Welcome, doctors! You’re about to begin an exciting journey of starting your own hospital in India, and this guide is here to help you navigate the process, with a particular focus on level 1A and 1B hospitals in India.
The Indian healthcare sector is expanding rapidly, presenting both challenges and immense opportunities. By understanding the regulations, establishing a solid foundation, and prioritizing patient care, you can create a successful and impactful healthcare facility.
This guide will walk you through essential aspects such as legal requirements, hospital construction, staff management, and delivering excellent patient care. With this valuable information, you’ll be well-equipped to make informed decisions and establish a thriving hospital in the Level 1A and Level 1B categories.
What is a Hospital?
A hospital is a clinical establishment that provides comprehensive patient treatment through qualified medical staff and modern healthcare equipment, typically following the allopathic system of medicine.
Hospitals are designed to admit and care for inpatients who require overnight stays or longer. In contrast, other clinical establishments, such as clinics, polyclinics, and daycare centers, provide services but do not have inpatient facilities. Some specialized institutions, like hospices, may offer care without overnight stays.
The hospitals are categorized into different levels based on the services they offer, ranging from basic to advanced care. Level 1 (A) hospitals provide basic healthcare services, including general medical treatment and inpatient facilities, commonly found in rural areas.
Level 1 (B) hospitals build on this foundation by incorporating specialized care in fields like general surgery, pediatrics, and obstetrics.
Level 2 hospitals offer a broader range of specialized services, including emergency care, diagnostic labs, and imaging, typically located in larger towns or cities.
Level 3 hospitals go further by offering advanced super-specialty services such as cardiology, neurology, and oncology, often catering to complex medical needs. Finally, Level 4 hospitals, or teaching hospitals, are affiliated with universities and focus on medical education, research, and providing tertiary care through specialized treatments and super-specialist services.
To understand more about the hospital caterogization, please refer to the full guide here.
Hospital Levels and Their Definitions
Hospital Level 1 (A): Hospitals at this level provide general medical services with indoor admission facilities. They are staffed by recognized allopathic medical graduates (e.g., MBBS) and may also offer general dentistry services provided by BDS graduates. The examples of level 1A include primary health centers (PHCs), government and private hospitals, and nursing homes run by MBBS doctors.
Hospital Level 1 (B): These hospitals offer all the services available at Level 1 (A) and additionally provide specialist medical services from basic specialties such as general medicine, general surgery, paediatrics, obstetrics & gynaecology, and dentistry.
They offer both indoor and outpatient (OPD) services and are supported by necessary systems like pharmacies and laboratories.The examples of level 1B include general hospitals, community health centers, sub-divisional hospitals, private hospitals with similar services, and district hospitals in some areas.
Scope of Level 1A and 1B Hospitals in India
The scope of services provided at hospitals Level 1A and 1B, practicing allopathy or modern systems of medicine, may include patient care in any or all of the following specialties:
- General Medicine
- Obstetrics & Gynaecology (Non-surgical)
- Pediatrics
- Community Health and Family Medicine
- General Dentistry
Additionally, these hospitals are required to offer basic support services, including:
- Registration/Help Desk and Billing
- Diagnostic Services (which may be provided in-house, outsourced, or through partnerships):
- Collection Centers/Laboratories
- X-ray
- Ultrasound (USG)
- Waste Management Services, including both general and biomedical waste management.
Hospital Infrastructure and Requirements
Signage
- The hospital must display appropriate signage in at least two languages. A board indicating “24-hour emergency available” is recommended.
- A prominent board displaying the name of the hospital should be placed at the building’s entrance.
- Directional signage must be placed both within the facility and, where applicable, in the surrounding area to guide patients to the hospital.
- The following informative signage should be displayed:
- Name of the care provider with registration number.
- Registration details of the hospital, as applicable.
- Availability of the fee structure for various services.
- Timings of the facility and services offered.
- Mandatory information, such as compliance with the PNDT Act.
- Important contact numbers, such as for the Blood Bank, Fire Department, Police, and Ambulance Services.
Safety Signage
- Safety hazard and caution signs, including those for electrical shock, inflammable articles, and radiation, must be displayed at relevant locations, as per applicable laws.
- Fire exit signage should be clearly visible.
- “No Smoking” signage must be placed at prominent locations.
Other Requirements
- Access to the hospital should be convenient for both patients and visitors.
- Access must comply with the “Persons with Disabilities Act,” ensuring that individuals with mobility restrictions can easily enter the hospital.
