Welcome, Doctors!
Opening an AYUSH hospital requires careful planning and adherence to various guidelines to ensure your hospital provides the best care for your patients.
In this guide, we will walk you through the essential steps for setting up an AYUSH hospital with up to 10 beds, covering key aspects such as the hospital definition, scope of services, infrastructure, human resource requirements, and more. Let’s get started!
What is a Hospital?
A hospital is a clinical establishment that provides treatment to patients through qualified and trained staff, particularly by registered practitioners in Ayurveda, Unani, Siddha, Sowa Rigpa, Homoeopathy, or certified Yoga & Naturopathy practitioners, as per the relevant statutes of your State or Union Territory.
Hospitals may practice one or more of these systems and may even integrate them with Allopathy.
Hospitals serve both inpatients and outpatients. Inpatients are those who are admitted to the hospital and stay overnight or longer, while outpatients are those who visit the hospital for diagnosis, treatment, or therapy but do not stay overnight.
As a hospital, you will have the necessary facilities to admit and care for inpatients. On the other hand, other clinical establishments like clinics, polyclinics, or dispensaries do not provide inpatient care, although exceptions like hospices exist. Your hospital might also include multiple departments, each focused on different types of diseases.
Hospitals can be located in either rural or urban settings and may be run by the public or private sector:
- Public Sector: Includes central, state, or local governments, public sector undertakings, or registered societies.
- Private Sector: Can be run by individual proprietorships, partnerships, companies, co-operatives, trusts, or charitable organizations.
The guidelines from the National Commission for Indian System of Medicine (NCISM) and National Council for Homeopathy (NCH), or other legal bodies, must be followed to ensure your hospital meets all the necessary legal requirements.
See Also: A Comprehensive Guide For Doctors On Hospital Categorization And Setting Up Your Own Facility
Scope of Services for AYUSH Hospital
As an AYUSH hospital with up to 10 beds, you can offer a variety of services, depending on the systems of medicine you decide to integrate. These may include:
- Ayurveda: Panchkarma, Marma Therapy, Kshar Sutra, Agni Karma, etc.
- Unani: Ilaj Bit Tadbeer.
- Siddha: Varmam, Pura Maruthuvamin.
- Sowa Rigpa: Las-Na treatments.
- Yoga & Naturopathy: Nauli, Dhauti, Neti, Fasting, Mud therapy, etc.
It is crucial to ensure that all treatments align with these systems and that you have qualified professionals to carry out these procedures safely.
Infrastructure Required
Creating a hospital with high-quality care starts with the right infrastructure. Here are the key components you need to consider:
- Signage: Ensure clear signage in at least two languages, prominently displaying the hospital’s name. Directional signs inside the hospital will help guide patients to different areas. Informative signage should include:
- Doctor’s name and qualifications.
- Registration number of the doctor.
- Fees for outpatient and inpatient services.
- Hospital timings and available facilities.
- A certificate of registration under the Clinical Establishments Act (CE Act).
- Doctor’s name and qualifications.
- Access and Cleanliness: Your hospital must offer comfortable access for patients, visitors, and attendants. Maintaining a clean and hygienic environment is critical for the well-being of everyone. You should also provide 24-hour potable drinking water and electricity.
- Toilets and Maintenance: Separate, clean toilets for male and female patients are essential. You should have a regular maintenance schedule for both the hospital building and its equipment. All furniture and fixtures should be regularly checked to ensure they remain functional.
Equipment for AYUSH Hospital
Make sure to equip your hospital with the right medical tools and equipment for the services you provide. The equipment should be well-maintained, undergo regular inspections, and be cleaned frequently. It’s important to have a robust maintenance system in place to keep the equipment in optimal condition.
Drugs and Consumables
- Medicines: You will need to maintain a sufficient stock of medicines and consumables based on your hospital’s scope of services and bed capacity.
- Storage: Medicines should be stored safely, in clean, well-lit spaces, following the required standards.
- Inventory: Establish an efficient inventory management system to keep track of your medicines. Ensure that emergency drugs are readily available at all times.
Human Resource Requirements
The staffing needs for a clinical establishment depend on the scope of services provided and the number of beds. Here are the minimum staffing requirements for an AYUSH hospital with up to 10 beds:
- Doctor: One registered practitioner in Ayurveda, Unani, Siddha, Sowa Rigpa, or Homeopathy. If you offer Yoga & Naturopathy services, the practitioner must be certified according to state or UT laws.
