PROFESSIONAL TRAINING AND DEVELOPMENT OF STAFF
Issue date: 01-01-26
Revision date: 01-01-27
NABH Ref:- Pre Accreditation Entry Level standards for Hospitals-2nd Edition: Nov-2025
Document No.: GHV/ARC/ HRM / 001
PROFESSIONAL TRAINING AND DEVELOPMENT OF STAFF
TRAINING & DEVELOPMENT POLICY
Purpose:
• To ensure that the staff joining the organization is appropriately trained on the functional
aspects of the job and to provide a platform for continuous learning and development
• Training activities are well planned
• Customer satisfaction is enhanced on continuous basis
Scope:
All employees on the rolls of APOLLO SPECTRA SHEETLA HOSPITAL and on a Retainer ship agreement
Responsibility:
HR & HOD’s are responsible for effective implementation
Policy:
APOLLO SPECTRA SHEETLA HOSPITAL is committed to train all its employees to:
o Provide excellence in patient care
o Achieve highest standards of training and research
o Understand and internalize the Institute’s vision, values, principles and policies
o Facilitate and improve job performance
o Encourage employee self development
Once an employee is inducted and oriented to the Institute, it shall be the responsibility of the
respective departmental heads to impart function specific training before allowing an employee to
function independently. The span of training may vary from department to department depending on
the nature of the task and the experience and learning potential of the individual.
• The training module and the time table is made by the concerned department and the
department shall contain a record of the training status of the employee.
• If the Departmental head feels that a particular employee has not shown a learning attitude in
spite of imparting relevant training, the HR Department is immediately informed. The HR
Department then determines the future course of action.
• Under no circumstances, an employee is allowed to impart independent patient care without
relevant functional training and being certified by the departmental Head to do so.
Prepared By: Quality Manager Approved By: Centre Head
PROFESSIONAL TRAINING AND DEVELOPMENT OF STAFF
Issue date: 01-01-26
Revision date: 01-01-27
NABH Ref:- Pre Accreditation Entry Level standards for Hospitals-2nd Edition: Nov-2025
Document No.: GHV/ARC/ HRM / 001
• The Nursing and the Paramedics shall be imparted training by the Bio Medical Engineers/
Company trainers/ HODs and supervisors whenever new equipment is installed. The HR
Department is informed by the concerned Departmental Head in case of any difficulty in the
imparting of training.
• It is the responsibility of the HR Department to conduct continuous behavioral training modules
especially for employees in the Managerial Grade and above, to build Leadership skills in the
Organization. The training calendar for these MDPs shall be released by the HR
Department to the Departmental Heads who in turn shall send in nominations for the program.
• The HR Department also conducts Grooming/ Etiquette/ Personality Development programs for
the Front line Customer facing staff and the same process of nominations shall be followed.
• An Employee at any time in consultation with his HOD can make a request to the HR
Department for a particular training which would result in learning and enhanced work
efficiency.
• The HR Department ensures that an employee is paid his full salary during the course of his
training conducted by the organization.
