Welcome Doctor!
If you are looking to establish an AYUSH hospital with 31-50 beds, it is essential to understand the minimum requirements and guidelines to ensure that your facility meets the standards for patient care, safety, and legal compliance.
This guide will walk you through the key aspects of building and managing a hospital, from infrastructure and equipment to human resources and patient care processes. By following these standards, you can create a hospital that provides high-quality care and meets the regulatory expectations. Let’s get started.
Scope of Services
In your hospital, you may choose to practice one or more traditional systems of medicine, such as Ayurveda, Unani, Siddha, Sowa Rigpa, Yoga & Naturopathy, or combine these with Allopathy. The services you provide will vary based on the system of medicine you focus on. Here are some examples:
- Ayurveda: Panchkarma, Marma Therapy, Kshar Sutra, Agni Karma
- Unani: Ilaj Bit Tadbeer
- Siddha: Varmam and PuraMaruthuvamin
- Sowa Rigpa: Las-Na
- Yoga & Naturopathy: Nauli, Dhauti, Neti, Fasting, Mud Therapy
Ensure that the services you provide are aligned with the principles of the chosen system(s) of medicine.
Infrastructure Requirements for Hospitals
A well-planned hospital infrastructure is essential for providing safe, hygienic, and effective patient care. Below are the key considerations and guidelines to ensure the hospital infrastructure supports the delivery of high-quality healthcare services.
Signage
Effective signage is crucial for clear communication and accessibility within the hospital. The following signage requirements should be adhered to:
- Language and Accessibility: Signage should be displayed in at least two languages to ensure clarity and accessibility for all patients and visitors.
- Hospital Name: A prominent board displaying the hospital name should be visible at the entrance.
- Directional Signage: Directional signs should be placed strategically throughout the hospital to guide patients and visitors to their respective destinations.
Informative Signage
To ensure transparency and help patients and visitors make informed decisions, certain essential details must be clearly displayed:
- Doctor’s Information: Display the doctor’s name, degrees, and registration number.
- Hospital Registration Details: Clearly show the hospital’s registration information.
- Service Fees: Display the fees for OPD (Outpatient Department) and IPD (Inpatient Department) services.
- Hospital Timings: Provide clear information about the hospital’s operating hours.
- Available Facilities: List all available services and specialties in the hospital.
- Registration under the CE Act: Ensure the certificate of registration under the Clinical Establishment (CE) Act is clearly visible.
General Requirements
The hospital should meet the following general infrastructure requirements to maintain a safe and efficient environment for patients, staff, and visitors:
- Accessibility: The hospital should be easily accessible to patients, visitors, and emergency vehicles.
- Hygiene: A clean and hygienic environment must be maintained for patients, attendants, staff, and visitors at all times.
- Water and Electricity Supply: Ensure a 24-hour supply of potable water and electricity, either from direct supply or backup sources.
- Separate Toilets: Provide separate public toilets for males and females for the convenience of visitors and patients.
- Building and Equipment Maintenance: Establish a system for the timely maintenance of buildings and hospital equipment.
- Furniture and Fixtures: The furniture and fixtures should be appropriate for the hospital’s activities and patient load, ensuring comfort and functionality. All items should be well-maintained.
Space Requirements in a AYUSH Hospital with 31-50 Beds
For hospitals with 31-50 beds, it is essential to adhere to specific minimum space and functional requirements to ensure a safe, comfortable, and efficient environment for patient care. The following guidelines detail the minimum space requirements for various hospital areas:
General Ward Requirements:
- Designated Areas: The ward should include designated areas for the doctor’s duty room, nursing station, store, clean and dirty utility rooms, janitor room, and toilets. These areas should be part of the hospital’s circulation area.
- Space Per Bed: The space per bed should be 50 sq. ft., with a minimum distance of 3.5 ft between two beds.
- Distance Between Rows of Beds: The minimum distance between two rows of beds should be 5 ft to ensure ample space for patient care and staff movement.
- Specialty Hospitals: For specialty hospitals such as those focusing on Ayurveda, Unani, Siddha, Sowa-Rigpa, Homeopathy, Yoga, or Naturopathy, the facilities should be appropriate and aligned with the services offered. The services provided should adhere to the principles of the respective system of medicine, focusing on diet, lifestyle, and basic treatment of diseases.
Labour Room Requirements (Where Applicable):
The labour room is an essential part of the hospital and requires specific considerations for patient and neonatal safety:
- Privacy and Infection Control: The obstetrical unit should provide privacy and reduce traffic through the unit to minimize the risk of infections.
