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Q Bulletin, Volume 1, No. 32 (Supplement 1), Jan - Dec 202412th National QA Convention, 8 %u2013 10 October 2024OP-06Reducing Leakage of Sputum Specimens for Mycobacterium Tuberculosis (MTB)Culture during Transportation to Johor Bahru Public Health Laboratory (JBPHL)Siti Noor Aisyah MH, Zulaikah M, Nur Eyuni MS, Nor Zahidi MK, Nor Mastika AW, Norhuda J,Nurhidayah MZ, Nur Haslinda A, Lora J, Siti Rozillah MR, Arisa Stella ATTibi/Leprosy Unit, Disease Section, Johor Bahru Public Health Laboratory, Johor, MalaysiaSELECTION OF OPPORTUNITIES FOR IMPROVEMENT:The percentage of leaking specimens for Mycobacterium tuberculosis (MTB) culture in Johor BahruPublic Health Laboratory (JBPHL) has increased from 1.5% in 2016 to 5% in 2018. Leaking specimenswill compromise specimen quality and may lead to inaccurate results, misdiagnosis, inappropriatetreatment, and increased morbidity and mortality due to tuberculosis (TB). The study aims to reduce thepercentage of leaked sputum specimens for MTB culture during transportation.KEY MEASURES FOR IMPROVEMENT:The indicator was measured using the percentage of leaked sputum specimens sent for MTB culture. Thestandard is <1% based on the Malaysian Society for Quality in Health (MSQH) Performance Indicator.PROCESS OF GATHERING INFORMATION:A quality improvement study was carried out on rejected sputum specimens for MTB culture. This studyinvolves three cycles; improvement strategies were implemented in 2019 until June 2021 (Cycle 1),followed by additional remedial actions from January to June 2022 (Cycle 2) and January to June 2023(Cycle 3). Post-intervention assessments were conducted annually from July to December in eachrespective cycle. Data were extracted from the JBPHL database.ANALYSIS AND INTERPRETATION:Pre-intervention, 5% of specimens were rejected due to leaking. Contributing factors included improperspecimen packaging (39.4%), low-quality containers (27.3%), improper sample positioning (12.1%), andno proper carrier (9.1%).STRATEGIES FOR CHANGE:Remedial measures included the innovation of CT-Trans (container transportation system),communication with clients via WhatsApp group and letters, education sessions during TB course andHari Bersama Pelanggan, laboratory visits and flowchart distribution to clinics.EFFECT OF CHANGE:The ABNA has decreased from 4% to -0.52%. The percentage of leaking specimens was successfullyreduced to 0.67% in Cycle 1 (2021), 0.51% in Cycle 2 (2022), and sustained at 0.48% in Cycle 3 (2023),This reduction has saved operating costs approximately RM13,252.00.THE NEXT STEP:Efforts have been made to replicate and adopt CT-Trans innovation in all health clinics in Johor and weaim to introduce it to other states nationwide.31 | Page