This is the program started to benefit the labour room and maternity cases in govt sector of health care. Quality of care is import in health sectors. Providing Safe birth to the pregnent aldy even at the pheripheral level is the main intenstion of the program
2. LAQSHYA- LABOUR ROOM QUALITY
IMPROVEMENT INITIATIVE GUIDELINE
Started in 2018-19 in karnataka
Goal- To reduce preventable maternal and
newborn mortality, morbidity and still births
associated with care around delivery in
labour room and maternity OT
To ensure respectful maternity care.
3.
4. LaQshya is all about improving Quality of Care
around birth
1. Quality Certification of Labour Room and/or
OT – through the existing system
2. Attainment of 75% of Facility level targets
3. At least 80% beneficiaries are satisfied with
the care
5. LABOUR ROOM
DO’S DON’TS
Providing privacy to pregnant women
during the intrapartum period, by way
of separate labour room or at least a
private cubicle
Presence of birth companion during
the labour
Freedom to choose a comfortable
position during birthing (squatting,
standing, etc.)
Adherence to Clinical protocols for
management of labour
Use of Labour beds instead of tables y
Place baby on mother’s abdomen y
Initiation of Breast feeding within one
hour of birth
Induction and augmentation of labour
without sound clinical indications
Any verbal or physical abuse of the
pregnant women
Insisting on conventional lithotomy
position for the delivery
Immediate clamping and cutting of the
umbilical cord
Separating baby from the mother for
routine care & procedure
‘Out of Pocket Expenditures (OOPE)
on drugs, diagnostics, including
demand by the staff for gratuitous
payment by families for celebration of
the baby’s birth
6. OBJECTIVES
1. To reduce maternal and newborn mortality &
morbidity due to APH, PPH, retained placenta,
preterm, preeclampsia & eclampsia, obstructed
labour, puerperal sepsis, newborn asphyxia, and
sepsis, etc.
2. To improve Quality of care during the delivery and
immediate post-partum care, stabilization of
complications and ensure timely referrals, and enable
an effective two-way follow-up system.
3. To enhance satisfaction of beneficiaries visiting the
health facilities and provide Respectful Maternity
Care (RMC) to all pregnant women attending the
public health facility.
7. NQAS: AREAS OF CONCERN
Service
Provision
Inputs Support
Services
Clinical
Care
Infection
Control
Quality
Management
Outcome
Patients’
Rights
13. RAPID IMPROVEMENT EVENTS
Cycle 1: Real-time Partograph generation including shift to
electronic partograph & usage of safe birth check-list & surgical
safety check-list and strengthening documentation practices for
generating robust data for driving improvement.
Cycle 2: Presence of Birth companion during delivery, respectful
maternity care and enhancement of patients’ satisfaction.
Cycle 3: Assessment, Triage and timely management of
complications including strengthening of referral protocols.
Cycle 4: Management of Labour as per protocols including
AMTSL & rational use of Oxytocin.
Cycle 5: Essential and emergency care of Newborn & Pre-term
babies including management of birth asphyxia and timely
initiation of breast feeding as well as KMC for preterm newborn.
Cycle 6: Infection Prevention including Biomedical Waste
Management.
14. STRUCTURAL IMPROVEMENT
Upgrading the infrastructure as per norm &
realistic case-load
Human Resource augmentation and upskilling
Ensuring availability of functional & calibrated
equipment, as per need
Strengthening supply chain of drugs &
consumables
15. PROCESS IMPROVEMENT
Assessment and Triage
Enablers for Respectful care
Management of Labour including Active Management
of Third stage of labour
Management of complications and High-Risk
Pregnancies
Management of referral services
Perioperative processes for C-Section
New-born care and resuscitation
Management of required Support services
17. ZONING IN OT
1. PROTECTIVE - Reception, Waiting, Trolley
Bay, Change Rooms, Rooms for administrative
staff, Stores & Record, Conference Room, etc.
2. CLEAN AREA – Pre-operative, Post-operative,
Plaster Room, Staff lounges, Stores, etc.
3. STERILE AREA Operating Theatre, Scrub
Room, Anaesthesia, Setup Room
4. DISPOSAL AREA - Dirty Utility, Disposal areas
from each OT & Corridor leading to disposal
zone, Disposal Corridor
18. OPERATION THEATRE
Functional Pre and post-operative area
Dedicated nursing staff for pre and post-
operative area
Availability of Essential Equipment,
maintenance & calibration
Cleaning & disinfection protocol
Availability of Anaesthesia Services
Monitoring Indicators
19. LIST OF FACILITIES UNDER LAQSHYA
PROGRAMME- RAICHUR DISTRICT
RIMS
Manvi TH
Deodurga TH
Sindanuru TH
Lingasuguru TH
Arkere CHC
20. POINTS TO DISCUSS
Checklist of labour room and maternity OT
Monthly report submission
OSCE-training