In today’s evolving healthcare landscape, quality is no longer a benchmark—it’s a baseline. Most healthcare organizations in India have moved past the stage of asking why NABH is important. The focus now is on how to implement it meaningfully, so systems run smoothly and patients receive consistent, safe, and ethical care.

This blog series will explore each of the 10 NABH chapters—one per day—starting with the foundation: AAC (Access, Assessment, and Continuity of Care).

Before we begin, here’s a list of the 10 core chapters in NABH accreditation standards:

🔹 NABH Standard Chapters

1. AAC – Access, Assessment and Continuity of Care

2. CARE OF PATIENTS (COP)

3. MANAGEMENT OF MEDICATIONS (MOM)

4. PATIENT RIGHTS AND EDUCATION (PRE)

5. HOSPITAL INFECTION CONTROL (HIC)

6. CONTINUOUS QUALITY IMPROVEMENT (CQI)

7. RESPONSIBILITIES OF MANAGEMENT (ROM)

8. FACILITY MANAGEMENT AND SAFETY (FMS)

9. HUMAN RESOURCE MANAGEMENT (HRM)

10. INFORMATION MANAGEMENT SYSTEM (IMS)
    
    

Chapter 1: AAC – Access, Assessment & Continuity of Care

🔍 What is AAC?

AAC forms the clinical backbone of the NABH standard. It focuses on the patient’s journey from entry to exit, ensuring that care is delivered in a structured, timely, and coordinated manner. It's not just about treating the patient—it's about how the patient is received, diagnosed, monitored, and transitioned (either discharged, referred, or followed up).

🧩 Key Elements of AAC

AAC is typically broken down into the following standard elements:

1. Patient Access

2. Admission Protocols

3. Initial Assessment

4. Ongoing/Periodic Reassessment

5. Referral & Transfer Processes

6. Discharge Planning

7. Continuity of Care Post-Discharge

📅 When is AAC relevant?

AAC is active every moment a patient engages with the hospital—from first inquiry at the reception to their final visit or communication post-discharge. Whether it’s a walk-in emergency, a scheduled surgery, or a routine consultation, the AAC chapter applies.

❓Why is AAC critical?

• Reduces errors: Structured assessment reduces misdiagnosis.

• Builds trust: Patients feel assured when they see defined pathways.

• Ensures timely intervention: Delays in admission or reassessment can cost lives.

• Improves outcomes: Coordination among departments leads to better care plans.

• Legal protection: Proper documentation of access, assessments, and continuity acts as a strong legal defense.

⚙️ How does a hospital implement AAC?

Let’s break it down:

✅ Access

• Define clearly written criteria for admission, transfer, and referral.

• Emergency vs. elective cases need distinct protocols.

• Ensure availability of staff at entry points like reception and triage.

• Display services available and not available, so expectations are managed.
  
  

✅ Assessment

• Conduct a thorough initial assessment within a defined time (usually 1 hour).

• Clinical assessment, nursing assessment, and nutrition screening should be included.

• Develop assessment formats and ensure they are filled at the point of care.
  
  

✅ Reassessment

• Based on patient condition, frequency should be defined (e.g., every shift, every 12 hours).

• Use clinical judgment + policy-defined frequency.

• Include pain assessment, vital signs, psychological needs, etc.
  
  

✅ Referral/Transfer

• Maintain written protocols for referral and inter/intra-hospital transfer.

• Use transfer forms/checklists—include reason, vital signs, and communication with receiving department.

• Always document verbal or written consent.
  
  

✅ Discharge Planning

• Begin discharge planning early in the admission cycle.

• Include patient education, medication instructions, follow-up dates, and warning signs.

• Create discharge summary formats to ensure consistency.
  
  

✅ Continuity of Care

• Track follow-ups via appointment logs, phone calls, or home visits (as applicable).

• Educate patient/caregivers at each visit.

• Keep communication open across specialties to ensure consistency.
  
  

🧠 Common Challenges in AAC

• Delayed assessments in emergency or night shifts.

• Unclear documentation practices.

• Inconsistencies between departments (e.g., ER vs. IPD).

• Lack of patient understanding of discharge instructions.

• Referrals without complete handover notes.

🌱 What AAC means in practice

AAC is about building a care pathway. Every nurse, doctor, admin staff, and technician plays a part. For example:

A patient walks in with chest pain → Reception logs time and sends to ER → ER team assesses within 10 mins → Cardiologist is called → Admission is done with proper notes → Treatment begins → Reassessments happen every shift → Discharge with lifestyle advice → Cardiologist follow-up scheduled.

When this works seamlessly, the hospital doesn’t just meet NABH standards—it lives them.

🛠 How Optimize Helps You Implement AAC on Autopilot

At Optimize, we believe that systems work best when they’re not just documented but internalized. Our role is to help your team understand the "why" behind each form, process, and checklist—so that your AAC system runs like clockwork, even without continuous supervision.

• We simplify documentation into usable formats.

• We train your team to act, not just write.

• We simulate patient journeys to test gaps.

• We audit softly—to identify where automation, policy, or training can reduce dependency on specific individuals.
  
  

Our aim is to ensure that your hospital doesn’t just pass NABH but embeds quality into its culture—so care continues, no matter what.

🗓️ Stay tuned for tomorrow’s blog, where we’ll dive into Chapter 2: Care of Patients (COP) — the heart of clinical service delivery.