensions 2200mm X 1800mm must be
provided.
C.3.3 Civil Requirements
7. Space between 2 rows of beds in a ward should be minimum 5 ft.
8. Distance between 2 beds should be minimum 3.5 ft. if more than one bed is present
9. If clinic has beds then: measured between the facing borders of adjoining beds there shall be at least
3 feet of distance if the beds are mobile and provided with functional wheels and at least 4 feet if
beds do not have functional wheels.
10. If there are no beds then this requirement is not applicable.
11. Size of hospital bed should be minimum 6’ x 3’
12. Area per bed should be Minimum 50 sq. ft. / bed
C.3.4 HVAC/ AC/ Ventilation/ Cross Ventilation Requirements
4. Air-conditioning and Room Heating in operation theatre and neo-natal units should be provided.
5. The ventilation in the hospital may be achieved by either natural supply or by mechanical exhaust of
air.
6. Cross ventilation/ Mechanical ventilation by fans and or exhausts to achieve comfortable
environment without noxious odours.
C.3.5 Others
2. Air coolers or hot air convectors may be provided for the comfort of patients and staff depending on the local needs.
C.4 Public Utilities
C.4.1 Safe drinking water
3. Round the clock availability of safe drinking water for patients, staff and visitors.
4. Hospital should be provided with water coolers and refrigerator in wards and departments
depending upon the local needs.
C.4.2 Sanitary Requirements
5. Arrangement should be made for round the clock piped water supply along with an overhead water storage tank with pumping and boosting arrangements.
6. Approximately 10000 liters of potable water per day is required for a 100 bedded hospital.
7. Separate provision for firefighting should be available.
8. Water softening plant should be considered where hardness of water is a major problem.
Drainage and Sanitation
221
3. The construction and maintenance of drainage and sanitation system for waste water, surface water, sub-soil water and sewerage shall be in accordance with the prescribed standards. Prescribed standards and local guidelines shall be followed.
4. Waste Disposal System: National guidelines on Bio-Medical Waste Management and a Notification of Environment and Forests are at Annexure – I.
D. Equipments /instruments
This includes the type, number, minimum specification & functionality of equipments required in the
facility under the following headings
D.1 Therapeutic equipments
1: Outpatient department (OPD)
1: Equipments /Instruments Requirements for Outpatient Department (OPD)::
S. No.
Name of the Equipment
Clinic
Minimum 10 bedded Hospital
11- 25 bedded Hospital
26-50 bedded Hospital
51-100 bedded Hospital
More than 100 bedded hospital
Teaching Hospital
A chair and a table for Co1n.sultant
1 per consultation room
2.
X-ray viewer
1 per consultation room
3.
An examination table of 6 ft. X 2.5 ft. With privacy screen
1 per consultation room
4.
Blood pressure apparatus,
1 per consultation room
5.
Stethoscope
1 per consultation room
6.
Torch
1 per consultation room
7.
Thermometer
1 per consultation room
8.
Weighing machine.
1 per consultation room
9.
Essential diagnostic tools required for examination of patients as per the scope of services offered by the hospital.
As per requirement
10
Light source which gives light colour and temperature similar to solar light, Light intensity of at least 500 lux at the point of
. examination
As per requirement
222
2: In-Patient Department (IPD)
2:Equipments /instruments for In-Patient department (IPD):
Sr. No.
Name of the Equipment
Minimum 10 bedded Hospital
11- 25 bedded Hospital
26-50 bedded Hospital
51-100 bedded Hospital
More than 100 bedded hospital
Teaching Hospital
Back rest
1.
As per requirement
2.
Bain marie trolley stainless steel 1 per floor
As per requirement
3.
Biomedical waste colour coded bins
Each per floor
4.
Clock per ward
1 per ward
5.
Containers for kitchen
As required
6.
Dust bins in each ward & consultation room
1 per ward
7.
Fridge
As required
8.
Heavy duty Torch light – 1 per ward
1 per ward
9.
Intercom System
As required
10.
Non mercury Thermometer clinical – 1 per ward
1 per ward
11.