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Q Bulletin, Volume 1, No. 32 (Supplement 1), Jan - Dec 202412th National QA Convention, 8 %u2013 10 October 2024OP-18Improving Appropriate Outpatient Rehabilitation Management of ModeratelySevere COVID-19 Survivors in Hospital Sungai BulohAkmal Hafizah Z1, Raiha Hasni MH1, Pamela CSY1, Izuan Effendi AW1, Amitha NSL1, Fatnin FaqihaAM1, Tan BC1, Dayang Nur Atheerah K1, Nurfaezah K1, Dr Raagini L1, Syarifah Nur%u2019aini SAK1,Muhammad Shafaat S1, Muhd Zulkifli A2, Nur Diana A3, Zarina Z41Clinical Rehabilitation Unit, Rehabilitation Medicine Department, Hospital Sungai Buloh2Physiotherapy Unit, Rehabilitation Medicine Department, Hospital Sungai Buloh3 Occupational Therapy Unit, Rehabilitation Medicine Department, Hospital Sungai Buloh4Rehabilitation Nursing Unit, Rehabilitation Medicine Department, Hospital Sungai BulohSELECTION OF OPPORTUNITIES FOR IMPROVEMENT:Moderately severe COVID-19 survivors may potentially experience significant multi-system impairment,functional incapacitation and disability. Hence, rehabilitation%u2019s pivotal role is to return them to their bestfunctional level. The verification study showed only 16.3% of moderately severe COVID-19 survivorswere provided with appropriate outpatient rehabilitation management. This study aims to improveappropriate outpatient rehabilitation management of moderately severe COVID-19 survivors in HospitalSungai Buloh.KEY MEASURES FOR IMPROVEMENT:The key indicator for improvement was measured using the percentage of moderately severe COVID- 19survivors provided with appropriate outpatient rehabilitation management. The standard was set at 80%.PROCESS OF GATHERING INFORMATION:A quality improvement study was conducted involving a universal sampling of moderately severeCOVID-19 survivors referred for outpatient rehabilitation management. Data were collected throughretrospective review of electronic hospital information system clinical documentation, interviews andfocus group discussions involving rehabilitation personnels, patients or their caregivers, and auditchecklist form. Verification study was conducted from July %u2013 December 2020; Cycle 1 from July %u2013December 2021, Cycle 2 from July to December 2022 and Cycle 3 from July to December 2023.ANALYSIS AND INTERPRETATION:We found the key contributing factors were a lack of awareness, knowledge and practice involvingrehabilitation personnels and COVID-19 survivors or their caregivers; and the non-availability ofguidelines for COVID-19 rehabilitation and educational resources for the survivors and their caregivers.STRATEGIES FOR CHANGE:The strategies implemented were in-service and out-service trainings, establishing a clinical frameworkfor outpatient rehabilitation management; provision of a multi-disciplinary COVID-19 RehabilitationOutpatient Specialised Services (CROSS), teleconsultation, and collaborative educational resources.EFFECT OF CHANGE:The percentage has increased from 16.3% to 44.2% in Cycle 1; then improved to 87.5% in Cycle 2 andsubsequently 89.7% in Cycle 3. Achievable Benefit Not Achieved (ABNA) has improved from 63.7% to17.5%, then -7.5% and finally -9.7%.THE NEXT STEP:We aim to explore the potential application of the clinical framework and multidisciplinary serviceestablishment for conventional cases such as for spinal cord injury rehabilitation.43 | Page