Exploring Quality Management Practices Following the Implementation of National Quality Assurance Standards at a Community Health Centre in Budgam

Abstract

Healthcare quality is an important aspect of an effective and sustainable health system. Sustaining quality after certification is essential and a long-term goal for public health facilities in India. This study examined quality management practices following NQAS implementation at a community health centre (CHC) in Budgam, assessed the quality of care provided and patient satisfaction level, and explored the organizational barriers in the implementation of NQAS at public health facilities. A hospital-based mixed-method study was conducted at one purposively selected CHC. The study assessed the quality management indicators in pre-certification period (June to September 2025) and post-certification period (June to September 2026). Quantitative data was collected using a structured questionnaire and from facility records. Qualitative data was obtained from key informant interviews conducted with the facility staff. The facility had an overall NQAS score of 89.4%. Compared with the pre-certification period, outpatient visits increased by 32%, ECG services by 24.7%, laboratory investigations by 3.2%, and X-ray services by 3.4% in post-certification period. The institutional deliveries increased from 80% to 92% after certification. The participation of staff in trainings increased from 67.6% to 98.3%, while as NQAS training coverage increased from 18.4% to 86.8% after the certification. About 70% of patients were fully satisfied with the quality of care and services received. The study found improvements in quality management practices, staff training coverage, and patient satisfaction following NQAS implementation. Sustaining these improvements will require regular committee reviews, effective implementation of the PDCA cycle, continuous staff training and capacity building, and addressing existing organizational barriers.