Clinical Establishment Act Standards for Physiotherapy Centre

CEA /Physiotherapy Centre- 023

Standard No. CEA/Physiotherapy Centre- 023

Page 1
Clinical Establishment Act Standards for Physiotherapy Centre
CEA /Physiotherapy Centre- 023

Clinical Establishment
Act Standard for
Physiotherapy Centre

Standard No. CEA/Physiotherapy Centre- 023

Page 2
Clinical Establishment Act Standards for Physiotherapy Centre
CEA /Physiotherapy Centre- 023

Introduction
In 2010 Clinical Establishments (Registration and Regulation) Act, 2010 has been
enacted by the Central Government to provide for registration and regulation of all clinical
establishments in the country with a view to prescribe the minimum standards of facilities
and services provided by them.

The Ministry has notified the “National Council for Clinical Establishments” and ‘The Clinical
Establishments (Central Government) Rules, 2012” under this Act vide Gazette. This Act is
applicable to all kinds of clinical establishments from the public and private sectors, of all
recognized systems of medicine including single doctor clinics. The only exception will be
establishments run by the Armed forces.

Page 3
Clinical Establishment Act Standards for Physiotherapy Centre
CEA /Physiotherapy Centre- 023

Table of Contents

Sr. No. Particulars Page No.

1. Definition

2. Scope

3. Infrastructure
4. Furniture & Fixtures
5. Equipment/Instruments

6. Human Resource
7. Support Service
8. Legal/statutory Requirements

9. Record Maintenance and Reporting

10. Process
11. Annexure 1

12. Annexure 2

13. Annexure 3
14. Annexure 4
15. Glossary

Page 4
Clinical Establishment Act Standards for Physiotherapy Centre
CEA /Physiotherapy Centre- 023

Physiotherapy Centre

1. Definition

A physiotherapy centre is an allied Healthcare establishment providing, physical

therapy services by a physiotherapist to patients with a recent prescription or referral
from a licensed medical doctor (physician/surgeon). Depending on the disease
condition a review and re-prescription by a treating medical doctor is required for
continuing physiotherapy services.

2. Scope (as applicable)

These set of common minimum standards framed shall be applicable to stand alone
physiotherapy centre with one or more physiotherapists
2.1 And physiotherapy sections attached to hospitals or polyclinic.

2.2 Various therapies under the scope is as follows:

2.2.1Electrotherapy (Adult / Paediatrics)

a) Hydrocollator (Hot Packs).

b) Paraffin Wax Bath Infrared/Ultra violet radiation lamps. (Cold) –

Cryotherapy.

c) Shortwave diathermy

d) Ultra sound Therapy (1 & 3 MHz).

e) Electrical energy- TENS (Trans cutaneous Nerve Stimulator).

f) Low and Medium frequency currents: IFT(Interferrential Therapy)/

g) Electrical muscle stimulator.

2.2.2 Exercise therapy

a) Shoulder exercise unit

b) Wrist and Hand exercise units

Page 5
Clinical Establishment Act Standards for Physiotherapy Centre
CEA /Physiotherapy Centre- 023

c) Abduction ladder

d) Over head Pulley system/ Multiple Pulley exercise unit

e) Weight cuffs (Optional)

f) Dumbbell exercise set, Mat exercise (floor) mat

g) Parallel Bars and Wall bars

h) Examination couches (number according to the patient load)

i) Quadriceps table, Mobilization/Stabilizing belts, Patient evaluation kit

(including Goniometer, Percussion Hammer, Measuring tape etc.),
Walking aids (sticks, crutches, frames and wheel chairs etc.)

2.2.3 Mechano Therapy

a) Cervical and Lumber Traction systems(Intermittent and Constant) with

traction table

2.2.4 Hydrotherapy

2.2.5 Manual therapy

a) To deliver primary service in health education and health promotion.

b) To deliver health care services of physiotherapy and rehabilitative

nature.

3. Infrastructure Requirements

3.1 The physical facility shall be developed and maintained to provide safe and
secure environment for patients, their families, staff and visitors. It shall be
situated in a place having clean surroundings and shall comply with local
byelaws in force, if any from time to time.

3.2 The minimum space requirement for carrying out the basic functions of the
facility shall be as per Annexure 1.

3.3 The area shall be well illuminated, ventilated and clean with adequate water
supply.

Page 6
Clinical Establishment Act Standards for Physiotherapy Centre
CEA /Physiotherapy Centre- 023

3.4 The total area requirement can be broadly classified into two categories viz.
Common Area and Treatment area. The common area shall include facilities
such as reception, waiting, toilet, consultation, etc. The treatment area shall
include space requirements for main equipment and for ancillary services.

