KIMSHEALTH, India and the Middle East

Signatory since 2020

Founded in Kerala, India, in 2003, KIMSHEALTH is a privately owned network of hospitals and healthcare facilities in India and five Gulf Cooperation Council countries—Bahrain, Oman, Saudi Arabia, Qatar and the United Arab Emirates. KIMSHEALTH has 2,000 beds, 600 physicians, a staff of more than 6,000 people, and 23 academic programs. The network has been a pioneer in making quality healthcare affordable and accessible. Dr. M.I. Sahadulla, group chairman and managing director of KIMSHEALTH, explains what attracted him to EPiHC and what steps the network is taking to implement to implement the principles.

 

BECOMING A SIGNATORY

DR. SAHADULLA: I have thought for years that the healthcare system needed an international organization devoted to ethical practices and standards. Thus, I was delighted to learn about EPiHC through the Association of Healthcare Providers of India (AHPI), of which I am one of the founders and directors. KIMSHEALTH immediately became a signatory. From our beginnings, KIMSHEALTH has been based on the three pillars of quality, patient safety, and ethics. We also knew this was an area which needed improvement in India. We have an organizational structure, including an advisory board of independent directors, which helps us maintain our standards. EPiHC is appearing just as awareness is growing of the importance of better healthcare practices. Twenty years ago, the quality of healthcare was not measurable in India. Today there are credible key performance indicators and it has been shown that financial performance is improved, not diminished, by investments in quality. Healthcare professionals are steadily moving toward greater self-control and self-awareness. I used to talk about ethics at healthcare conferences in India, and many people raised their eyebrows. They were skeptical. Today, people bring up ethical concerns themselves. Many problematic practices have been stopped, and if we and other similar organizations continue to be role models, then the field will continue to move forward.

 

THE PRINCIPLES

#2 Making a Positive Contribution to Society

DR. SAHADULLA: India is a developing country with people at many economic levels. At KIMSHEALTH, we are always thinking about how to make healthcare more affordable. This is a difficult challenge for a private hospital. Unfortunately, about 60 percent of medical expenses in India are paid out of pocket by patients. We have therefore dedicated 2–3 percent of our revenues to subsidized care. We have subsidized heart surgeries for people below the poverty line, knee replacements for teachers with osteoarthritis, and many other kinds of routine care. We have a major corporate social responsibility activity of providing totally free prosthetic limbs for amputees. In recent years, India’s corporate social responsibility laws have enabled us to expand these subsidies. During the pandemic, we have helped some villages in India with the tablets they need for online schooling and with free vaccinations.

#5 Respecting the Environment

DR. SAHADULLA: Being environmentally friendly is very important. We use solar energy for electricity, energy conservation in our building design, and rain harvesting for our water supply. Risk management is crucial because of biomedical risks, including the risks inherent in waste segregation. We were fortunate to adopt these practices early on, because they have helped us develop our reputation and track record. Our new block has been awarded Green Platinum certification by [the] Indian Green Building Council (IGBC) and is the first platinum-rated hospital in Kerala under the IGBC Green New Building Rating System.

#6 Upholding Patients’ Rights

DR. SAHADULLA: On patients’ rights, we began posting signs and setting up channels for patient complaints about 15 years ago. I think this has helped us develop a high level of trust. We also practice routinely “open disclosure,” for example, when something goes wrong in the operating room or the ICU, we disclose [it] to the relatives and assure them that we have taken all the corrective measures.

#10 Supporting Ethical Practices and Preventing Harm

DR. SAHADULLA: One example of ethical practices relates to organ transplants. There is often controversy over whether the brain death of the donor is properly monitored and certified. Regulations are not always followed. But today, India has established nodal agencies in most of the states for confirming brain death. Now brain death has to be confirmed by two Apnea tests done six hours apart by two physicians, (one from outside the facility) nominated by the Government, along with the treating physician and hospital administrator. We are working toward similar yardsticks in many fields of healthcare delivery.