- Neonatal Safety: Measures should be implemented to ensure the safety and security of neonates within the obstetrical unit.
- Neonatal Resuscitation Facilities: Neonatal resuscitation facilities should be available within the obstetrical unit, conveniently located near the delivery room.
- Facilities for Medication and Equipment: The labour room should have designated spaces for medication, handwashing, charting, and storage of medical supplies and equipment.
- Medical Equipment: The labour room should be equipped with necessary medical equipment, including oxygen and suction systems for immediate use.
Space Requirements for Various Hospital Areas:
- Outpatient Department (OPD): The minimum space requirement for each OPD room is 100 sq. ft., providing adequate room for patient examinations and consultations.
- Inpatient Department (IPD): The minimum space required for each bed in the inpatient department is 50 sq. ft., ensuring sufficient space for patient accommodation and care.
- Minor Operation Theatre/Procedure or Therapy Room (Where Applicable): The minimum space requirement for a minor operation theatre or therapy room is 150 sq. ft. to accommodate minor procedures or therapeutic treatments.
- Labour Room (Where Applicable): The minimum space required for a labour room is 150 sq. ft., ensuring it is adequately equipped for childbirth and obstetrical care.
- Neonatal Care Room (Where Applicable): The neonatal care room should have a minimum space of 150 sq. ft., providing adequate space for proper monitoring and care of newborns.
- Operation Theatre (Where Applicable): The minimum space requirement for an operating room is 263.71 sq. ft. per operating room, providing enough space for medical staff, equipment, and patient care during surgical procedures.
Other Functional Areas: It include, waiting area, administrative area, laboratory, diagnostics, pharmacy, front office, or reception. The space for other functional areas should be appropriately sized based on the hospital’s scope of services and patient load. Proper space planning will ensure smooth operation, efficient patient flow, and easy access to essential services.
Operation Theatre Requirements (Where Applicable):
The operation theatre (OT) is one of the most critical areas in a hospital and must be planned and equipped to ensure safety, sterility, and operational efficiency. The following guidelines outline the essential requirements for the OT:
- Zoning of the OT Complex: The OT complex must be properly zoned to segregate different work areas. The key zones include:
- Sterile Area: Includes the operating room, sterile store, and anesthesia room.
- Clean Zone: Includes equipment or medical stores, scrub areas, pre and post-operative areas, and linen bays.
- Protective Zone: Includes the change room, doctor’s room, and toilets.
- Dirty Area: Handles contaminated items.
- Sterile Area: Includes the operating room, sterile store, and anesthesia room.
- Aseptic Environment: Special attention should be given to maintaining a high level of asepsis (germ-free environment) to prevent infections for both patients and medical staff.
- Doors and Access: The doors to pre-operative and recovery rooms should have a minimum clear width of 1.5 meters to allow for easy access by patients and medical personnel.
- Air Conditioning: Air conditioning is essential in all areas of the OT to maintain a controlled and sterile environment. Window or split AC units should be avoided as they are re-circulating units that can become sources of infection.
- Air Filtration: Proper air filtration systems must be installed to maintain a clean and sterile atmosphere in the OT.
- Temperature and Humidity Monitoring: Temperature and humidity levels should be continuously monitored within the OT to ensure they remain within acceptable limits for surgical procedures.
- Medical Gas and Equipment Supply: All OTs should be equipped with essential medical supplies such as oxygen, nitrous oxide, suction systems, and compressed air for anesthesia and patient care during surgeries.
- Operational Equipment: Necessary medical equipment, such as shadowless lights, Boyle’s apparatus, and other life-saving tools, should be available and in working condition to ensure a successful surgical outcome.
- Uninterrupted Power Supply: A reliable and uninterrupted power supply must be guaranteed for the OT complex. Backup power systems, such as generators, must be available to ensure surgeries can continue in the event of a power failure.
Equipment and Instruments
To provide comprehensive patient care, your hospital must be equipped with the right medical equipment. Here’s what you need to consider:
- Ensure that you have adequate medical equipment based on the scope of services provided and the number of beds in your hospital.
- Establish a system for maintenance and inspection of equipment to keep them in good working condition.
- Follow a routine for cleaning and sterilization to maintain the proper functioning of equipment.
For a detailed list of the equipment required for different departments and services, click here.
Drugs and Consumables
Drugs and consumables are a vital part of hospital operations. Here’s what you need to ensure:
- Keep adequate drugs and consumables available, in line with the services offered and your hospital’s bed capacity.
- Store drugs in a clean, well-lit, and safe environment.
- Ensure you have a defined process for drug storage, inventory management, and dispensing.