3.5 The facility shall be adequately provided with working space to allow orderly
and logical placement of equipment, material and movement of personnel so
as to maintain safe operations.

3.6 The space requirement in treatment area shall be as per as per the scope of
service and workload. The ancillary area like facility for storage (cabinet etc),
facility for backup equipment like UPS/generator etc. shall also be available,
please refer to Annexure 1.

3.7 Common area can be shared between the different divisions/sections of the
centre/HCO. Within the centre various work sections can also share the
resources and space however not compromising the quality of work.

3.8 The physiotherapy centre shall have a prominent board/signage displaying

the name of the centre in local language at the gate or on the building.

3.9 The following other signage shall be well displayed in the language
understood by the local public in the area:

a) Name of the physiotherapist with registration number.

b) Fee structure of the physiotherapist/ physical therapy services.

c) Timings (For ex – from 8am -2pm)

d) Services provided within the facility

4. Furniture & Fixtures

4.1 Furniture and fixtures shall be available in accordance with the activities and
workload of the physiotherapy centre.

4.2 The furniture and fixtures shall be functional all the time. For indicative list of
items refers to Annexure 2. (This list is indicative and not exhaustive).

5. Equipment/Instruments

Page 7
Clinical Establishment Act Standards for Physiotherapy Centre
CEA /Physiotherapy Centre- 023

5.1 The physiotherapy centre shall have essential equipments as per Annexure 4.

5.2 Other physiotherapy equipments as per the scope of service and work load
requirement shall be available.

5.3 Adequate space for storage of equipments

5.4 All equipment shall be in good working condition at all times. Periodic
inspection, cleaning, maintenance of equipments should be done.

6. Human Resource

6.1 Physiotherapist as per the scope of the physiotherapy centre shall be

registered with State physiotherapy & Occupational Therapy Council,
wherever applicable.
6.2 The services provided by the physiotherapy professionals shall be in
consonance with their qualifications, training and registration.

6.3 Personnel record containing personal and professional information shall be

maintained for each staff.

6.4 Periodic skill enhancement/up gradation /refresher trainings shall be provided

for all categories of the staff relevant to their job profile. For Human resource
requirement refer to Annexure 3.

7. Support Service

7.1 Support services like registration, billing, waste management, etc., can be
shared with the hospital.

7.2 Support Staff: In a physiotherapy centre minimum one support staff shall be
available to meet the care treatment and service needs of the patient.
However number may depend upon the workload and scope of the service
being provided by the clinical establishment.

8. Legal/statutory Requirements

8.1 Every application must be accompanied with the documents confirming

compliance with local regulations and law.

9. Record Maintenance and Reporting

Page 8
Clinical Establishment Act Standards for Physiotherapy Centre
CEA /Physiotherapy Centre- 023

9.1 Copies of all records and statistics shall be kept with the clinical establishment
concerned for at least 3 or 5 years or in accordance with the CEA act.

9.2 All clinical establishments shall be responsible for submission of information

and statistics in time of emergency or disaster or epidemic situation or as
required from time to time by National Council CEA 2010.

10. Process

10.1 Registration: Every patient visiting the physiotherapy centre shall be

registered.

10.2 Assessment and plan of care The physiotherapist card/slip of every

registered patient must bear the minimum following legibly at every visit:
Working diagnosis as provided by the treating medical doctor who has
referred the patient, Relevant history and examination findings, Plan of care
listing the exercises and physical modalities, Signature and date of the
physical therapist, A review and re-prescription from the treating medical
doctor after three weeks for continuing plan of care.

10.3 Infection Control:

a) The physiotherapy centre shall take all precautions to control infections

like practicing hand hygiene etc.

b) Availability of clean water for hand washing /liberal use of sanitizer shall
be maintained throughout the working hours of the physiotherapy centre.

c) Sanitation and hygiene of the toilets if available shall be maintained.

d) Mopping of all patient care areas with disinfectant shall be done at least
once a day.

10.4 Safety Considerations

a) The establishment shall make effort shall to take care of patient safety
aspects like patient fall, etc.

b) The establishment shall make effort to keep the centre pest and termite
free.

10.5Biomedical waste Management

Page 9
Clinical Establishment Act Standards for Physiotherapy Centre
CEA /Physiotherapy Centre- 023

a) Biomedical waste shall be managed in accordance with the BMW

management and handling Rules, 1998.

10.6. First Aid

a) Provision shall be made for providing First Aid.

b) Contact details of ambulance hospital etc shall be available.

c) Staff shall be trained on BLS.

