Maintenance reliability in healthcare infrastructure ensures patient safety, operational efficiency, and compliance with quality standards. This study examines the application of the Plan-Do-Check-Act (PDCA) cycle as a strategic framework to address recurring maintenance challenges at the Ilocos Training and Regional Medical Center (ITRMC), focusing specifically on its Engineering Unit. Utilizing a qualitative case study design, data were collected through direct observations, document analysis, and semi-structured interviews with key personnel. The findings highlight a successful transition from a reactive maintenance approach to a proactive, data-driven system anchored in the PDCA methodology. Implementation of the cycle led to improved resource allocation, reduced service disruptions, and the institutionalization of preventive maintenance practices. Moreover, the initiative fostered a culture of continuous quality improvement within the organization. This research offers practical, evidence-based insights for other resource-constrained public healthcare institutions aiming to optimize infrastructure management and service reliability.