Page 19 - Q BULLETIN, Ministry of Health Malaysia, VOLUME 1, NO. 31 (SUPPLEMENT 1), JAN-DEC 2022

Q Bulletin, Volume 1, No. 31 (Supplement 1), Jan - Dec 2022
th
11 National QA Convention, 4 – 6 October 2022
OP-05

Increasing the Percentage of Patients Aged 60 Years Old and Above Receiving Removable
Partial Dentures (RPD) Within 8 Weeks in Klinik Pergigian (KP) Kulim

Yong ZP , Munirah Y , A’qilah F , Muhammad Luqman MN , Harison J 2
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1 Klinik Pergigian Lunas, Kedah
2 Klinik Pergigian Kulim, Kedah
3 Klinik Pergigian Taman Selasih, Kedah
SELECTION OF OPPORTUNITIES FOR IMPROVEMENT:
Elderly patients aged ≥60 years old who requested and are suitable for RPD have prolonged total treatment
durations in KP Kulim, which adversely impacts their quality of life. The verification study in 2018 showed
only 23.9% of these patients received their dentures within eight weeks. We aimed to increase the percentage
of patients aged ≥ 60 years old receiving RPD within eight weeks.

KEY MEASURES FOR IMPROVEMENT:
The indicator measuring improvement was the percentage of patients ≥ 60 years old receiving their RPD
within eight weeks in KP Kulim. The standard was > 65% based on the State Key Performance Indicator.

PROCESS OF GATHERING INFORMATION:
A quality improvement study was conducted involving 46 patients (60 years old and above) who had requested
and were found suitable for RPD from January - December 2018. Patients’ denture progression data was
collected via a checklist form filled out by the dental officer in charge. A questionnaire to assess contributing
factors was circulated among 24 dental personnel (15 dental officers, six dental surgery assistants, and three
dental technicians). Implementation of remedial measures and re-evaluation were done concurrently involving
43 patients (January 2019 - March 2020).

ANALYSIS AND INTERPRETATION:
Pre-remedial percentage of patients ≥ 60 years old who received RPD within eight weeks in KP Kulim was
23.9%. Contributing factors identified were an increased number of postponed appointments (79.2%) and
repeated clinical steps (95.8%).

STRATEGIES FOR CHANGE:
The strategies included prioritising cases, implementing a denture progression form, updating work procedures
through WhatsApp, conducting CDE sessions, and modifying workflows to reduce treatment time frames.

EFFECT OF CHANGE:
The percentage of patients ≥ 60 years old receiving RPD within eight weeks increased from 23.9% to 67.5%.
ABNA improved from 41.1% to -2.5 %.

THE NEXT STEP:
This study was expanded to KP Lunas and KP Taman Selasih. We plan to replicate the strategies at the state
level. Innovation of a bite registration technique will be introduced.

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