NABH Stroke Centre Certification: NABH-WSO Standards, Levels and How to Apply

NABH does not accredit stroke units as such. It certifies them, through the NABH-WSO Stroke Centre Certification Programme run jointly with the World Stroke Organization (WSO). Hospitals are certified as an Essential Stroke Centre or an Advanced Stroke Centre for two years. They are assessed against NABH’s Certification Standards for Stroke Centre (1st edition, September 2023), which has 10 chapters, 46 standards and 224 objective elements. This guide explains the levels, what the standard expects, the quality indicators NABH tracks and how to apply.

The NABH-WSO partnership

The collaboration is confirmed by both organisations. NABH says it signed a memorandum of understanding with WSO in November 2022 to launch stroke centre certification in India. WSO reports that the joint programme was launched on 1 November 2022 in New Delhi, at a National Stroke Summit organised by FICCI.

WSO’s stroke standards were merged into NABH’s format, so the programme follows the same structure as NABH’s hospital accreditation. NABH published the standard in September 2023 and invited applications from stroke care centres in October 2023. In 2026 WSO announced the national roll-out of the joint certification pathway, so hospitals across India can now register through either the NABH or the WSO portal.

NABH’s 2023 notice called it a “Stroke Standards Accreditation Programme”, which is why many hospitals still search for “NABH stroke accreditation”. The standard itself, and NABH’s current programme page, describe a certification. It is separate from NABH hospital accreditation.

Essential and Advanced Stroke Centres

The joint programme certifies hospitals at one of two levels, depending on their stroke services, infrastructure and workforce:

• Essential Stroke Centre: for hospitals providing organised acute stroke care, with the people and processes needed for timely assessment, diagnosis, treatment and ongoing management.
• Advanced Stroke Centre: for hospitals providing comprehensive stroke services, including advanced diagnostics, specialised multidisciplinary care, advanced interventions and a leadership role in regional stroke networks.

The level you can apply for is decided by WSO’s self-assessment. WSO says a hospital qualifies for a level when it meets all of that level’s mandatory criteria and at least 75% of the recommended ones.

What each level typically requires

Before the joint roll-out, NABH certified Primary and Advanced Stroke Centres. Its eligibility documents for those levels are still linked from the programme page and show the capability expected at each level. Use them as a guide and confirm current criteria in the WSO self-assessment.

Both levels also needed carotid duplex ultrasound, written protocols for triage, diagnosis and emergency treatment, a telemedicine policy, a designated certification coordinator and nurse stroke coordinator, and monitoring of key indicators. The centre had to be functioning for at least six months and following the standards for at least three months before assessment.

What the stroke centre standard covers

The standard uses the same ten chapters as NABH’s hospital standards. The first five are patient-centred and the last five are organisation-centred:

The Care of Patients chapter carries most of the stroke-specific requirements. Among other things, the standard expects:

• Evidence-based clinical pathways and protocols for stroke care, with emergency staff who know them and can rapidly activate a stroke code.
• A designated interdisciplinary acute stroke team.
• Structured assessment with a validated tool such as the NIH Stroke Scale, done by a qualified nurse or physician from the stroke team.
• Swallow screening before anything by mouth: patients are screened for dysphagia before receiving oral medicines, food or fluids.
• Blood glucose testing before deciding whether a patient is eligible for thrombolysis.
• Rehabilitation and nutritional therapy provided consistently and collaboratively.
• Transfer arrangements: a written transfer protocol, agreement or MoU with at least one hospital able to provide timely stroke services when the centre cannot.

Outside the clinical chapters, the requirements will look familiar to any NABH quality team. They include patient rights and education, a documented complaint redressal procedure with corrective and preventive action, infection control, incident reporting, staff training and records. Our guides to patient safety measures in hospitals and handling patient complaints cover these shared foundations.

Quality indicators for stroke centres

Stroke treatment is time-critical, so much of the standard is about measuring speed and outcomes. The standard lists key indicators every stroke centre should monitor, including:

• Time from arrival to the first brain scan.
• Share of eligible patients given IV thrombolysis within the defined time frame.
• Symptomatic intracranial haemorrhage within 24 hours of thrombolysis.
• Share of patients with a documented dysphagia screen on admission.
• Referral to physiotherapy or rehabilitation within the defined time frame.
• Functional outcome at the end of follow-up, and in-hospital deaths within 7 days of admission.
• Pressure ulcers, deep vein thrombosis and falls after admission, and stock-outs of the thrombolytic drug.

Advanced centres also track endovascular treatment: how many eligible patients receive it in time, complications, and how well blood flow is restored.

The standard’s indicator annex sets door-to-needle targets for thrombolysis. Centres should treat at least 75% of thrombolysed patients within 60 minutes of arrival, or at least 50% within 45 minutes. For thrombectomy at advanced centres, the door-to-device target is 90 minutes for patients arriving directly and 60 minutes for transfers. In the joint programme, hospitals submit quality data with their application and NABH and WSO review key stroke indicators every year.

For more on choosing and tracking indicators, see our guide to quality indicators for NABH.

How to get certified

NABH sets out a single pathway, whichever portal a hospital starts from:

1. Register on the NABH or WSO registration portal.
2. Complete WSO’s self-assessment to find out which level you are eligible for.
3. Pay the fees to NABH and WSO, separately on each platform.
4. Submit your application with supporting documents and quality indicator data.
5. Undergo an on-site assessment by NABH-WSO assessors.
6. Receive certification as an Essential or Advanced Stroke Centre, valid for two years.

NABH lists the total fee as USD 300 for government and public hospitals and USD 1,000 for private hospitals, split between NABH and WSO, with GST extra on the NABH share. Certified hospitals get one year of WSO society membership and are listed in WSO’s global network of certified stroke centres. NABH and WSO also run a Programme on Implementation for hospitals that request it.

Before you register, it helps to:

• Read the standard in full and map each objective element to an owner, a policy and the evidence you will show.
• Write or update your stroke pathway, stroke code, thrombolysis and transfer protocols.
• Start collecting indicator data early, because you will need to show recent figures.
• Train emergency, nursing and rehabilitation staff and run mock stroke codes.

How it fits with NABH hospital accreditation

Stroke certification sits alongside full hospital accreditation rather than replacing it. Because the standard uses NABH’s ten-chapter structure, hospitals already working to the NABH 6th edition standards can reuse much of their documentation.

The two also overlap on measurement. The 6th edition hospital standards include a door-to-needle indicator: the percentage of thrombolysed stroke patients treated within 60 minutes of arrival, reported monthly. It is mandatory where neurology is within the hospital’s scope. NABH’s earlier eligibility documents limited stroke certification to NABH-accredited or certified hospitals and small healthcare organisations. The joint programme page now says it is open to public and private hospitals providing stroke care. If you are planning full accreditation too, our step-by-step guide to the NABH accreditation process covers the main route.

Patient experience matters in stroke care as well, from the emergency department to discharge and rehabilitation. LazyMonkey’s patient feedback system for hospitals collects discharge feedback through QR codes and alerts staff to negative responses, which supports the complaint-handling and improvement work the standard asks for.

Frequently Asked Questions