- The hospital should maintain a clean, safe, and hygienic environment for patients, staff, and visitors.
- A 24-hour supply of potable drinking water and hand hygiene facilities must be available.
- The hospital must have a continuous power supply, either directly or from alternate sources.
- Clean public toilets must be provided.
- Furniture and fixtures should be appropriate to the hospital’s activities and workload, ensuring functionality and proper maintenance.
Space Requirements for Hospital Level 1
- Ward Beds and Surrounding Space: A minimum of 6 sqm per bed. Additionally, circulation space should account for 30% of the total area, including nursing stations, ward stores, and sanitary facilities.
- Minor Operation Theatre/Procedure Room: The desired minimum size is 10.5 sqm.
- Labour Room: The required space per labour table is 10.5 sqm.
- Other Areas:
- Nursing stations, doctors’ duty rooms, stores, clean and dirty utilities, circulating areas, and toilets should be appropriately sized.
- Clean utility and stores should be a minimum of 10.5 sqm, while dirty utility areas require 7 sqm. Toilets should have a minimum space of 3.5 sqm.
- Nursing stations, doctors’ duty rooms, stores, clean and dirty utilities, circulating areas, and toilets should be appropriately sized.
- Bio-medical Waste Storage: A minimum of 5 sqm is required for bio-medical waste storage.
Functional Areas
Other areas like laboratories, diagnostics, the front office/reception, waiting areas, and administrative offices should be sized according to the hospital’s scope of service and patient load.
Detailed Requirements for Specific Areas
- Wards:
- The ward should include designated areas for nursing stations, doctors’ duty rooms, stores, clean and dirty utilities, janitor rooms, and toilets. These should be part of the circulation area.
- For a general ward with 12 beds, at least one working counter and one hand-wash basin should be provided.
- The distance between beds should ideally be 1 meter.
- The space at the head end of each bed should be at least 0.25 meters.
- Door widths should be at least 1.2 meters, with corridors being a minimum of 2.5 meters wide.
- The ward should include designated areas for nursing stations, doctors’ duty rooms, stores, clean and dirty utilities, janitor rooms, and toilets. These should be part of the circulation area.
- Labour Room:
- The obstetric unit must offer privacy, prevent unnecessary traffic, and minimize infection risks.
- Safety and security measures for neonates should be in place.
- Resuscitation facilities for neonates must be available within the obstetrical unit and close to the delivery room.
- The room should include facilities for medication, handwashing, charting, and storage.
- The labour room should be equipped with oxygen and suction systems.
- The obstetric unit must offer privacy, prevent unnecessary traffic, and minimize infection risks.
- Emergency Room (if available):
- Emergency beds should have a surrounding space of at least 10.5 sqm per bed.
Furniture and Fixtures (Indicative List)
- Examination table
- Writing tables
- Chairs
- Almirahs (wardrobes)
- Waiting benches
- Medical/surgical beds
- Labour table (if applicable)
- Wheelchairs/stretchers
- Medicine trolley, instrument trolley
- Screens/curtains
- Foot steps
- Bedside tables
- Baby cots (if applicable)
- Stools
- Medicine chest
- Examination lamps
- View boxes (for X-ray films)
- Fans
- Tube lights/lighting fixtures
- Wash basins
- IV stands
- Colour-coded bins for bio-medical waste
This is an indicative list and should be adjusted based on the hospital’s size and the scope of services provided.
Medical Equipment and Instruments
The hospital must ensure that it maintains sufficient medical equipment and instruments, appropriately aligned with the range of services offered and the number of beds available.
Furthermore, a system should be established for the maintenance of critical equipment, ensuring its continuous functionality. In addition, all equipment should be kept in optimal working condition through regular inspections, cleaning, and routine maintenance.
To support this, annual maintenance checks should also be scheduled to prevent any potential malfunctions and ensure the equipment’s reliability. Let’s have a look at the list of emergency equipment provided.
Emergency Equipment
- Resuscitation equipment including laryngoscope, endotracheal tubes, suction equipment, xylocaine spray, oropharyngeal and nasopharyngeal airways, and Ambu Bag (adult & pediatric, neonatal if required).
- Oxygen cylinders with flow meter, tubing, catheter, face mask, and nasal prongs.
- Suction apparatus.
- Defibrillator with accessories (desirable).
- Equipment for dressing, bandaging, and suturing.
- Basic diagnostic equipment, such as non-mercury blood pressure apparatus, stethoscope, weighing machine, and thermometer (non-mercury).
- ECG machine.
- Pulse oximeter (desirable).
