Healthcare organizations treats patients with different background (such as religion, economic class, literacy level, race, language etc.) and in different settings (such as general ward, sharing room, single room and deluxe room). They are expected to not to discriminate between their patients and provide them a uniform medical care per their clinical requirement. To ensure this, hospitals must have a policy that specifies what constitutes uniform care and what practices must be followed to ensure that patients are not discriminated on the basis of their background or category of their accommodation. The essential part of the policy is provision of uniform medical care and does not applies to those services and facilities that are non-clinical in nature.
Following elements of care shall be implemented to ensure uniform care to all patient
1. Standard treatment protocol – Hospitals must develop/adopt treatment protocols or treatment guidelines for various diagnosis or clinical conditions and must use the same as a standard for providing care to all patients irrespective of his/her background or the category of accommodation. This will prevent any discrimination between patients receiving clinical care for similar health problems.
2. Life saving measures – Life-saving clinical intervention (such as CPR, use of life saving drugs, emergency intubation, emergency oxygen support, emergency ventilator support etc.) whenever required by any patient shall be provided irrespective of whether or not patient pays or can pays for it.
3. Emergency care – Emergency care services shall be available to all patients who need emergency care. No patient shall be denied to access emergency care for any reason. Each patient arriving at the hospital’s emergency shall be triaged to determine the level of emergency and shall be prioritized accordingly. The emergency treatment shall be provided as per the emergency management protocols.
4. Clinical referral services – Whenever required a referral advice must be sought for a patient. The referral advice must be honoured by the doctor to whom the case is being referred to.
5. Informed Consent – Informed consent is an essential part of decision making in clinical care and one of the essential patient right. Informed consent, wherever required, must be taken from patients in a uniform manner as per Informed consent policy and procedure of the hospital.
6. Infection prevention measures – Infection prevention practices (such as standard precaution, isolation precaution, use of personal protective equipment etc.) shall be uniformly followed for all patient irrespective of setting in which he/she is being treated. Aseptic techniques and infection control practices shall be followed as per hospital’s infection control manual.
7. Patient safety measures – Each patient must be uniformly prevented against any mishap, accidents or medical errors by following patient safety protocols and practices. These include, medication safety, surgical safety, safety of vulnerable patient, blood transfusion safety and safety during various clinical procedures
8. Intensive Care services – Intensive care services shall be provided to patient only on the basis of patient’s criticality and need of intensive care. Admission and discharge from intensive care unit shall be on the basis of defined admission and discharge criteria and same shall be applied for all patient
9. Rational use of blood and blood products – Blood and blood products shall be rationally used on the basis of clinical requirement and not on the basis of patient’s capability to pay. Hospital’s policy on rational use of blood and blood products must be used in case of all patients who may require blood.
10. Organ Transplant – Organ shall be made available to a recipient patient in accordance to Transplant of Human Organ act and hospital’s policy on organ donation. Organ shall not be provided on commercial or any other basis except what has been described in law.
It shall be mandatory for all care providers to provide uniform care to patients with similar health conditions. Hospitals must have following systems in place to ensure compliance to this policy
1. Medical Audit – Medical audit must be conducted on a random basis to measure the compliance to standard treatment protocols. It should be used as a tool to ascertain that patients with similar health problems are being provided uniform care.
2. Informing patients about rights – Patient shall be made aware of their rights to avail uniform care
3. Patient complaint and redress mechanism – A system should be in place for patient to register complaint if they feel that they have been discriminated. A redress mechanism must also be in place to process all such complaints