• The Head of H.R. / Quality Manager will be responsible for drawing out the training plan as
per the needs identified. The procedure regarding training need analysis and other details are
contained in the Training Manual
Minimum recommended training and professional development activities*:
S. No. Category of staff Annual
1. Consultants/Specialists Ten days
2. Faculty members/ Administrative heads Ten days
3. Resident doctors (Senior/ Junior) Five days
4. Nursing staff Five days
5. Technical staff Five days
*This includes: Workshops, CMEs, Seminars. Conferences etc.- Within and outside APOLLO SPECTRA
SHEETLA HOSPITAL
Prepared By: Quality Manager Approved By: Centre Head
PROFESSIONAL TRAINING AND DEVELOPMENT OF STAFF
Issue date: 01-01-26
Revision date: 01-01-27
NABH Ref:- Pre Accreditation Entry Level standards for Hospitals-2nd Edition: Nov-2025
Document No.: GHV/ARC/ HRM / 001
Flowchart of the Training Process
Customer Feedback Performance H.O.D Technological/
Appraisal Observations Organizational Change
Identify training needs/Gap
Training need/ Gap Analysis
Preparation of aa training
Outlining training plan
calendar
Training Execution
Training Records
Topic Individual Departmental
External Internal
Prepared By: Quality Manager Approved By: Centre Head
PROFESSIONAL TRAINING AND DEVELOPMENT OF STAFF
Issue date: 01-01-26
Revision date: 01-01-27
NABH Ref:- Pre Accreditation Entry Level standards for Hospitals-2nd Edition: Nov-2025
Document No.: GHV/ARC/ HRM / 001
PROCEDURES FOR STAFF TRAINING
S.N Activity Responsibility
1.0 Policy For Training Needs
1.1 The Training Needs of all employees are identified (based on Qualifications/
Knowledge/ Experience/ Skills/ Attitude) in any of following stages:
• The new employees on joining
HR
• Functional skill and behavioral requirements in case of new inductees,
HR
role changes/enhancements and promotions
• New organizational initiatives/prerogatives HR
• Annual appraisals; The competence assessment evaluation at least once HOD
a year
HOD and HR
• Internal and external customer feedback
HOD and HR
• New equipment, process and policies HOD and HR
• The changing of work assigned
• The new requirements arising due to corrective & preventive actions HOD and HR
1.2 The Competence level is assessed using the tools given below: HR/ HOD
• Bio Data of employee
• Training Record
• Competency mapping for all roles and Knowledge skill gap assessment of
the individual
• Customer feedback
• Self assessment by the individuals
• Performance Appraisal Report
Prepared By: Quality Manager Approved By: Centre Head
PROFESSIONAL TRAINING AND DEVELOPMENT OF STAFF
Issue date: 01-01-26
Revision date: 01-01-27
NABH Ref:- Pre Accreditation Entry Level standards for Hospitals-2nd Edition: Nov-2025
Document No.: GHV/ARC/ HRM / 001
1.3 The competence assessment is carried out on 1-10 scale, where HR/ HOD
1 indicates - no knowledge & no skill
2 – 3 indicates - have knowledge but cannot do independently
4 -- 5 indicates - have knowledge & can do independently
6 -- 7 indicates - have knowledge & can do independently but
cannot guide others
8 - 9 indicates - have knowledge & can do independently and
can guide others
10 indicates - have knowledge & can do independently and
can also develop others
Prepared By: Quality Manager Approved By: Centre Head
PROFESSIONAL TRAINING AND DEVELOPMENT OF STAFF
Issue date: 01-01-26
Revision date: 01-01-27
NABH Ref:- Pre Accreditation Entry Level standards for Hospitals-2nd Edition: Nov-2025
Document No.: GHV/ARC/ HRM / 001
PROCEDURES FOR STAFF TRAINING
S.N Activity Responsibility
2.0 Training Plan
2.1 Based on above HR prepares objectives & target for improving competence action HR/ HOD
plan (through identifying the gaps). If
weighted gap is greater than 6 … the training is highly
recommended
weighted gap is between 3 and 6 … the training is recommended
weighted gap is between 2 and 3 …the training is useful but no
urgency
weighted gap is 1 ,,,, immediate need for training
2.2 Instructional Design: HR/ HOD
All training content are developed with the aim of standardizing training across
trainers. Each programme developed has a facilitator’s guide along with the
training material. The process followed in the development of training programme
includes the following steps:
• Identification of the enabling objectives
• Content creation as per the objectives
• Validation by subject matter by experts
• Correction, printing and archive
• Modify/ update periodically
2.3 Imparting Training: HR/ HOD
All training is conducted as per pre-intimated schedule/ calendar.
All training is conducted as per the facilitator’s guide.
2.4 Training Vehicles/mode ( or action plan ) includes any one or more of the HR/ HOD
following:
• Class room training
• Facilitated videos
• Formal apprenticeship & mentoring programs
• Guided self study / computer aided instructions
• External training courses
• Professional conferences / seminars , etc
Prepared By: Quality Manager Approved By: Centre Head
PROFESSIONAL TRAINING AND DEVELOPMENT OF STAFF
Issue date: 01-01-26
Revision date: 01-01-27
NABH Ref:- Pre Accreditation Entry Level standards for Hospitals-2nd Edition: Nov-2025
Document No.: GHV/ARC/ HRM / 001
2.5 Adequate resources and funding are provided for implementing the training HR/ HOD
program , which includes :
• Designated person responsible for implementing training program
• Tools to support training program activities
• Appropriate facilities to conduct training
• Maintaining training records.
