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A New Covenant of Care: A roadmap for healthcare excellence in Jammu & Kashmir

  • DR. FIAZ MAQBOOL FAZILI By DR. FIAZ MAQBOOL FAZILI
  • Comments 0
  • 07 Oct 2025

    The pursuit of robust, equitable, and high-quality healthcare is a cornerstone of a progressive society. In Jammu & Kashmir, under the stewardship of the Lieutenant Governor, we stand at a pivotal moment. There is a palpable commitment to transforming our public health system, moving beyond mere infrastructure to building an edifice of trust, safety, and patient-centric care. This​ write-up   outlines a concrete, actionable road map to achieve this noble goal, with profound appreciation for the initial steps taken and a clear-eyed vision for the future. The foundation for this transformation is already being laid. The recent directives from the administration, emphasizing transparency and accountability, have set the right tone. The leadership of key figures—Health Minister M​rs. Sakina Itoo, whose political will is crucial; Secretary Health, ​Dr. Syed Abid Rasheed, whose administrative acumen drives implementation; Director SKIMS, Dr. Ashraf Ganie, a stalwart of clinical excellence; and Principal GMC​ Srinagar, Dr. Iffat, ​and others in leadership and management positions who shape our future medical professionals—provides a formidable team to steer this change.  The challenge now is to institutionalize these efforts, making quality and safety not a sporadic initiative but the very DNA of our healthcare delivery. This road map is built on four interconnected pillars: Systemic Strengthening, Vigilant Monitoring, Restorative Redressal, and a Culture of Trust. The first pillar, Systemic Strengthening, involves building the bedrock of quality. Since quality is not an accident but the result of intentional design, our priority must be to hardwire safety into every clinical process. This begins with moving away from a culture of individual practice variations by establishing standardized treatment protocols.  A state-level committee of senior clinicians from SKIMS and all Government Medical Colleges should be tasked with developing and mandating evidence-based Standard Operating Procedures for the most common conditions and procedures to reduce errors and ensure consistency. Concurrently, we must invest in our human capital—our greatest asset.  Continuous professional development for doctors and nurses must be mandatory, encompassing skill-upgradation, telemedicine training, and crucial non-technical skills like communication and teamwork. Furthermore, a reliable supply chain of genuine medicines is non-negotiable, requiring a centralized, tech-driven procurement and distribution system with real-time tracking to eliminate stock-outs and prevent spurious drugs.   The second pillar, Vigilant Monitoring, serves as the engine of continuous improvement. A system that does not measure its performance cannot improve, so we must establish a culture of data-driven oversight. This can be achieved through robust clinical audits at every major hospital. These should be systematic, blame-free reviews of patient outcomes against set standards, designed for learning and system refinement.  The administration's emphasis on "surprise checks" is a masterstroke that must now be professionalized through dedicated, multi-disciplinary teams conducting unannounced inspections that go beyond cleanliness to verify patient records, sterilization protocols, and staff adherence to SOPs. The findings should be compiled in a public-facing "Swasthya Nidhi" report to build confidence.  Finally, we must track what matters by displaying Key Performance Indicators—such as average waiting times, infection rates, and patient satisfaction scores—publicly in all hospitals, creating positive pressure for improvement. The third pillar, Restorative Redressal, focuses on healing through hearing. Patient complaints are not a nuisance but a gift of free consultancy, pointing to systemic flaws. Our approach must be swift, fair, and just. We propose establishing an independent J&K State Patient Safety Commission, an autonomous body comprising retired judges, senior doctors, and civil society representatives to serve as the single window for all inquiries into patient complaints.  The goal of this commission should not be solely punitive but primarily restorative, operating under a "Just Culture" framework that distinguishes between human error, at-risk behaviour, and reckless conduct. This encourages open reporting without fear of undue retribution. Moreover, healthcare providers must be trained in transparent communication and the power of a sincere apology, which can prevent grievances from escalating and is fundamental to building trust and confidence. The fourth and final pillar, fostering a culture of trust, is the goal. This involves shifting the culture from defensive bureaucracy to compassionate collaboration. We can achieve this by actively engaging patients and their families in care decisions through simple measures like whiteboards in rooms or involving them in handovers.  The symbolic power of leadership walks, where figures like Minister Sakina Itoo, Secretary Abid Rasheed, Dr. Ashraf Ganie, and Dr. Iffat conduct unannounced rounds to genuinely listen to patients and staff, sends a powerful message that quality is everyone's business. Lastly, we must actively celebrate and reward instances of exemplary care and successful quality projects, as positive reinforcement is a far more potent motivator than fear. PICK UPS; The road to healthcare excellence is a marathon, not a sprint. It demands sustained political will, unwavering administrative support, and the wholehearted commitment of our medical fraternity. The leadership in place is capable of shepherding this transformation.    By systematically strengthening our clinical processes, instituting vigilant and transparent monitoring, creating a fair and restorative redressal system, and relentlessly focusing on a culture of trust, we can ensure that every citizen of Jammu & Kashmir receives the safe, dignified, and high-quality healthcare they deserve. This is not just a policy imperative; it is our moral and social covenant. Let us walk this path together.   (Author is a healthcare policy analyst and senior consultant surgeon, focuses on healthcare quality, policy reforms, and accreditation standards in Jammu and Kashmir. He can be reached at: drfiazfazili@gmail.com)

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