Introduction:

The increasing burden of diabetes mellitus, corresponding to Prameha/Madhumeha in Ayurveda, presents complex clinical and quality-related challenges for Ayurveda hospitals, particularly in the care of vulnerable diabetic patients with chronic disease and complications. Continuous Quality Assurance (CQA) is essential to ensure safe, standardized, and patient-centered diabetes care. This review explores the application of CQA in Ayurveda hospitals through the HEARTS strategy of Quality Healthcare—Holistic, Effective, Accessible, Reliable, Tailored, and Sustainable care, emphasizing its relevance in long-term diabetic management.

Methods:

A narrative review was conducted using classical Ayurvedic literature, including Charaka Samhita and Sushruta Samhita, along with contemporary regulatory and quality frameworks such as Ministry of AYUSH guidelines, NABH standards, WHO recommendations on traditional medicine, and ISO 9001:2015 quality management principles. Core domains of quality assurance—patient identification, initial and nutritional assessment, documentation, therapeutic protocols, medication safety, Panchakarma SOPs, infection control, follow-up, and Continuous Quality Improvement (CQI)—were systematically examined in the context of Ayurveda-based diabetic care, aligned with the HEARTS quality framework.

Results:

Implementation of CQA using the HEARTS strategy demonstrated improved standardization and consistency in Prameha management within Ayurveda hospitals. Holistic and tailored approaches supported individualized treatment planning based on Prakriti and Vikriti, while effective and reliable practices enhanced therapeutic safety, documentation accuracy, and continuity of care. Accessible and sustainable service models facilitated long-term follow-up, patient adherence, and preventive interventions, contributing to improved clinical outcomes and patient satisfaction among vulnerable diabetic populations.

Discussion:

The HEARTS-based CQA framework provides a structured and integrative approach to quality improvement in Ayurveda hospitals delivering diabetic care. By harmonizing classical Ayurvedic principles with modern quality and safety standards, CQA strengthens clinical governance, reduces risk, and promotes sustainable, people-centered diabetes management. Adoption of the HEARTS strategy positions Ayurveda hospitals as credible, quality-driven institutions capable of addressing the growing public health challenge of diabetes.