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Q Bulletin, Volume 1, No. 32 (Supplement 1), Jan - Dec 202412th National QA Convention, 8 %u2013 10 October 2024OP-17Reduction of Intra-Oral Periapical Radiograph Rejection Rate at Tengkera DentalClinicLai SM1, Than CY2, Mok E1, Noorul Nadiah NZ31Klinik Pergigian Ayer Molek, Melaka Tengah, Melaka2Klinik Pergigian Tengkera, Melaka Tengah, Melaka3Pejabat Kesihatan Pergigian Daerah Melaka Tengah, MelakaSELECTION OF OPPORTUNITIES FOR IMPROVEMENT:Intra-oral periapical (IOPA) radiograph is a crucial adjunct in diagnosing dental diseases. Obtainingdiagnostically acceptable radiographs on the first attempt is vital, as rejected radiographs waste time andmoney. At Tengkera Dental Clinic, the rejection rate of IOPA radiographs showed a concerning increase,rising from 6.4% in 2021 to 7.0% in 2022. This study aimed to reduce the rejection rate to below 5%within one year.KEY MEASURES FOR IMPROVEMENT:The indicator was the rejection rate of IOPA radiographs. The standard was <5% of the total IOPAradiographs taken, a quality objective set by the Oral Health Division of Melaka.PROCESS OF GATHERING INFORMATION:Verification study spanned from May to June 2023. The rejection rate was obtained from the monthlyreport (BK13). A clinical audit and a self-administered questionnaire were conducted among 25 dentalofficers and dental surgery assistants, to assess operators%u2019 knowledge, experience and skills in radiographtaking and processing.ANALYSIS AND INTERPRETATION:The rejection rate in the verification study was 5.9%. The main factors were poor knowledge and skillsamong operators (25%), inappropriate methods for taking and processing radiographs (26%), and patientmovement during radiation exposure (86%).STRATEGIES FOR CHANGE:In cycle 1, the current guideline was converted into infographic posters. Hands-on training and clinicalaudits were conducted to improve operators%u2019 knowledge and skills. In cycle 2, a video demonstration andan innovative tool were created to help patients stay still during radiograph taking.EFFECT OF CHANGE:After two cycles, the rejection rate was reduced to 2.2%, with an ABNA of -2.8%. All criteria of MOGCwere achieved to 95-100%. The cost was reduced by RM104.40 (43%) within a year. Patients alsoreported increased satisfaction, decreased pain and reduced anxiety during radiograph taking.THE NEXT STEP:Remedial measures have been implemented at other dental clinics, to be followed by the medicalradiology department. An English version of the video demonstration is currently being developed.42 | Page