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Q Bulletin, Volume 1, No. 32 (Supplement 1), Jan - Dec 202412th National QA Convention, 8 %u2013 10 October 2024PP-26Improving HbA1c Level to Less Than 6.5% among Type 2 Diabetes Mellitus Patientsat Klinik Kesihatan Kulim, Kulim DistrictAnis Farhanah AR1, Nazatul Asma NA2, Cik Normadiah S2, Mohd Zukri I3, Nur Husna SH3, Izzati MM2,Fazdlizan AH2, Nurfazilla I21Klinik Kesihatan Merbau Pulas, Kulim, Kedah2 Klinik Kesihatan Kulim, Kulim, Kedah3Pejabat Kesihatan Daerah Kulim, KedahSELECTION OF OPPORTUNITIES FOR IMPROVEMENT:Public health clinics in Kulim District Kedah have suboptimal Type 2 Diabetes Mellitus (T2DM)management with 15.7% district HbA1c achievement in 2022. Klinik Kesihatan Kulim (KK Kulim) hadthe lowest achievement rate at 14.5%. Therefore, tailored interventions to improve T2DM care arenecessary. Achieving an HbA1c level of %u22646.5% is crucial in effectively managing diabetes and reducingthe risk of related complications.KEY MEASURES FOR IMPROVEMENT:The indicator measured was the proportion of T2DM patients with HbA1c %u22646.5%, with a standard targetset at %u226530% following the Quality Assurance Diabetes Program by the Ministry of Health.PROCESS OF GATHERING INFORMATION:In 2023, a quality improvement study was conducted at KK Kulim, involving randomly selected patientsfrom the National Diabetes Registry (NDR). Data on HbA1c levels and contributing factors werecollected using the NDR and a questionnaire assessing knowledge, attitude, and practice among patientsand staff. Interventions were implemented from April to June 2023, with a post-remedial evaluationconducted from July to December 2023.ANALYSIS AND INTERPRETATION:The study found that 27.0% of T2DM patients had HbA1c levels %u22646.5%. Contributing factors includepatient-related factors such as insufficient disease knowledge (14.0%), negative attitudes (20.0%), poorpractices (20.0%), healthcare worker issues like guideline non-adherence (66.7%), and fair diabetes careknowledge (37.0%). Another factor was lengthy appointment intervals (86.0%).STRATEGY FOR CHANGE:An innovative approach was implemented using targeted health education through hyperlinked flip chartsfor one-to-one virtual clinic sessions.EFFECT OF CHANGE:The proportion of T2DM patients with HbA1c %u22646.5% improved to 32.3%. Patient knowledge, attitude,and practice improved by 3.0%, 18.0%, and 14.0%, respectively. Guideline non-adherence decreased to27.2%, while staff knowledge increased to 85.0%. 100.0% patients with HbA1c >6.5% were givenappointments within three months.THE NEXT STEP:The plan is to scale up the intervention throughout Kedah, aligning with the broader trend of leveragingtechnology to enhance healthcare delivery at the national scale.79 | Page