- Nebulizer with accessories.
Other Equipment and Consumables
The following equipment and consumables should be available and in good working condition, based on the scope of services and bed strength:
Non-Medical Equipment
- Administration:
- Office equipment and furniture.
- Office equipment and furniture.
- Electricity:
- Emergency lights.
- Emergency lights.
- Water Supply:
- Hand-washing sinks/taps/bowls in all areas.
- Storage tank.
- Water purification chemicals or filters.
- Water source for drinking.
- Waste Disposal:
- 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.
- Safety:
- Fire extinguishers.
- Vehicles (four-wheeler, ambulance – if available).
- Medical Stores:
- Lockable storage.
- Refrigeration.
- Kitchen (Own/Outsourced):
- Cooking pots, utensils, and stove.
- Food refrigeration.
- Plates, cups, and cutlery.
- Storage.
- Washing and drying area facilities.
- Laundry (Own/Outsourced):
- Detergent/soap.
- Washing and rinsing equipment/bowls.
- Housekeeping:
- Brooms, brushes, and mops.
- Buckets.
- Soap and disinfectant.
Medical Equipment
- Outpatient Rooms:
- Non-mercury blood pressure apparatus and stethoscope.
- Container for sharps disposal.
- Desk and chairs.
- Examination gloves.
- Examination table.
- Hand washing facilities.
- Light source.
- Minor surgical instruments (Level 1B and above).
- Ophthalmoscope (Level 2 and above).
- Otoscope (Level 2 and above).
- Patellar hammer.
- Receptacle for soiled pads, dressings, etc.
- Separate biohazard disposal.
- Sterile equipment storage.
- Sutures.
- Thermometer (non-mercury).
- Torch with extra batteries.
- Weighing scale.
- Women and Child Health Examination Room:
- Non-mercury blood pressure apparatus and stethoscope.
- Contraceptive supplies.
- Birth register.
- Examination gloves.
- Examination table with stirrups.
- Fetal stethoscope (Level 1B and above).
- Doppler (Level 3).
- Hand washing facility.
- Height measure.
- IUD insertion set.
- Pregnant women register.
- Speculum and vaginal examination kit.
- Syringes and needles.
- Tape measure.
- Toco Cardiograph (Level 2 and above).
- Labour Room:
- 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 cylinder/concentrator.
- Partograph charts.
- Self-inflating bag and mask (adult and neonatal size).
- Suction machine.
- Suturing sets.
- Thermometer (non-mercury).
- Tray with routine and emergency drugs, syringes, and needles.
- Urinary catheters and collection bags.
- Vacuum extractor set.
- Work surface near bed for newborn resuscitation.
- Inpatient Wards:
- Basic examination equipment (stethoscope, non-mercury BP apparatus, etc.).
- Beds, washable mattresses, and linen.
- Curtains.
- Dressing sets.
- Dressing/medicine trolley.
- Gloves.
- IV stands.
- Medicine storage cabinet.
- Oxygen cylinder and concentrator.
- Patient trolley on wheels.
- PPE kits.
- Suction machine.
- Urinals and bedpans.
- Operation Theatre (If Available):
- Adequate storage.
- Ambu resuscitation set with adult and child masks.
- Defibrillator.
- Electrocautery (Level 1B and above).
- Fixed operating lights (Level 3).
- Fixed suction machine (Level 2 and above).
- Hand washing facilities.
- Instrument tray and trolley.
- Laryngoscope set (Level 1B and above).
- Mayo stands.
- Mobile operating light.
- Ophthalmic operating microscope (Level 2 and above).
- Oral airways, various sizes.
- Oxygen cylinder and concentrator.
- Patient trolley on wheels.
- Portable suction machine.
- Safety box.
- Anesthesia Equipment (If Applicable):
- Anesthetic trolley/machine (Level 2 and above).
- CO2 monitor (Level 2 and above).
- O2 monitor (Level 2 and above).
- Endoscopic Equipment (If Applicable):
- Endoscopic instruments and necessary accessories (Level 3).
- Bronchoscope (Level 3).
- Colonoscope (Level 3).
- Endoscope (Level 3).
- Fiber optic laryngoscope (Level 3).
- Central Supply (If Applicable):
- Amputation set.
- Caesarean/hysterectomy set.
- Dilatation and curettage set.
- Endoscopic instrument cleaning machines and solutions.
- Hernia set.
- Laparotomy set.
- Linens.
- Locked storage.
- Operating drapes.
- Ophthalmic instruments.