Emergency drugs and consumables must be available at all times.
Human Resource Requirements
Qualified, trained, and registered professionals are necessary to run the hospital effectively. You will need to have:
- One registered practitioner for each additional 20 beds above 30 beds, depending on the system of medicine.
- One registered nurse for every 10 beds.
- Two male and two female therapists (if applicable).
- Two pharmacists (if you are running an in-house pharmacy).
- Five attendants or multipurpose workers.
Ensure that each staff member’s personal record contains relevant documentation, including appointment letters, qualifications, and training certificates.
Support Services for AYUSH Hospital
Efficient support services will enhance the quality of care provided. Below are the key support services to be considered:
Registration, Help Desk, and Billing
- Set up a registration or help desk that guides patients and provides them with relevant information, such as available services, cost estimates, etc.
- Ensure transparent billing, with clear lists of charges for different services. A tariff list should be available to patients.
Diagnostic Services
- Provide diagnostic services either in-house or through outsourcing. These services should meet the standards of patient care.
Pharmacy Services
- Maintain an in-house pharmacy or outsource pharmacy services. Make sure to comply with all legal requirements related to pharmacy operations.
Sterilization and Linen Management
- Set up a sterilization area to ensure the proper cleaning and storage of medical instruments and linens.
- Have a system for managing soiled linen in a hygienic manner.
Waste Management
- Segregate, collect, transport, store, and dispose of general waste as per local laws.
- Biomedical waste should be managed in accordance with the Biomedical Waste Management Rules.
Ambulance Services
Provide ambulance services for patient transfer or referrals, either through in-house or outsourced providers, complying with local laws.
Legal and Statutory Requirements for AYUSH Hospital with 31-50 Beds
As you embark on the journey of opening a hospital, it’s crucial to ensure that your facility complies with various legal and statutory requirements. These regulations are set by the local and state health authorities to ensure that your hospital operates safely, efficiently, and in compliance with the law.
Below is a comprehensive list of legal requirements that you must comply with before and after starting your hospital. Note that not all of these may apply to your specific case, depending on the size of the hospital, location, and the type of services you plan to offer.
Registration and Licensing
- Registration under Nursing Home Act or Medical Establishment Act: Ensure that your hospital is duly registered under the applicable local or state laws. This registration authorizes your facility to operate legally.
- Clinical Establishments Registration: In some states, you may also be required to register as a clinical establishment to ensure adherence to specific health standards.
- Bio-medical Waste Management Licenses: Obtain authorization from the Pollution Control Board (PCB) for handling bio-medical waste. Additionally, a Memorandum of Understanding (MOU) with a vendor for waste management is also mandatory.
Medical Equipment and Radiation Licenses
- AERB Licenses: If your hospital plans to use medical equipment like CT scans or X-rays, the Atomic Energy Regulatory Board (AERB) provides guidelines and licenses for these machines. Ensure that you obtain type approval and layout approval from the AERB. Additionally, you’ll need to acquire a license for CT scans, interventional radiology, or other radiological machines.
- Medical Gases Licenses: Hospitals using medical gases must comply with licensing regulations under the Explosives Act.
Safety and Emergency Preparedness
- NOC from Fire Department: A no-objection certificate (NOC) from the Fire Department is essential. This confirms that your hospital is equipped with necessary fire safety measures like fire extinguishers, alarm systems, and emergency exits.
- Ambulance Service Permits: If your hospital offers ambulance services (either in-house or outsourced), make sure you have the required commercial vehicle permits and a commercial driver’s license for all drivers. Additionally, check for any specific pollution control licenses needed for ambulances.
Building and Infrastructure
- Building Completion License: This license ensures that your hospital building is constructed as per the approved architectural plans and complies with all safety and construction standards.
- Lift Licenses: If your hospital is equipped with elevators, each lift must be licensed to ensure safety and proper operation.
- DG Set Approval: If your hospital uses a diesel generator (DG) set as a backup power source, approval for commissioning is mandatory.
- Diesel Storage Licenses: Obtain the required licenses if your hospital stores diesel or other fuels for emergency power backup.
Operational and Health Compliance
- Food Safety Licenses: Hospitals that provide food services must comply with food safety regulations and obtain the necessary licenses to ensure that the food served is hygienic and safe.
- Narcotic Drug Licenses: If your hospital prescribes narcotics or controlled substances, you will need to acquire a narcotic drug license.
- Blood Bank Licenses: If your hospital operates a blood bank, you must obtain the appropriate licenses from the relevant authorities.