Page 10
Clinical Establishment Act Standards for Physiotherapy Centre
CEA /Physiotherapy Centre- 023

Annexure – 1

Minimum infrastructure requirements shall be as follows:

S.No Minimum Area

1 Reception, Waiting & Reception, waiting, consultation room etc. shall be
Consultation adequate as per the requirement and workload of
the physiotherapy center
2 Ancillary area / space Ancillary area/space for storage of records,
reagents, consumables, stationary etc including
eating area for staff shall be available in
accordance with the workload
3 Electrotherapy (Adult / Minimum one chamber of 10 ft.X7 ft for Diathermy
Paediatrics) unit and another chamber of same size for other
electrotherapy modalities with examination
couches, linen and electric fitting of required load,
as per the specifications of the modalities.
Separate space for Wax Bath and Hydrocollator as
per the patient load and equipment specifications
4 Exercise Therapy Minimum one consultation room (15 ftX10 ft at
least), Treatment rooms/cabins (at least three of
10ftX10ft each) and space for the Parallel bars,
Gait training and Floor/mat exercises. The centre
should have essential facilities like wash basins,
wash rooms etc.
5 Mechano Therapy Minimum one chamber of 10 ft.X7 ft to
accommodate Cervical and Lumber Traction
systems (Intermittent and Constant) with traction
table and other material so as to provide adequate
working space to carry out safe procedure.
6 Manual therapy Manual therapy couch or the Examination couch.
can be accommodated in the Exercise therapy
space.
7 Hydrotherapy Optional. If there, should be placed in the separate
chamber of the size as per the equipment
specifications. For example if Hubbard’s
equipment is used, it requires a chamber of not
less than 15ftX15ft along with the facility of
changing room and wash room.

Page 11
Clinical Establishment Act Standards for Physiotherapy Centre
CEA /Physiotherapy Centre- 023

Annexure –2

Furniture and Fixtures

S.N. ARTICLES
1. Table
2. Chairs
3. Examination Table/couch
4. Screens
5. Foot Step
6. Stools
7. Storage Cabinet for records etc.
8. BMW storage area

Page 12
Clinical Establishment Act Standards for Physiotherapy Centre
CEA /Physiotherapy Centre- 023

Annexure- 3

Indicative list of minimum equipment/instrument required is as follows:

I. Essential Equipment:

S. No. Name of the equipment Minimum No. of equipment

Specifications
1 Stethoscope 1

2 Thermometer Digital 1

3 Torch (flash lights) 1

4 Sphygmomanometer(B.P. Digital 1
Apparatus)

5 Weighing Adult 1
machine(Optional)

II. Emergency Equipment:

S. Name of the Equipment Minimum No. of Equipment

No. Specifications
3 Fire Extinguisher - 1

III. PHYSIOTHERAPY EQUIPMENTS

The physiotherapy equipment relevant to the scope and workload shall be

available as follows:

PHYSIOTHERAPY EQUIPMENTS DETAILS

Electrotherapy Equipment’s
1 Short Wave Diathermy
2 Ultrasonic Therapy
3 Interferential Therapy
4 Hot Pack Unit
5 Paraffin Wax Bath
6 TENS
7 LASER (Optional)
8 Muscle Stimulator

Page 13
Clinical Establishment Act Standards for Physiotherapy Centre
CEA /Physiotherapy Centre- 023

9 Cold Packs
10 C.P.M.
Exercise Therapy Equipment’s

13 Shoulder Wheel
14 Over Head Pulley
15 Wall Ladder
16 Supinator Pronator Exerciser
17 Heel Exerciser
18 Ankle Exerciser
19 Parallel Bars (optional)
20 Tilt Table (optional)
21 Walker / Crutches / Canes
22 Stationary Bicycle
23 Treadmill (Optional)
24 Vibrator for Chest Physiotherapy(Optional)
25 Swiss Ball (Optional)
26 Dumbbells / Weight Cuffs (Optional)
27 Gripper / Gel Balls (Optional)
28 Thera Bands / Thera Tubes (Optional)
29 Spiro meter (Optional)
30 Peak flow meter(Optional)
31 Hydrotherapy (Optional)
Mechano Therapy
32 Traction Unit (Cervical/ Lumbar)
Manual therapy
33 Manual Therapy couch/Examination couch (Optional)
Hydrotherapy
33 Hydrotherapy pool or Hubberd tank (Optional)

Page 14
Clinical Establishment Act Standards for Physiotherapy Centre
CEA /Physiotherapy Centre- 023

Annexure- 4

Minimum human resource requirement shall be as follows:

S. Category Minimum Registration Remarks

no. Qualifications with the
(from recognized concerned
university) council
(if applicable)

1 Physiotherapist-1 BPT from recognized State Where council

university/DPT Physiotherapy & registration is
awarded till 1991 Occupational not applicable,
from recognized Therapy Council registration
University shall be done
with Indian
association of
physiotherapy

Page 15