- Protective caps, aprons, shoes, and gowns.
- Pelvic/fistula repair set.
- Sterile gloves.
- Sterilization equipment for instruments and linens.
- Surgical supplies (e.g., sutures, dressings).
- Thoracocentesis set.
- Thoracostomy set with appropriate tubes and water seal bottles.
- Thoracotomy set.
- Thyroid/Parathyroid set.
- Tracheostomy set.
- Tubal ligation set.
- Vascular repair set.
Other specialized equipment should be provided according to the services available in the hospital. To know more about how to choose the right medical equipment in India check here.
Drugs, Medical Devices, and Consumables
The hospital must ensure the availability of adequate drugs, medical devices, and consumables, in line with the scope of services provided and the number of beds. Additionally, emergency drugs and consumables must be accessible at all times to address urgent needs.
Furthermore, drug storage should be maintained in a clean, well-lit, and secure environment, fully complying with applicable laws and regulations. In order to ensure proper management, the facility must establish clear procedures for the storage, inventory control, and dispensing of drugs, both within the pharmacy and in patient care areas.
Emergency Drugs and Consumables (Essential in All Hospitals)
Injections:
- INJ. Diazepam 10 mg
- INJ. Frusemide 20 mg
- INJ. Ondansetron 8 mg/4 ml
- INJ. Ranitidine
- INJ. Nor Adrenaline 4 mg
- INJ. Phenytoin 50 mg
- INJ. Diclofenac 75 mg
- INJ. Deriphyllin
- INJ. Chlorpheniramine Maleate
- INJ. Hydrocortisone 100 mg
- INJ. Atropine 0.6 mg
- INJ. Adrenaline 1 mg
- INJ. KCL
- Sterile Water
- INJ. Soda Bicarbonate
- INJ. Dopamine
- INJ. Naloxone 400 mcg
- INJ. Lignocaine 50 ml
- Tab. Sorbitrate
- Tab. Aspirin
- INJ. Tetanus
Other:
- Nebulizer Salbutamol 2.5 ml
- Nebulizer Budesonide
- Lignocaine Jelly 2%
- Activated Charcoal
- Calcium (Injection or Tablet)
Fluids:
- RL (Ringer’s Lactate) 500 ml
- NS (Normal Saline) 500 ml
- NS (Normal Saline) 250 ml
- NS (Normal Saline) 100 ml
- DNS (Dextrose Normal Saline) 500 ml
- Dextrose 5% 500 ml
- Dextrose 10% 500 ml
- Pediatric IV Infusion Solution 500 ml
Other Drugs and Consumables
Other drugs and consumables should be available based on the scope of services, bed strength, and patient turnover. Now that we have covered the drugs required for hospitals, let’s have a look at human resource such as staff required for level 1A and 1B hospitals in India.
Human Resource Requirements for Level 1A and 1B Hospitals in India
The hospital must employ qualified and trained medical and nursing staff, ensuring that their skills align with the scope of services provided and the level of medical or nursing care required.
In addition, support and paramedical staff should also be qualified and trained according to the services offered and the hospital’s specific needs. Furthermore, for each staff member, including contractual personnel, a personal record must be maintained.
This record should include the appointment order, documentary evidence of qualifications and/or training, and professional registration, where applicable, to ensure proper documentation and compliance.
Minimum Staffing Requirements for Hospital Level 1
The human resource requirements for a hospital depend on the scope of services provided, bed strength, and the hospital’s workload. However, based on the level of care provided, the following are the minimum staffing requirements for a Hospital Level 1:
- Doctors
- A qualified doctor shall be available round the clock on site (Desirable for Level 1A).
- Level 1A shall have an MBBS-qualified doctor. The doctor must be approved as per state government rules and regulations.
- Level 1B shall have an MBBS doctor with required postgraduate qualifications.
- Nurses
- Qualified nurses per unit per shift must be available, based on the requirements laid down by “The Indian Nursing Council, 1985,” the occupancy rate, and the distribution of beds (Desirable).
- Qualified nurses per unit per shift must be available, based on the requirements laid down by “The Indian Nursing Council, 1985,” the occupancy rate, and the distribution of beds (Desirable).
- Pharmacist
- One pharmacist, if an in-house pharmacy is available.
- One pharmacist, if an in-house pharmacy is available.
- Lab Technician
- One lab technician (minimum DMLT). BSc, MSc, or MLT is desirable, if in-house laboratory services are available.
- One lab technician (minimum DMLT). BSc, MSc, or MLT is desirable, if in-house laboratory services are available.
