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Q Bulletin, Volume 1, No. 32 (Supplement 1), Jan - Dec 202412th National QA Convention, 8 %u2013 10 October 2024PP-28Reducing Bone Rejection by UMMC Bone Bank through Improved Work ProceduresRamalingam S, Mohd S, Yusof N, Yasin NF, Mansor AUMMC Bone Bank, Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, Universiti Malaya,Kuala Lumpur.SELECTION OF OPPORTUNITIES FOR IMPROVEMENT:The annual rejection rate of bones donated by orthopaedic patients was 36.8% in 2013, peaking at 50% in2015. This study aimed to reduce the annual rejection of donated bones from orthopaedic patients inUniversity Malaya Medical Centre (UMMC).KEY MEASURES FOR IMPROVEMENT:The study indicator is the annual percentage of bone rejections, out of all donated bones from orthopaedicpatients. A standard of <30% was decided upon consensus by the UMMC Bone Bank.PROCESS OF GATHERING INFORMATION:This quality improvement study began in 2013-2016 (verification phase), followed by 2017-2018(remedial phase) and 2019-2023 (post-remedial phase). Data were collected from the annual bonecollection and rejection logs. Universal sampling was used.ANALYSIS AND INTERPRETATION:During verification phase, the highest number of bones rejected were 205 (52.7%), 75 (36.6%) were dueto non-technical reasons: patients refused to donate (14.6%), no consent forms (either missing or notreturned) (12.2%), and improper bone handling (9.8%).STRATEGIES FOR CHANGE:Intervention included briefing for doctors on strategies to approach patients using an improved donorconsent. OT nurses were supplied with Bone Donor Kit, which contains items for serology andbacteriology tests, and bags for bone packaging.EFFECT OF CHANGE:The percentage of annual bone rejection significantly dropped to 29.1% in 2017, 21.5% during2019-2023, and reached the lowest at 14.8% in 2021 (p<0.05). No bone was rejected due to consent orhandling issues. Notably, the ABNA was successfully reduced from 22.7% to 0%.THE NEXT STEP:This achievement underscores the efficacy of our targeted strategies in optimising procedures for donatedbones in UMMC Bone Bank. Continuous training for doctors and nurses will be conducted annually toensure no bone rejection due to non-technical or human handling factors. Future efforts will focus onmaintaining these gains and identifying further opportunities for improvement.81 | Page