Outsourcing and Employment Compliance
- MoU or Agreement with Outsourced Human Resource Agencies: If you hire staff through outsourced agencies, ensure that an MOU or agreement is in place, in accordance with labor laws.
- Provident Fund or ESI Act: Compliance with the Employees’ Provident Fund (EPF) or Employee State Insurance (ESI) Act is mandatory for hospitals with more than a certain number of employees.
Specialized Acts and Regulations
- MTP Act: If your hospital provides medical termination of pregnancy (MTP) services, comply with the MTP Act, which governs the procedures for abortion.
- PNDT Act: The Pre-Conception and Pre-Natal Diagnostic Techniques (PNDT) Act prohibits the misuse of prenatal diagnostic techniques for sex determination and mandates that you follow strict guidelines if you offer such services.
- Transplantation of Human Organs Act: If your hospital offers organ transplant services, comply with this act which regulates the removal, storage, and transplantation of human organs.
Financial and Legal Compliance
- Sales Tax Registration: Register for sales tax if your hospital provides taxable services or goods.
- PAN (Permanent Account Number): Ensure your hospital is registered for a PAN number with the Income Tax Department for all financial transactions.
- No Objection Certificate under Pollution Control Act: Obtain a no-objection certificate under the Pollution Control Act (Air or Water) to ensure that your hospital meets environmental regulations for air and water quality.
Communication and Safety
- Wireless Operation Certificate from Indian P & T: Hospitals using wireless communication systems must acquire a wireless operation certificate from the Indian Post and Telegraph department.
- Arms Act, 1950: If your hospital uses armed security personnel, ensure that you comply with the Arms Act, which governs the use of firearms in security services.
This list may seem exhaustive, but it is essential for ensuring that your hospital not only meets regulatory standards but also provides a safe and secure environment for patients and staff. Compliance with these laws ensures the smooth operation of your hospital and helps build trust within the community.
Remember to regularly check the expiration dates for these licenses and renew them in time. Being proactive in managing these legal and statutory requirements will prevent future complications and enable your hospital to provide exceptional care while adhering to the law.
By keeping your hospital compliant with these legal requirements, you’ll not only provide quality healthcare but also ensure that you are on the right side of the law.
Record Maintenance and Reporting
It is crucial to maintain proper medical records, whether in physical or digital format. These records must ensure confidentiality, security, and integrity. For Inpatient (IPD) patients, records should be maintained in line with national or local laws.
Key points to remember:
- Medical records must include essential information such as patient details, treatment provided, and discharge summary.
- Ensure the records are kept confidential and secure at all times.
Basic Processes for Patient Care
Registration, Billing, and Help Desk
- Ensure all patients are registered at the hospital and are informed about their rights, responsibilities, and expected costs.
- Use ABHA numbers (if applicable) for patient identification.
Assessment and Plan of Care
- Conduct an initial assessment of each patient upon arrival.
- Based on the assessment, a treatment plan will be made by the registered practitioner, which may include admission, treatment, referrals, or investigations.
- Consent for admission should be obtained.
Informed Consent
For any surgical or invasive procedure, informed consent must be obtained from the patient or their guardian. The consent document should be in an understandable language and format.
Patient Care and Safety
- Provide care based on standard treatment guidelines and inform patients about preventive and curative aspects.
- Monitor patients throughout their treatment, including after procedures, and document all findings.
Infection Control
- Follow infection control practices to prevent healthcare-associated infections.
- Maintain adequate hygiene, especially in high-risk areas like operation theatres, labor rooms, and procedure rooms.
Discharge Summary
Provide a discharge summary to every patient upon discharge. This summary should include all relevant clinical details and discharge advice.
Wrapping it Up
Establishing an AYUSH hospital with 31-50 beds is a significant and rewarding undertaking that requires careful planning, adherence to regulations, and a commitment to providing high-quality, holistic patient care.
By following the infrastructure guidelines, ensuring proper staffing, maintaining essential equipment, and meeting the legal requirements, you can create a facility that supports the health and well-being of your community while upholding the values of traditional medicine.
As a doctor embarking on this journey, your dedication to patient care and your vision for integrating AYUSH practices into modern healthcare will undoubtedly have a lasting impact.
With patience, perseverance, and the right resources, you have the potential to build a successful and thriving hospital that meets both the medical and emotional needs of your patients.
Wishing you all the best in your endeavors. May your hospital provide healing, hope, and wellness to many. Stay focused, stay compassionate, and continue to be the beacon of care and healing in your community!
See Also: How To Open An AYUSH Hospital With Up To 10 Beds In India: A Complete Guide
