NABH 6th Edition Standards: Chapters, Objective Elements and How Hospitals Are Scored

Key dates

The accreditation cycle remains four years, with surveillance in year 2 and re-application in year 4.

The 10 chapters

Every chapter now has its own element-by-element guide: AAC: Access, Assessment and Continuity of Care, COP: Care of Patients, MOM: Management of Medication, PRE: Patient Rights and Education, IPC: Infection Prevention and Control, PSQ: Patient Safety and Quality Improvement, ROM: Responsibility of Management, FMS: Facility Management and Safety, HRM: Human Resource Management, IMS: Information Management System.

NABH's document prints 135 for COP, but its own category breakdown for COP adds to 136, matching the 639 total. The infection chapter is titled Infection Prevention and Control (IPC) — in the 5th Edition it was Hospital Infection Control (HIC) — reflecting a broader prevention focus.

Four levels of objective elements

The chapters with the most Core elements are HRM (16), COP, MOM and IPC (13 each) and PRE (12). That tells you where NABH sees the highest risk: people, clinical care, medicines, infection and patient rights.

How scoring works

Each element is scored on a five-point scale: 5 full compliance down to 1 no compliance.

For initial accreditation:

• every Core element scores at least 4;
• overall compliance on Commitment elements is at least 80%;
• the average score of each standard and each chapter is at least 4;
• no standard has more than one element scored 2 or less;
• every element at 3 or below has an accepted action plan with timelines; elements at 2 or below need a plan with a risk assessment.

At surveillance, Achievement elements must also reach 80%, and previously weak elements must have improved. At re-accreditation, Excellence elements must reach 80% and no element in any standard may score 2 or less.

In practice the per-standard and per-chapter averages catch hospitals out: one chapter left for "later" — often IMS or FMS — can sink the whole result.

What the 6th Edition emphasises

NABH's introduction to the edition highlights:

• patient-centred care with a focus on outcomes and continuous improvement;
• technology to enhance care delivery;
• the well-being and satisfaction of healthcare professionals;
• sustainable practices in healthcare delivery.

It also adds annexures on medication errors, risk management, patient-reported outcome measures (PROMs), patient-reported experience measures (PREMs) and clinical audit.

What this means for your preparation

1. Map all 639 elements, marking the 105 Core elements in red. These are non-negotiable.
2. Build outcome measurement in, not only process indicators — PROMs and PREMs, clinical audit cycles with re-audit, and evidence that results changed practice.
3. Formalise risk management — a risk register by department, reviewed and acted upon.
4. Treat medication errors as learning — a non-punitive reporting system, analysis and feedback.
5. Look after staff — occupational health, workload and grievance mechanisms are part of the standard's intent.
6. Plan for surveillance from day one — Achievement elements will be checked in year 2.

If your hospital was accredited under the 5th Edition, your next assessment is under the 6th. Our NABH documentation checklist is organised by these chapters, and we can run a 6th Edition gap analysis scored on the new rules.