Evaluating Quality Improvement Initiatives in Operation Theatres and Labour Rooms: A Study of Budgam's Community Health Centres

Abstract

Purpose: Quality Improvement (QI) initiatives are essential in Operation Theatres (OTs) and Labor Rooms (LRs) because they have a direct impact on maternal and neonatal outcomes as well as patient safety. Despite the existence of national quality standards and guidelines, evidence on their implementation level remains limited. This study aimed to assess the implementation, compliance, and effectiveness of QI initiatives in Operation Theatres (OTs) and Labor Rooms (LRs) across CHCs in District Budgam. Methods: A cross-sectional mixed-methods study was conducted across nine CHCs in Budgam. Facility audits, record reviews, and key informant interviews were conducted using a structured checklist adapted from the National Quality Assurance Standards (NQAS), the Kayakalp, and the LaQshya frameworks. Quantitative data were analyzed using descriptive statistics, while qualitative data were thematically analyzed. Results: Significant disparities were observed between FRU and non-FRU CHCs. FRUs reported higher delivery volumes (mean 198.3 vs. 6.7; p<0.001), greater staff training coverage (92.4% vs. 33.3%; p=0.003), and higher patient satisfaction. Infrastructure gaps, inconsistent infection prevention practices, limited staff availability, and partial adoption of safety checklists were noted across facilities. A strong inverse correlation was observed between staff training and surgical site infection rates (r = −0.82). No maternal or neonatal deaths were recorded during the study period. Conclusion: Despite the presence of national QI frameworks, implementation at the CHC level remains uneven. Strengthening infrastructure, workforce capacity, protocol adherence, and monitoring mechanisms is essential to improve the quality of care in OTs and LRs.