Continuous Quality Improvement in Maternal and Newborn Care in Sangareddy Hospital

Margaret Crotty, the Executive Director of the New York based nonprofit, Partnership for Children, and one of the newest members of the Board of Directors of ACCESS Health International, recently visited Sangareddy Hospital in Hyderabad, Telangana to view their maternal and newborn quality improvement programs.

District Hospital Sangareddy Hospital was one of the first hospitals to join the Safe Care, Saving Lives program, back in 2014. Sangareddy is a district headquarters hospital that caters to a population of roughly one and a half million people. It has a well equipped labor room with five beds and a twenty bed Special Newborn Care Unit with round the clock available specialists. Each month, the hospitals delivers roughly six hundred babies and admits nearly two hundred babies to the Special Newborn Care Unit.

The quality improvement team at Sangareddy, led by Medical Superintendent Dr. K Raju and Dr. Rahim, Neonatologist and Nodal Officer in the Special Newborn Care Unit, have been working to reduce newborn deaths related to sepsis and complications of prematurity. These are two of the leading causes of death among newborns in India.

To reduce sepsis in the Special Newborn Care Unit the quality improvement team worked on compliance of hand hygiene, adherence to aseptic non-touch techniques for intravenous insertions, and timely and appropriate use of antibiotics. Through these efforts, the hospital reduced the incidence of sepsis from twenty percent in 2014 to seven percent in 2017. During the same time period, hospital staff achieved a four percent reduction in deaths due to sepsis. The hospital also significantly reduced expenditures on antibiotics, proving that improving the quality of care often leads to reductions in costs.

The quality improvement team at Sangareddy is also working to reduce complications due to prematurity by increasingly administering antenatal corticosteroids for women who are between 24 and 36 weeks pregnant. They have also improved temperature monitoring within the first fifteen minutes of a child being admitted into the Special Newborn Care Unit and have improved exclusive breastmilk feeding for newborns. These efforts have significantly reduced Respiratory Distress Syndrome cases from eleven percent in 2014 to five percent in 2017. Death rates due to Respiratory Distress Syndrome cases were also reduced to five percent from thirteen percent over a period of three years.

The visit to Sangareddy Hospital was an opportunity to showcase the impressive achievements in maternal and newborn care in the district hospital and also an opportunity for Ms. Crotty and ACCESS Health to thank Dr. Raju and Dr. Rahim for their leadership.