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Q Bulletin, Volume 1, No. 32 (Supplement 1), Jan - Dec 202412th National QA Convention, 8 %u2013 10 October 2024PP-19Improving the Percentage of Guideline Directed Medical Therapy among Patientswith Heart FailureEJ Koh, ZW Chan, HSL EstherDepartment of Internal Medicine, Taiping Hospital, Perak State Health DepartmentSELECTION OF OPPORTUNITIES FOR IMPROVEMENT:Guideline-Directed Medical Therapy (GDMT) in heart failure management is a combination of fourmedications proven to reduce hospitalisation and death. Our verification study in 2023 showed only31.8% of patients were on GDMT. This study aims to improve the percentage of patients on GDMT.KEY MEASURES FOR IMPROVEMENT:The indicator used is the percentage of patients attending heart failure clinic started on GDMT withinthree months. The standard is 80% based on the American College of Cardiology 2020 guidelines.PROCESS OF GATHERING INFORMATION:A quality improvement study was done involving heart failure patients treated in the medical outpatientclinic in the Taiping Hospital. All patient files were audited during the verification phase (January -February 2023). Data was recorded in an audit form. Doctors and patients were interviewed using avalidated questionnaire to determine contributing factors. Post remedial evaluations were done in twocycles between November 2023 and February 2024.ANALYSIS AND INTERPRETATION:The contributing factors included long appointment intervals in MOPD (100%), lack of knowledge onGDMT among doctors (50%) and patients (80%) and inadequate patient counselling (70%).STRATEGIES FOR CHANGE:A multidisciplinary heart failure clinic was established to allow structured, earlier and rapid up-titration ofGDMT. This clinic included doctors, pharmacists and nurses. Patient%u2019s educational pamphlets were madeavailable as hardcopies. Continuous medical education on the importance of GDMT was delivered tomedical doctors.EFFECT OF CHANGE:The indicator%u2019s achievement improved from 32% to 60% and 70% in cycle 1 and 2 respectively.Appointment interval in MOPD was reduced from three to one month. Comprehensive counselling on therole of GDMT and compliance to medications were given to all patients during the clinic appointment,compared to just 70% previously. GDMT knowledge among doctors increased to 80%.THE NEXT STEP:Taiping Hospital joined the national taskforce to develop a national heart failure module and the workingpaper was presented to the Director General of Health in May 2024.70 | Page