- Nurse: At least one registered nurse to assist with patient care.
- Therapist: One male and one female therapist based on the services offered.
- Pharmacist: One pharmacist if you have an in-house pharmacy.
- Attendant/Multipurpose Worker: Two attendants or multipurpose workers for basic duties and patient care assistance.
The need for additional support staff will depend on the services you offer. Ensure that each staff member has proper documentation, including qualifications, training, and professional registration, where applicable.
Legal or Statutory Requirements
Your hospital must comply with all local laws and regulations, including obtaining licenses, certifications, and registrations, as well as adhering to health and safety guidelines set by the relevant authorities.
Record Maintenance and Reporting
- Format and Accessibility: Keep medical records in either physical or digital format to ensure easy access for authorized personnel.
- Confidentiality and Security: Maintain patient record confidentiality, ensuring its integrity and security at all times.
- Compliance: Medical records must adhere to national or local laws regarding record-keeping. You’ll also need to submit health information and statistics related to national health programs when required.
Content of Medical Record
Ensure that the medical record includes at least the following:
- Treating Doctor’s Information: Name and registration number.
- Patient Information: Full name, contact number, and demographic details.
- Clinical History: Relevant clinical history, assessment findings, diagnosis, and treatment.
- Investigation Reports: Relevant lab or imaging results.
- Treatment and Care: Detailed account of treatments, surgeries, therapies, etc.
- Discharge Summary: Include the patient’s condition upon discharge, treatments, progress, and post-discharge instructions.
Support Services for AYUSH Hospital
To run a successful hospital, you must ensure certain support services are in place.
Registration and Help Desk Services
The hospital must register all patients upon arrival, preferably using their ABHA number. If the required services are unavailable at the facility, patients should be directed to the nearest appropriate healthcare center.
Once registered, patients are guided to the relevant service area based on their clinical needs. Additionally, patients will be informed about their rights and responsibilities, cost estimates, third-party services (such as insurance), and other essential information.
The hospital’s billing should follow the applicable tariff list, which must be made available to patients in a clear and accessible format.
Assessment and Plan of Care
Each patient will undergo an initial assessment by qualified or trained personnel. Based on this assessment, further management of the patient will be determined, which may include outpatient treatment, admission, transfer, referral, or necessary investigations.
At the time of admission, the hospital will take a general consent for admission from the patient. If there are no available beds or if the patient’s condition requires more specialized care, they will be referred to another facility, along with all the necessary clinical documentation.
Admitted patients should be reassessed at least once a day or as needed, and these assessments must be documented. Furthermore, when a male practitioner examines or treats a female patient (or vice versa), a female attendant or nurse must be present.
Informed Consent
Informed consent is a crucial element of patient care. Before performing any surgery, invasive procedure, or treatment, the hospital must obtain consent from the patient or their guardian, especially in cases where the patient is a minor or mentally disabled.
The consent must be provided in simple, clear language that the patient or guardian can easily understand. This ensures that they are fully informed about the procedure, including its risks, potential complications, and available alternatives.
At a minimum, the informed consent form should include the following details:
Patient or Guardian’s Name (in case the patient is a minor or mentally disabled).
Patient Registration Number.
Date of Admission.
Name and Registration Number of the Treating Doctor.
Description of Therapy/Surgery/Investigation: A clear explanation of the procedure, including potential complications.
Signature of the Patient or Guardian with the date and time.
Patient Care and Education
The hospital must provide patient care in line with Standard Treatment Guidelines prescribed by the central or state government. Patients and their families should be educated on preventive, curative, promotive, and rehabilitative aspects of care, either verbally or through printed materials.
All documents related to any surgical or invasive procedures performed must be carefully maintained in the patient’s case file. Continuous monitoring of the patient during and after every procedure is required, with all observations documented.
Medical Prescription, Administration, and Monitoring
Prescriptions should include the patient’s name, date, medication details (including dosage, route, frequency, and duration), and the prescribing doctor’s registration number and signature.
If the patient has any known drug allergies, they should be documented, and the patient should be informed. The hospital ensures that the correct medication is administered to the correct patient by verifying their identity, medication, dosage, route, and expiry date before administration.
Patients are monitored after medication administration, and any adverse reactions or events must be recorded and reported.