- X-ray Technician
- One X-ray technician (minimum Diploma in X-ray Technician course), if in-house X-ray facilities are available.
- One X-ray technician (minimum Diploma in X-ray Technician course), if in-house X-ray facilities are available.
- Multi-task Staff
- At least one multi-task staff member.
- At least one multi-task staff member.
Additional support and administrative staff will be required depending on the scope of services provided by the hospital.
Support Services for Level 1A and 1B Hospitals in India
The hospital must have a Registration/Help-desk and Billing counter to assist patients throughout their visit. Additionally, diagnostic services, whether provided in-house or outsourced, should be aligned with the hospital’s scope of services to ensure comprehensive care.
Furthermore, the hospital must adhere to local regulations for the segregation, collection, transportation, storage, and disposal of general waste. Similarly, the handling of biomedical waste must comply with the Biomedical Waste Handling Rules to ensure safety and environmental responsibility.
Lastly, the hospital should make necessary arrangements for the safe transportation of patients for transfers, referrals, investigations, and other needs, either through outsourcing or by managing self-owned vehicles.
Legal/Statutory Requirements
The hospital must comply with all local regulations and laws. Below is a list of legal requirements to be complied with by a hospital, as applicable by the local or state health authority (all may not be applicable):
- Registration under Nursing Home Act/Medical Establishment Act
- Bio-medical Waste Management Licenses
- Authorization of the healthcare organization (HCO) by the Pollution Control Board (PCB)
- Memorandum of Understanding (MOU) with vendor
- AERB Licenses (As per AERB regulations)
- No Objection Certificate (NOC) from Fire Department
- Ambulance
- Commercial Vehicle Permit
- Commercial Driver’s License
- Pollution Control Licenses
- Building Completion Licenses
- Lift License for Each Lift
- DG Set Approval for Commissioning
- Diesel Storage Licenses
- Retail and Bulk Drug License (Pharmacy)
- Food Safety Licenses
- Narcotic Drug Licenses
- Medical Gases Licenses/Explosives Act Compliance
- Clinical Establishments Registration (if applicable)
- Blood Bank Licenses
- MOU/Agreement with Outsourced Human Resource Agencies (as per clinical establishment standards and labor laws)
- Spirit License
- Electricity Rules Compliance
- Provident Fund/ESI Act Compliance
- MTP (Medical Termination of Pregnancy) Act Compliance
- PNDT (Pre-Conception and Pre-Natal Diagnostic Techniques) Act Compliance
- Sales Tax Registration
- Permanent Account Number (PAN)
- No Objection Certificate under Pollution Control Act (Air/Water)
- Arms Act, 1950 (if guards have weapons)
It is important to note that some of these licenses and approvals may vary based on state regulations.
Record Maintenance and Reporting
The hospital must maintain medical records as prescribed by the Clinical Establishment Act, ensuring that the minimum required information is included. These records may be kept in either physical or digital format, depending on the hospital’s infrastructure.
Moreover, the hospital must ensure the confidentiality, security, and integrity of all records to protect patient privacy. In addition, the medical records of in-patient (IPD) patients must be maintained in compliance with national or local laws, the Medical Council of India (MCI) guidelines, and any relevant court orders.
Furthermore, the hospital is responsible for maintaining health information and statistics related to national programs, notifiable diseases, and emergencies, such as disasters and epidemics. These records should be provided to district authorities in the prescribed formats and within the specified frequency.
Content of Medical Records
Medical records shall, at a minimum, contain the following information:
- Name and registration number of the treating doctor
- Name, demographic details, and contact number of the patient
- Relevant clinical history, assessment and reassessment 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 and death summary (where applicable)
See Also: Electronic Medical Records (EMRs) Vs. Paper Records: A Comparative Analysis
Basic Processes for Level 1A and 1B Hospitals in India
The following outlines key procedures and standards that the hospital must adhere to in order to ensure quality care, patient safety, and effective management throughout a patient’s visit, from registration to discharge.
- The hospital shall register all patients who visit the hospital, except when the required service is not available in the facility, in which case the patient will be guided to the appropriate nearest facility.
- Patients shall be informed about their rights and responsibilities, cost estimates, third-party services (e.g., insurance), and other relevant information.
- Billing shall be based on the hospital tariff list, which shall be made available to patients in a suitable format.
- Each patient shall undergo an initial assessment by qualified and/or trained personnel.
- Further management of the patient shall be done by a registered medical practitioner based on the findings of the initial assessment, such as OPD treatment, admission, transfer/referral, investigation, etc.
