Standard for Clinics, Polyclinics & Dispensaries.

In our continuous quest to help our members, we are publishing in this issue, standards for Clinics / Polyclinic / Dispensaries.

These standards are given for information of our members to help them do a “Self Audit” of their clinical establishments and be prepared for an official audit by an authority which will be appointed by QCI when clinical establishment Act comes into existence.

IMA – Mumbai West will be approaching the QCI  to become an official agency to give accreditation to the clinical establishments of our members. We will need doctors to work as official auditors who will need to go to members’ clinical establishments, do audit and give the recommendation for accreditation. They will of course be paid a due remuneration for their efforts.

Definition:

Clinic: A standalone healthcare facility for services ( other than OPD of a hospital).

Polyclinic: A clinic which provides services in 2 or more specialties, working in co-operation and sharing the same facilities

Dispensaries: A clinic which in addition to patient care, provides facilities for dispensing medicines.

Medical professional:

1. The above should be owned by a person who is in possession of M.B.B.S. Degree and is registered with Medical Council.
2. Shall; be aware about procedure to handle medico legal cases.
3. Shall notify communicable diseases to appropriate authority
4. In case if a patient is photographed, obtain written consent.
5. Shall be aware about the procedure to handle needle prick injury
6. Shall have list of specialists in the neighboring area.
7. Shall have list of emergency numbers.

Continuous Medical Education for Medical professional:

1. The doctor should attend CME of at least 6 credit hours per year out of which at least ½ hour should be on emergency medicines.
2. In case of polyclinics, all the doctors’ certificates shall be available.

Waiting Area:

1. Should be well lit, comfortable and should have recreation material to make waiting experience, educative, informative & relaxing.
2. Quality Policy, Policy to treat female patients & patient’s rights and responsibilities shall be displayed at least in 2 languages.
3. Fumigation shall be done once a week and record maintained.

Examination Area:

1. Shall be well lit, comfortable and should have weighting scale, Stethoscope, Thermometer, BP Apparatus, Ophthalmoscope, Auroscope, Examination trolley consisting of gloves, kidney trey, Cotton etc.
2. There should be facility to provide necessary privacy during examination.
3. Fumigation shall be done once a week.
4. It is advisable to discourage street footwear in this area.

Staff:

1. The staff should be provided with lab coat, identity card with photo.
2. The staff should undergo health check-up for communicable diseases, at least once a year.
3. The staff shall be aware criteria to identify patients who may need immediate assistance.
4. The staff shall be aware about emergency numbers and steps to be taken in case of emergency.

Records:

1. Doctor shall maintain detailed records and information regarding their patients including name, address, contact nos., medical history, allergies and other alerts (optional: blood group, HIV status), treatment plan advised, treatment rendered, medicines prescribed, etc.
2. Prescription shall be legible, signed, dated and timed.

Immunizations:

1. The doctor and the staff should be immunized for following diseases and the vaccine record shall be available. In case if the vaccination is done prior to the process of accreditation, self declaration shall be available.

2.8A Tetanus

2.8B Hepatitis-B

2. Vaccination records must be maintained.

The immunization should be for the staff that has completed 3 months of employment.

Protection:

1. The Doctor and his / her staff should use gloves, eye / face protecting shields and aprons whenever necessary.
2. Universal precautions for prevention of transmission of diseases shall be observed.

Hand wash:

1. The doctor and the staff should follow the correct procedure of hand wash / scrubbing habits.
2. For routine examination, usages of antibacterial hand sanitizer solutions available in the market are acceptable substitute for hand wash.

The clinic / polyclinic / dispensary shall demonstrate following:

1. The waiting room, examination room and toilet, if available shall have provision of illumination through emergency light.
2. At convenient location a suggestion box / book shall be available for persons desiring to use them.
3. The establishment shall be registered for removal of bio medical waste through authorized agency.
4. Correct display of time and current month calendar shall be available.
5. All the purchases must be registered in purchase order book and the purchased products must be verified.

Additional requirements: The clinic / Polyclinic / Dispensary shall have following items.

1. 1. Glucometer
2. 2. 1^st aid box
3. 3. Emergency medicines
4. 4. Fire extinguisher
5. 5. Oxygen cylinder
6. 6. Nebuliser.

Please note that:

1. Activities not documented will not be considered as done.
2. Shall means compulsory and shroud means recommended.
3. The spirit of the standard is to offer guidelines in line with current practices observed in many countries.

Dr. Ashok Balsekar

Hon. Secretary