Infection Control
The hospital must follow standard precautions such as hand hygiene and personal protective equipment (PPE) usage to reduce the risk of healthcare-associated infections.
Adequate spacing in patient care areas must be maintained to prevent the transmission of infections, and all hospital areas should be cleaned regularly with disinfectants.
Infection control practices must be strictly followed in high-risk areas such as operation theatres, labor rooms, and procedure rooms. Housekeeping services must ensure proper hygiene and sanitation throughout the hospital.
Safety of Patients, Staff, Visitors, and Relatives
Ensuring the safety and security of patients, staff, visitors, and relatives is paramount. The hospital should have appropriate safety measures and installations in place to maintain a safe environment for everyone involved.
Patient Information and Education
The hospital should ensure that patients and their families are fully informed about the patient’s condition, proposed treatments, risks, alternatives, benefits, and expected costs.
Regular updates should be provided if there are any changes in the patient’s condition. In addition, patients and their families must be educated about the safe and effective use of medication, diet, and disease prevention strategies.
Discharge Summary
A discharge summary is an essential document that must be provided to all patients upon their discharge from the hospital. It should be written in clear and easily understandable language. The discharge summary must include, at a minimum, the following details:
Name and Registration Number of the Treating Doctor: The details of the attending doctor responsible for the patient’s care.
Patient Details: Include the patient’s name, demographic information, and contact number (if available).
Admission and Discharge Dates: The specific dates when the patient was admitted and when they were discharged.
Clinical History and Diagnosis: A summary of the patient’s relevant medical history, findings from assessments, and the final diagnosis.
Investigation Results: A summary of the test or laboratory results that were obtained during the patient’s stay.
Treatment Provided: Detailed information on medical treatments, therapies, surgeries, or any other care that was administered during the patient’s stay.
Discharge Instructions: Information on prescribed medications, follow-up care, and any other instructions for the patient.
Emergency Care Instructions: Clear guidance on when and how to seek urgent care if necessary.
By adhering to these guidelines, you will not only meet regulatory standards but also provide your patients with comprehensive and clear information about their treatment and care after discharge. In cases of transfer, leaving against medical advice (LAMA), or even death, a discharge summary must still be provided.
Patient Care, Rights, and Responsibilities
Providing quality care goes beyond treatment. Ensure patients are well-informed about their condition, treatments, risks, and alternatives. Respecting patient rights, such as the right to confidentiality, informed consent, and non-discrimination, is critical to building trust and delivering excellent care. These rights include:
- The right to be informed about the nature of their illness, proposed investigations, treatments, expected results, possible complications, and expected costs.
- The right to access a copy of case papers, patient records, investigation reports, and detailed bills.
- The right to informed consent before specific tests or treatments.
- The right to seek a second opinion from a clinician of their choice, with records provided by the treating hospital.
- The right to confidentiality, dignity, and privacy during treatment.
- The right to have a female attendant present during physical examinations of female patients by male practitioners (and vice versa).
- The right to non-discrimination in treatment, including on the basis of HIV status.
- The right to choose alternative treatment options, if available.
Patients’ Responsibilities
Likewise, patients must also fulfill their responsibilities, such as providing relevant health information, cooperating with medical personnel, and following the prescribed treatments. These include:
- Providing all relevant health information.
- Cooperating with doctors during examinations and treatments.
- Following all instructions provided by medical personnel.
- Paying hospital fees on time.
- Respecting the dignity of hospital staff.
- Refraining from any violent behavior.
By ensuring that both patient rights and responsibilities are respected, the hospital fosters a safe and respectful environment for all individuals involved in the care process.
See Also: How To Open A Polyclinic In India: A Comprehensive Guide
Wrapping it Up
Setting up an ayush hospital with up to 10 beds is both a rewarding and responsible endeavor that requires careful attention to detail. By following the guidelines above, you will not only meet legal and regulatory standards but also create an environment that fosters healing, well-being, and trust between you and your patients.
Remember, every step, from infrastructure to maintaining medical records and ensuring patient rights, contributes to the success of your practice. Your role as an AYUSH practitioner gives you the opportunity to provide holistic, alternative treatments that can significantly improve the lives of your patients.
We wish you the best of luck in establishing your AYUSH hospital. May your efforts lead to good health, peace, and prosperity for the communities you serve.
Good luck, and here’s to your success!
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