1. Current Status of NABH Accreditation for Blood Banks in India
Mr. Bindu Madhav Yenigalla
Assistant Director, NABH

2. Introduction to NABH
National Accreditation Board for Hospitals and Healthcare Providers (NABH) is a constituent board of Quality Council of India (QCI).
QCI was established as an autonomous body under the Department of Industrial Policy & Promotion (DIPP) of Ministry of Commerce and Industry.
NABH was born in 2005 and started its 1st accreditation programme for hospitals in 2006.

3. Activities of NABH Accreditation Programmes – Currently 14 Programmes
Certification – Currently 05 Programmes
Empanelment – Currently 03 Programmes
Education and Training
Programme on Implementation (Hands on Training)
Awareness Workshops

4. Different Programmes run by NABH
Accreditation Programmes
Opioid Substitution Therapy
Hospitals
IRCA
SHCO’s
Certification Programmes
Medical Imaging Services
Pre-Accreditation Entry Level for Hospitals
Blood Bank & Transfusion Services
Pre-Accreditation Entry Level for SHCO’s
Blood Storage Centres
Nursing Excellence
Emergency Department
Primary Healthcare Centres
Medical Laboratory
Allopathic Clinics
Empanelment Programmes
Eye Care Organisations
AYUSH Hospitals
CGHS
Wellness Centres & Spas
ECHS
Ethics Committee (Clinical Trial)
Medical Value Travel Facilitator
Dental Clinics

5. Need for Accreditation
Accreditation would be the single most important approach for improving the quality of blood banks.
Accreditation of blood banks/blood centres and blood transfusion services strives to improve the quality and safety of collecting, processing, testing, transfusion and distribution of blood and blood products.
It provides assurance that blood bank is operating to a prescribed level of technical competency that meets national and/or international regulatory requirements.
Accreditation can help any institution to know its strengths, weaknesses and opportunities through an informed review process.
Source: Systems for accreditation in blood transfusion services; S. Hindawi
ISBT Science Series (2009) 4, 14–17

6. Milestones Standards:
In Jan 2008, 1st Edition of BB Standards were released.
In Jan 2013, 1st Edition of BSC Standards were released.
In June 2016, 3rd Edition of BB Standards was released.
NABH Accreditation Standards for Blood Banks & Transfusion Services, 3rd Edition has 11 Standards, 59 Clauses and 156 Sub clauses to monitor the services being delivered in the Blood Bank for achieving safe Blood for Transfusion.

7. NABH Accreditation Standards for Blood Banks & Transfusion Services, 3rd Edition
Organization and Management
Identification of Deviations and Adverse Effects
Accommodation and Environment
Performance Improvement
Personnel
Document Control
Equipment
Records
External Services & Supplies
Internal Audit and Management Review
Process Control

8. NABH Accreditation Standards for Blood Storage Centres (BSC), 1st Edition
Organization And Management
Process Control
Accommodation and Environment
Continuous Improvement
Personnel
Document Control and Records
Equipment
Internal audit and Management Review
External Services and Supplies

9. Scope of Services Facility Services
Blood bank/ Blood Center having whole blood facility only
Whole Blood
Whole Blood Irradiated
Blood bank/Blood Center having component facility (also whole blood)
Red Blood Cells (RBCs)
Deglycerolized RBCs
Frozen RBCs 40% Glycerol
RBCs Irradiated
RBCs Leukocytes Reduced
Rejuvenated RBCs
Deglycerolised Rejuvenated RBC
Frozen Rejuvenated RBCs
Washed RBCs
Apheresis RBCs
Apheresis RBCs Leukocytes Reduced

10. Facility
Services
Blood bank/Blood Center having component facility (also whole blood)
Platelets
Platelets Irradiated
Platelets Leukocytes Reduced
Apheresis Platelets
Apheresis Platelets Leukocytes reduced
Apheresis Platelets Irradiated
Apheresis Granulocytes
Apheresis Granulocytes Irradiated
Stem cell (PBSC) Apheresis
Cryoprecipitated AHF
Fresh Frozen Plasma (FFP)
Plasma Cryoprecipitate Reduced (CPP)
Liquid Plasma
Blood bank/Blood Center having component facility (also whole blood) with additional facility
Molecular Testing (NAT Testing)
HLA Typing & Matching
Blood bank/Blood Center having component facility (also whole blood) and additional procedures
Therapeutic Procedures

11. How were these standards developed?
Review of existing standards, scientific literature
Preparation of draft standards
Sent to various field experts, key holders & for public comments
Finalization of standards

12. Objective of these Standards
Provide a framework for quality assurance and quality improvement
Focus on patient safety and quality of patient care
Set basic standards that all organisations must achieve
To be revised periodically and raise the “bar”
Achieve International recognition

13. Benefits of Accreditation
Accreditation to a blood bank/blood centre stimulates continuous improvement.
It enables blood bank/blood transfusion services in demonstrating commitment to quality.
It raises community confidence in the services provided by the blood bank/blood transfusion services.
It also provides opportunity to blood bank/blood transfusion services to benchmark with the best.
It provides staff with continuous learning, good working environment and leadership.
It improves overall professional development of all the staff including Medical and Para Medical Staff.

