Kokilaben Dhirubhai Ambani Hospital: Commitment to Quality Has Built an Award-Winning Healthcare Brand in India

Kokilaben Hospital was founded in 1999 when the highly respected and beloved cardiologist Dr. Nitu Mandke began work on a large-scale heart hospital in Four Bungalows, Mumbai. When his life was tragically cut short by a heart attack in 2003, the project came to a halt.

Committed to seeing Dr. Mandke’s dream fulfilled, the Mandke family foundation approached the Reliance Group, an Indian conglomerate founded and managed by the Ambani family, about taking over the development. Seeing an opportunity to expand upon the original design and create one of India’s finest medical and clinical research facilities, the Reliance Group assumed the project. The new vision was to greatly expand the scope and raise India's global standing as a healthcare hub, emphasizing excellence in clinical services, diagnostics, and research. Thus, the Kokilaben Dhirubhai Ambani Hospital (KDAH) & Medical Research Institute, a multi-specialty quaternary care hospital, was born.

India’s $6 billion diagnostics market is highly fragmented, with an estimated 60,000 laboratories of all sizes providing diagnostic testing. The barriers to entry are low and the quality of testing varies widely.

From day one, the leadership of KDAH made a commitment to elevating the quality of their diagnostic services in order to differentiate themselves from other hospitals and earn the loyalty of physicians and patients. As Dr. Santosh Shetty, Executive Director and CEO of KDAH, shared, “Our goal since inception was to get accreditation for our hospital and laboratory services to ensure a comprehensive and robust quality assurance program. The College of American Pathologists (CAP) is our first accreditation, so chosen as laboratory medicine touches each patient.”

To ensure success, KDAH recruited Dr. Varsha Vadera as director of laboratory services. A clinical pathologist with extensive experience, Dr. Vadera had previously helped another facility earn CAP accreditation. She had also worked with the CAP to assess and inspect other laboratories seeking accreditation. “Hospital leadership was very keen to get CAP accreditation. It is very important to the growth of the hospital and to support clinical research and clinical trials. CAP accreditation is also recognized as the standard of quality by patients coming from abroad,” Dr. Vadera says. “I have a long association with the CAP, so I was comfortable leading the effort.”

After four years of rigorous preparation, KDAH earned CAP accreditation in 2013, and has maintained its accreditation for nearly a decade. Two tools have been instrumental in this achievement: the CAP’s accreditation checklists and the proficiency testing/external quality assessment (PT/EQA) program.

The checklists indicate exactly what is required to earn and remain compliant with CAP accreditation, including policies and procedures to ensure quality testing and patient safety. Dr. Vadera used the CAP checklists to create documentation for internal audits and incident reports. “The checklists showed us how to document things and monitor all the tests that come through. This is very helpful with internal audits. We use incident reports to determine where errors were happening and where they were decreasing. This documentation helped us keep from repeating the same errors. All incident reports must be signed by me, so I always know what is going on in the lab. If there is a problem, it is addressed immediately.”

She adds, “We also send our incident reports to the hospital’s head of quality and select doctors. This leads to awareness of the improvements we are seeing. They are very happy getting the results, but it also makes them understand how much effort goes into delivering results.”

The CAP’s PT/EQA programs also provide tremendous value, as they cover virtually all aspects of pathology. Dr. Vadera appreciates their evaluation reports and participant summaries, which are informative and provide helpful data for improving her laboratory’s analytical performance.

In 2020–2021, during the height of the global pandemic, the CAP’s support was put to the test. Much to Dr. Vadera’s delight, the CAP never wavered in being a trusted resource. “The documentation cited in the CAP checklists and proficiency testing material provided for SARS-CoV-2 helped us set the protocols for the multiple departments involved in diagnosing and treating

COVID-19 patients. It gave the laboratory staff guidance for review and analysis of data systematically and thereby we were able to identify opportunities for improvement.”

KDAH’s physicians rely on diagnostic tests to help them provide the best and most appropriate care to patients. This requires physicians to trust the accuracy of the diagnostic laboratory. The hospital also relies on the revenue generated by performing these diagnostic tests. Dr. Vadera recalls one physician who questioned the laboratory’s results and wanted to send the tests to an outside facility.

“I told the doctor that we follow all the processes that we should be following based on the CAP and showed her the documentation. If she insisted, I would send the test out, but if the same result came back, I said she would pay for the test,” recalls Dr. Vadera. “The doctor agreed to look at our test results again. Eventually, there were no more complaints. Understanding CAP accreditation and what it involved gave this physician and others more confidence in results.”

She recalls a similar situation when physicians conducting a clinical trial were sending out the samples for the biochemical and rheumatology tests. “These were simple tests which we routinely do. Explaining CAP accreditation to these physicians, the quality it enables, and the lost revenue when tests are done outside the hospital changed their behavior.”

With quality as a priority and CAP accreditation being a critical enabler, KDAH has gone on to earn other coveted accreditations—recognitions that are important to physicians, researchers, and patients, both from India and from other countries. It has also taught the broader organization the nuances of quality and how to put them into practice every day.

The hospital’s commitment to its patients and to the quality of its processes has not gone unnoticed. KDAH has been showered with numerous awards. For seven straight years it has been ranked #1 in Mumbai and Western India by the annual Best Hospital Survey, and it was recognized by the Economic Times as the Best Healthcare Brand of 2022.

Dr. Vadera is both humbled by and happy with all the success. “We made CAP accreditation a priority on day one, and today our quality sets Kokilaben Hospital apart.”

• Ranked #1 in Mumbai and Western India in the 2021 Best Hospitals Survey (the seventh year in a row)
• Recognized as The Economic Times’ Best Healthcare Brand in 2022
• Received UNIVANTS of Healthcare Excellence Award for Exemplary Performance in Healthcare Sector