Are you a Community Health Officer (CHO) preparing your Sub-Health Center (Ayushman Arogya Mandir) for NQAS certification? This comprehensive step-by-step guide offers a month-wise timeline to help you meet all the National Quality Assurance Standards (NQAS). From infrastructure upgrades to documentation, training, and mock drills—follow this roadmap to boost service quality, ensure compliance, and deliver better patient care.

Step 1: Initial Preparation Phase

Orientation & Understanding

Understand NQAS framework (especially standards for SHC level).

Download and study:

  • NQAS Standards for SHCs
  • NQAS Checklist Toolkits
  • Guidelines from NHSRC

Attend any available training or orientation programs on NQAS (online/offline).

Step 2: Facility Gap Assessment

Identify Gaps with NQAS Tools

Conduct baseline assessment using the NQAS checklist.

Identify gaps in infrastructure, equipment, documentation, and practices.

Step 3: Formation of Quality Team

Form Quality Team & Create a plan

Form a Quality Assurance Team at SHC level.

ASHA (as community representative, if possible)

CHO – Team Lead

ANM

MPW

Step 4: Infrastructure & Resource Strengthening

Gap Assessment in Infrastructure & Resource Strengthening

✅ 1. Infrastructure Readiness

  • Ensure facility cleanliness, demarcation of areas (registration, OPD, waiting, etc.).
  • Display IEC materials, standard operating procedures (SOPs), and signages.

✅ 2. Equipment & Supplies

  • Ensure availability and functionality of:
    • Essential equipment (BP apparatus, glucometer, etc.)
    • Emergency kits, sterilizers, HBNC kits, etc.
  • Maintain calibration records.

✅ 3. Infection Prevention & Control (IPC)

Daily cleaning and mopping schedules

Implement:

Handwashing stations

Segregation of biomedical waste

Use of color-coded bins

Step 5: Documentation & Records System

Maintain Documentation & Records System

✅ 1. Record-Keeping Setup

  • Maintain updated and complete:
    • OPD register
    • Referral register
    • Stock register
    • Family folder
    • ANC, PNC, Immunization records
  • Use HMIS formats properly and timely upload data.

✅ 2. Development of SOPs

Translate into local language if needed.

Draft and display Standard Operating Procedures for:

OPD Management

Infection Control

Emergency Referrals

Cold Chain Maintenance

Step 6: Capacity Building & Mock Drills

Staff Training and Mock Drill

✅ 1. Staff Training

✅ 2. Conduct Mock Drills

Document the drill reports with photos and feedback.

Simulate:

Fire safety drill

Medical emergency (e.g., unconscious patient)

Referral process

Step 7: Internal Assessments & Corrections

Internal Assessment is an Important Step

✅ 1. Internal Quality Audits

  • Conduct weekly/monthly audits using the NQAS checklist.
  • Identify persistent gaps and plan corrective actions.

✅ 2. Patient Feedback Mechanism

Maintain a grievance redressal register.

Start a system for collecting and analyzing patient satisfaction feedback.

Step 8: Final Preparation & External Assessment Readiness

Assess External Assessment Readiness

✅ 1. Peer Review

  • Invite nearby CHOs and CHO Mentor or PHC teams to conduct peer evaluation.
  • Work on their feedback for improvement.

✅ 2. Documentation Finalization

  • Prepare ready-to-inspect files for:
    • Quality assurance committee meetings
    • SOPs and IEC
    • Equipment maintenance logs
    • Monthly reports
    • Registers (clinical, stock, referral)

✅ 3. Submission to District QA Cell

Ensure all key indicators are within standards.

Once confident, inform the District Quality Assurance Unit (DQAU) for mock or actual external assessment.

Step 9: Post-Assessment: Sustaining Quality

Sustain Quality and Improve Quality of Care in needed

✅ 1. Continuous Quality Improvement

  • Continue:
    • Monthly QA team meetings
    • Patient satisfaction surveys
    • Reporting and monitoring of indicators

✅ 2. Celebrate and Recognize Team Effort

Encourage a culture of quality and accountability.

Acknowledge staff contributions.

Bonus Tips for CHOs:

Final Words

Achieving NQAS certification is not just a compliance goal, but a step towards improved service delivery and patient satisfaction. With this timeline guide, every CHO can transform their Sub-Health Center into a model Ayushman Arogya Mandir.

Frequently Asked Questions (FAQs)

Q1. What is NQAS and why is it important for Sub-Health Centers?
A: NQAS (National Quality Assurance Standards) is a government framework designed to ensure quality healthcare services at public health facilities. For Sub-Health Centers, NQAS certification improves service delivery, builds community trust, and enhances patient satisfaction.

Q2. Who is responsible for NQAS implementation at the Sub-Health Center?
A: The Community Health Officer (CHO) is primarily responsible for leading NQAS implementation, supported by ANMs, MPWs, ASHAs, and other staff members as part of the Quality Assurance Team.

Q3. How long does it take to prepare a Sub-Health Center for NQAS certification?
A: With focused efforts, a Sub-Health Center can be NQAS-ready in 5–6 months, following a structured timeline covering assessment, training, documentation, and mock evaluations.

Q4. What are the key areas covered under NQAS for Sub-Health Centers?
A: Key areas include:

  • Infrastructure and facility cleanliness
  • Infection prevention and control
  • Availability of equipment and drugs
  • Proper documentation and record-keeping
  • Staff training and SOP implementation
  • Patient feedback and grievance redressal

Q5. Where can CHOs find official NQAS guidelines and checklists?
A: CHOs can download official guidelines, checklists, and SOP formats from the NHSRC website or through support from their District Quality Assurance Units (DQAUs).

Q6. Is patient feedback required for NQAS certification?
A: Yes, collecting and analyzing patient satisfaction feedback is a crucial part of the NQAS assessment. It helps demonstrate community engagement and quality improvement efforts.

Q7. Can a Sub-Health Center achieve NQAS certification without external support?
A: While it is possible, support from district and block-level health officials, peer reviews, and guidance from NHSRC can significantly improve chances of successful certification.

Q8. What happens after NQAS certification is achieved?
A: After certification, CHOs must continue quality improvement through regular audits, staff training, and maintaining standards. Certification is valid for a limited period and requires ongoing compliance.