14. Feedback on Accreditation System
Parameters
Average Score out of 4
Have you found NABH standards useful to your organization
3.5
Are standards easy to interpret?
3.2
Easiness in implementation of standards
3.0
How do you rate the assessment process
3.3
How do you rate the evaluation system (i.e. scoring system / NCs)

15. Continued… Parameters Average Score out of 4
Does NABH accreditation help in building trust among community
3.2
Does the implementation of NABH standards improves HCO processes
3.3
Overall Satisfaction
Which area / speciality / department is benefitted the most by implementation of NABH standards
Documentation
Quality of components
Component Separation
Process Control
Serology
Record Maintenance
Personnel
All areas of blood bank

16. Current Status of Accreditations
A total of 93 Blood Banks out of 119 applicant Blood banks are accredited.
09 Blood Banks have voluntarily withdrawn themselves from accreditation
05 applicants are under the process of accreditation
First Blood Storage Centre has been accredited in November 2018.

17. NO. OF ACCREDITED BLOOD BANKS
NAME OF THE STATE
NO. OF ACCREDITED BLOOD BANKS
NO. OF GOVT. BLOOD BANKS
ASSAM 4
MAHARASHTRA 26 2
ANDHRA PRADESH 1
MANIPUR
BIHAR
MEGHALAYA
CHATTISGARH
NAGALAND
DELHI 13
ORISSA
GUJARAT 5
PUNJAB 3
HIMACHAL PRADESH
PONDICHERRY
HARYANA
RAJASTHAN
JAMMU & KASHMIR
TAMIL NADU
JHARKHAND
TELANGANA
KARNATAKA 7
UTTARAKHAND
KERALA
UTTAR PRADESH
MADHYA PRADESH
WEST BENGAL

18. The Firsts
The First Blood Bank to be Accredited – Blood Bank, Fortis Hospital Limited, Mumbai, Maharashtra
The First Govt. Blood Bank to be Accredited - Department of IHBT, Civil Hospital, Asarwa, Ahmedabad, Gujarat
The First RBTC to be Accredited – RBTC, Aluva, Kerala
The First BSC to be Accredited – BSC, Ruby Hall Clinic, Wanowrie, Pune, Maharashtra

19. Assessment of Blood Banks in India - 2016
National AIDS Control Organization (NACO) and National Blood Transfusion Council (NBTC), Ministry of Health and Family Welfare, Government of India in collaboration with U.S Centers for Disease Control and Prevention (HHS/CDC) Division of Global HIV and TB (DGHT), India, Christian Medical College, Vellore & Christian Medical Association of India (CMAI), New Delhi
They have allotted 5 marks during the evaluation for Accreditation
4.6.7 Assessment score by Accreditation status: The mean score was found to be higher among blood banks that were accredited by National Accreditation Board of Hospitals and Health care Providers (NABH) in comparison to those that were not accredited.

20. NACO supported blood banks accredited by NABH scored higher than Non- NACO NABH accredited blood banks.

22. Amendments to the current standards are in process to bring standards in consonance with the revised regulations, addendum to the current standards will published soon.
Route map for the revision of current standards is planned.
We have conducted Blood Donation Camp on World Blood Donor’s Day (June 14) and QCI has donated 37 units of Blood.
NABH is a member of the Haemovigilance Programme of India (HvPI).

23. Education & Training
Almost 28 hands on training programmes for facilitating the implementation of NABH accreditation standards have been conducted.
One programme is conducted for every 2 months.
Forthcoming Hands on Training (Programme on Implementation (POI) of Standards) are scheduled as follows:
Dates of Workshop
Venue City
01 Dec Dec 2018
Bhopal
19 Jan Jan 2019
Jaipur
23 Mar Mar 2019
Madurai

24. Assessment Criteria and Fee Structure
Size of Blood Bank (units collected)
Accreditation Fee
For Blood Banks
For Blood Storage Centres
Application Fee
Annual Fee
< 5000 /annum
Rs. 10,000/-
Rs. 50,000/-
Rs. 5,000/-
Rs. 15,000/-
5001 – /annum
Rs. 25,000/-
Rs. 75,000/-
> 20, /annum
Rs. 40,000/-
Rs. 1,00,000/-
On the above fees, the GST shall be charged (as applicable on that day)

25. helpdesk@nabh.co (General) madhav@nabh.co (Blood Banks)
For any queries, please write to us at
(General)
(Blood Banks)
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26. SAFE BLOOD SAVEs Life
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