- The hospital shall ensure adequate and proper spacing in patient care areas to prevent the transmission of infections.
- Regular cleaning of all areas with disinfectant shall be carried out.
- Housekeeping and sanitary services shall ensure appropriate hygiene and sanitation in the establishment.
- Upon admission, general consent for admission shall be obtained from the patient.
- In case of non-availability of beds or if clinical needs warrant, the patient shall be referred to another facility along with the required clinical information or notes.
- Reassessments of admitted patients shall be done at least once a day and/or according to clinical needs, with these reassessments documented.
- Any examination, treatment, or management of a 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.
- The patient and their family shall be treated with dignity, courtesy, and politeness.
- The hospital shall provide care according to Standard Treatment Guidelines as notified by the central or state government (desirable).
- The hospital shall undertake to provide the medical examination and treatment required to stabilize the emergency medical condition of any individual who comes or is brought to the clinical establishment, within the staff and facilities available.
- Prescriptions shall include the name of the patient, date, name of the medication, dosage, route, frequency, duration, and the name, signature, and registration number of the medical practitioner, in legible writing.
- Drug allergies shall be ascertained before prescribing and administering medication. If any allergy is discovered, it shall be communicated to the patient and recorded in the case sheet.
- Patient identity, medication, dose, route, timing, and expiry date shall be verified prior to the administration of medication.
- Patients shall be monitored after medication administration, and any adverse drug reactions/events shall be recorded and reported.
- The hospital shall follow standard precautions, including hand hygiene and the use of personal protective equipment, to reduce the risk of healthcare-associated infections.
- The security and safety of patients, staff, visitors, and relatives shall be ensured through appropriate safety installations and the adoption of suitable safety measures.
- The patient and/or family members shall be informed about the disease condition, proposed care, including the risks, alternatives, and benefits. They shall also be informed about the expected cost of treatment, as well as any changes in condition and progress.
- Informed consent shall be obtained from the patient, next of kin, or legal guardian as required by prevailing guidelines/rules and regulations, in a language the patient can understand (e.g., before invasive procedures, blood transfusions, HIV testing, etc.).
- A discharge summary shall be provided to all patients discharged from the hospital.
- A discharge or death summary shall also be given to the patient or attendant in case of transfer, LAMA/DAMA, or death.
- The discharge summary shall include the necessary points in an understandable language and format.
Patients' Rights and Responsibilities
Patients' Rights
A patient and their representative have the following rights with respect to the clinical establishment:
- To receive adequate relevant information about the nature, cause of illness, proposed investigations, care, expected results of treatment, possible complications, and expected costs.
- To be informed of the rates charged for each type of service provided and the available facilities. These shall be displayed prominently in both local and English languages.
- To access a copy of case papers, patient records, investigation reports, and detailed bills.
- To give informed consent prior to specific tests/treatments (e.g., surgery, chemotherapy).
- To seek a second opinion from an appropriate clinician of the patient’s choice, with records and information provided by the treating hospital.
- To confidentiality, human dignity, and privacy during treatment.
- To ensure the presence of a female person during the physical examination of a female patient by a male practitioner.
- To non-discrimination regarding treatment and behavior based on HIV status.
- To choose alternative treatments, if options are available.
Patients' Responsibilities
- Provide all health-related information.
- Cooperate with doctors during examination and treatment.
- Follow all instructions given by the healthcare team.
- Pay hospital-agreed fees on time.
- Respect the dignity of doctors and other hospital staff.
- Never resort to violence.
Informed Consent/Consent Guidelines
The informed consent shall, at the least, contain the following information in an understandable language and format (preferably one that a layperson can easily comprehend):
- Name of the patient/guardian (in case of minor or mentally disabled).
- Registration number of the patient.
- Date of admission.
- Name and registration number of the treating doctor.
- Name of procedure/operation/investigation/blood transfusion/anesthesia and potential complications should be explained.
- Signature of the patient/guardian with date and time.
Discharge Summary
The discharge summary shall, at least, contain the following information in an understandable language and format:
- Name and registration number of the treating doctor.
- Name, demographic details, and contact number of the 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).
- Instructions on when and how to obtain urgent care.
Conclusion
Starting a hospital is challenging, but also very rewarding. By following the guidelines in this guide and prioritizing patient care, you can build a high-quality hospital that serves your community.
Remember to always put your patients first and provide them with the best possible care. We wish you the very best in your efforts to establish a successful hospital in India.