2.6 The training plan is reviewed by key responsibilities , and where required it is HR/ HOD
Revised
Prepared By: Quality Manager Approved By: Centre Head
PROFESSIONAL TRAINING AND DEVELOPMENT OF STAFF
Issue date: 01-01-26
Revision date: 01-01-27
NABH Ref:- Pre Accreditation Entry Level standards for Hospitals-2nd Edition: Nov-2025
Document No.: GHV/ARC/ HRM / 001
PROCEDURES FOR STAFF TRAINING
S.N Activity Responsibility
2.7 Standards for training materials used for training are developed and maintained HR/ HOD
by training In-charge. Training material includes:
• Training objectives
• Length of training
• Training plan
• Criteria for determining training effectiveness
• Procedure/system for periodically evaluating the effectiveness of training.
3.0 Training Records
3.1 Trainings are conducted as per plan; the attendance and time of training are Quality
recorded. Department
3.2 Records of all training attended by personnel are maintained in the form of Quality
departmental training excel sheet with the quality department file with following Department
details
• Name of the Personnel
• Training attended – Topic and No of Sessions
4.0 Training Effectiveness Evaluation
4.1 HR
Training effectiveness is evaluated based on objectives set or as per plan mutually
decided by HR and concerned functional head.
Learning checks at the end of each program (e.g. training evaluation through
questionnaire) Work place projects/ audits (as the case might be) are done.
Records of evaluation are maintained.
Participants not clearing both of the above would have to go for re-training / on
the job handholding.
5.0
Records Generated
Prepared By: Quality Manager Approved By: Centre Head
PROFESSIONAL TRAINING AND DEVELOPMENT OF STAFF
Issue date: 01-01-26
Revision date: 01-01-27
NABH Ref:- Pre Accreditation Entry Level standards for Hospitals-2nd Edition: Nov-2025
Document No.: GHV/ARC/ HRM / 001
Training Plan HR
Competence Skill Matrix (Annexure-5)
Training Attendance Records (Annexure-6)
Training Evaluation Report (Annexure-8)
Individual Training Records (Annexure-7)
Prepared By: Quality Manager Approved By: Centre Head
PROFESSIONAL TRAINING AND DEVELOPMENT OF STAFF
Issue date: 01-01-26
Revision date: 01-01-27
NABH Ref:- Pre Accreditation Entry Level standards for Hospitals-2nd Edition: Nov-2025
Document No.: GHV/ARC/ HRM / 001
TRAINING FRAMEWORK
Examples of
Department/ HR
Responsibilities and Individual Top Management
Line manager department
Actions
Identify own needs as Agree, support Consolidate Strategy,
per role and in & prioritize. organization Build culture and
Identify and discussion with Develop wide plan ensure commitment
prioritize manager training plan Identify
training and (personal Combine both Provide Organizational Needs
development development plan) top down support to as per scope, values
needs should be based (orgn.) needs + facilitate and and profile
around patient care bottom up plan
needs (and training (individual)
and research goals) needs
Use own experience Plan staff Provide Arrange sanctions,
to Act as release and support budgets, partnerships
Ensure Enabling
trainer/mentor/assess arrange on the with external
factors are in
or job agencies,
place
opportunities accreditation
Resources, Time,
Ensure fairness Memberships,
staff release,
and access to Encourage multi
all staff professional working
& training
Undertake training Undertake training Support Support Act as role models for
and development and put into practice individuals and Delivery of continuous
Activities (Ideal 10- training to take place teams in training plan development
15 days per year within place of work putting
per employee) learning into
practice
Reflect on learning Assess and Maintain MIS,
And whether it has review impact analyses, costs, Regular monitoring
been put into practice Staff should be effects etc
Prepared By: Quality Manager Approved By: Centre Head
PROFESSIONAL TRAINING AND DEVELOPMENT OF STAFF
Issue date: 01-01-26
Revision date: 01-01-27
NABH Ref:- Pre Accreditation Entry Level standards for Hospitals-2nd Edition: Nov-2025
Document No.: GHV/ARC/ HRM / 001
Monitor Appraisal able to Support
Review and demonstrate changes
evaluate role (career
competence progress, etc)
Appraisal
Prepared By: Quality Manager Approved By: Centre Head