NH began pursuing JCI accreditation at their major urban hospitals starting in 2010. Today they have eight of their hospitals JCI accredited. In 2022, NH’s leadership made the decision to go for JCI Enterprise Accreditation to ensure consistent quality of care is maintained across the JCI accredited hospitals. Joint Commission International’s (JCI) Enterprise Accreditation (EA), the monumental milestone was achieved in June 2023.
With eight of its hospitals already individually accredited by JCI, Narayana Health qualified to apply for the JCI EA. Narayana Health Managing Director and Group CEO, Dr. Emmanuel Rupert, explained the goal was to standardize across all facilities for better and more affordable care for the communities they serve. “There is no better way of getting this entire enterprise alignment than to go through the JCI Enterprise standards,” Dr. Rupert said. “It helped us align every aspect of care, not just the clinical aspect, but every aspect, be it the information technology, human resources, facilities, et cetera. “The entire framework is now aligned in a very comprehensive way for best-in-class patient safety and clinical outcomes and clinical care standards.”
About Narayana Health
With a mission ‘to make health care accessible to all,’ Narayana Health is one of India’s largest and most innovative health care systems with 18 hospitals, 7 heart centers, and 30 integrated care clinics (primary care facilities). Narayana Health provides affordable, high-quality care to roughly 3 million patients annually. Known for its efficient, low-cost model, the organization has significantly impacted health care delivery, particularly in cardiac surgery and cardiac care. Its flagship facility is the Narayana Institute of Cardiac Sciences, in Bangalore, and the health care system extends its services internationally with a hospital in the Cayman Islands.
A Shared Vision of Excellence
Why Pursue JCI Enterprise Accreditation?
While each facility within the health care system held the nationally mandated individual accreditations from India's National Accreditation Board for Hospitals & Healthcare Providers (NABH), they prioritized the need to acquire international accreditation recognition from JCI. Eight of Narayana Health’s main hospitals had already individually achieved JCI Hospital accreditation status and most recently invested in JCI Enterprise Accreditation to standardize patient care among those nine facilities. Dr. Rupert pointed out that although all facilities were robust and patient-centric, they didn’t operate with uniform processes and were not all at the same level of performance. The goal was to elevate all facilities to a world-class standard and benchmark against the best health care systems in the world.
JCI Enterprise Accreditation offered a path to achieve this uniformity by providing a comprehensive method to assess and ensure compliance across the network, align governance, and synchronize standards across all units. The decision to pursue JCI Enterprise Accreditation involved considerations around the potential for improved patient outcomes, increased staff engagement, and enhanced reputation.
Narayana Health’s leadership communicated their steadfast commitment to key stakeholders, from hospital leadership, department heads, financial officers, and quality improvement teams to doctors, nurses, clinicians, and housekeeping staff. Everyone in the organization knew this effort was important. The crystal-clear internal communication ignited a passionate, all-hands-on-deck effort that would be supported during the preparation stages by Narayana’s technology and IT teams, who provided crucial support, creating a framework that allowed daily activities to be cataloged and tracked, contributing directly to improvement measures.
This ensured the entire team observed consistent improvements in safety system adoption and standardization, and confirmed a cohesive approach, collaboration, and commitment at all organizational levels.
Preparing for Enterprise Accreditation
The alignment was significantly facilitated by the clinical teams’ commitment, driven by the clear impact on patient safety and outcomes. Far from being viewed as additional work, these efforts became integral to the daily operations.
The rigorous preparation ensured that the hospital system not only met the standards but also positioned itself to sustain high-quality care delivery across its facilities.
Successfully achieving accreditation was merely a milestone, not the end of the journey, according to Dr. Devi Shetty, Founder and Chairman of Narayana Health. "Achieving JCI Enterprise Accreditation has been a transformative journey for us,” he said. “It reflects our unwavering commitment to uphold the highest standards of care and operational excellence across our entire network.”
Today, Narayana Health maintains rigorous monthly meetings for monitoring and governance reviews, ultimately to ensure the continuation of high standards of patient-centered care across the health care system. The ongoing commitment is what truly defined their approach and its numerous beneficial impacts.
Stages of Narayana Health’s Preparation
JCI experts and resources were readily available across all these stages to address questions around interpretation and/or clarifications. Here is a breakdown of the footwork leading to Narayana Health’s JCI EA award.
The Tangible Benefits of JCI Enterprise Accreditation
Narayana Health's journey toward JCI Enterprise Accreditation included a rigorous process that resulted in a transformative evolution, leading to both improvements in patient outcomes and organizational operations. These changes have fundamentally altered the operational dynamics and human resource management at Narayana Health, aligning them more closely with top health care international standards, according to Narayana Health’s Group Chief Medical Director Dr. P M Uthappa.
A summary of the overarching benefits includes:
Key Quality Care Results
With quality care being a top objective, here are just some early results that Narayana Health is seeing from the accreditation process:
- Reduced Average Length of Stay: Post-accreditation, the average length of stay in hospitals decreased by 1-2 days, optimizing patient throughput and resource utilization.
- Lowered Infection Rates: There was a notable decrease in hospital-acquired infection rates, enhancing the safety of the patient environment.
- Improved Incident Reporting: The system for reporting medical incidents was significantly strengthened, fostering a culture of transparency and continuous improvement.
- Enhanced Clinical Pathways: Standardization of clinical pathways led to more consistent and efficient patient care across all facilities.
- Increased Patient Satisfaction: Patients noted higher satisfaction due to noticeable improvements in quality of care and safety standards, leading to repeat visits and referrals.
The Chief Medical Director's Perspective
“To achieve this, we began by examining the entire patient journey, from arrival to discharge, committing to the mantra of getting it right the first time at every touchpoint. This approach meant that any mistake not only compromised care but also increased costs and lengthened hospital stays.
"To reinforce this, we implemented robust clinical governance across our hospitals, structured like a pyramid with the board and CEO at the top, followed by myself overseeing quality, then the medical directors, and finally the clinical leads who manage the data and operational details.
"As we were doing well with individual hospital accreditations, our CEO, Dr. Rupert, introduced the concept of enterprise-wide standardization. This was a new and unexplored area for us, but we recognized its potential to enhance consistency and quality across all our facilities. By adopting an enterprise approach, we aimed to standardize care throughout our network, aligning each hospital to the highest standards set by JCI. This strategic shift elevated the level of health care we provided across our entire group."
