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Fulltext An audit of the quality of lateral cephalometric radiographs for orthodontic treatment

Mohd Zambri Mohamed Makhbul, Rashidah Burhanudin, Wan Nurazreena Wan Hassan

Malaysian Dental Journal, 2016;39(1):35-51.
MyJurnal

It is not uncommon for lateral cephalometric radiographs to be outsourced for orthodontic treatment, as not all orthodontic clinics in Malaysia have their own cephalometric radiograph machine. Since the quality of outsourced radiographs is not within the governance of the clinician, there is a need to monitor the quality of cephalometric radiographs received. Aim: To audit the quality of lateral cephalometric radiographs received at the Orthodontic Specialist Unit, Klinik Pergigian Cahaya Suria, Kuala Lumpur, Malaysia. Methodology: Lateral cephalometric records of patients with registration numbers up to 200 in 2015 were selected and assessed using a light box. The quality of good radiographs were based on 15 parameters: correct head position; presence of the scale; important structures centered on the film; patient’s name; date taken; patient’s identifier; label not obscuring radiograph; soft tissue visible; teeth in occlusion; good contrast; ‘A’ point identifiable; ‘B’ point identifiable; nasion identifiable; sella identifiable; incisors visible and their angulation measureable. Standard was set at 100%, as radiographs received should contain all parameters. Results: Five records were excluded (2 had no radiographs, 2 had digital radiographs, and 1 record could not be traced). 64.5% radiographs had all 15 parameters, 30.3%, 3.9% and 1.3% with 14, 13 and 12 parameters, respectively. Patient’s name, identifier, date taken, soft tissue visible, ‘B’ point identifiable, nasion identifiable were present in all radiographs (100%). Incisor visible and their angulation measurable were present in 99%; good contrast and ‘A’ point identifiable in 98%; presence of scale, important structures centred on films and sella identifiable in 97%, label not obscuring radiographs in 96%; correct head position in 86%; and teeth in occlusion in 88% of radiographs. Conclusion: There is a need to liaise with the radiology unit to improve the quality of radiographs taken.

Matched MeSH terms: Quality Assurance, Health Care
Experience of the first survey of the pilot project of Asian Quality Assurance Survey program

Lee KN, Yoon SY, Cho HI

Southeast Asian J. Trop. Med. Public Health, 2002;33 Suppl 2:30-43.
PMID: 12755265

The Asian Network for Clinical Laboratory Standardization (ANCLS) decided to start her First Inter-laboratory Quality Assurance survey at the business meeting during the Second Asian Colloquium on October 21-22, 2000 in Kobe, Japan. The first survey materials of Asian Quality Assurance Survey (AQuAS) were distributed in July 2001 to 21 hospitals in the field of chemistry and 22 hospitals in the field of hematology among total 24 participating laboratories from seven Asian countries: Indonesia, Japan, Korea, Malaysia, Philippines, Singapore and Thailand. The survey methods in chemistry and in hematology were somewhat different. In chemistry the survey material was considered as unknown but handled similarly to the sample from the patient. Nineteen routine tests were performed only once. The hematology samples were considered as unknown but handled similarly to control or calibration material. Five parameters were tested five times repetitively and their average for each parameter was calculated. All the results were supposed to be sent back to the office within two weeks. Although it took more than two weeks, the return rate was 100%. The analysis was performed in several ways such as all the results together, by instruments and by methods. Mean, standard deviation (SD), standard deviation index (SDI), coefficient of variation (CV) and variance index score (VIS) were to be calculated in chemistry, and in hematology the same parameter were to be calculated except CV and VIS. In the first survey, the CV in chemistry was not calculated and the analysis by instrument or by methodology was also not attempted since there were not enough participating hospitals to do such analysis. In hematology the analysis was done by instrument only. The survey process was carried out successfully though there were some difficulties in communication tools, transportation methods and handling of specimens due to different weather conditions, and returning the report in the correct unit and to the correct place. The submitted data were acceptable for analysis. There were some differences in the units of measurement in different countries or laboratories. It was necessary to convert some of the units. Some laboratories apparently do not perform certain tests such as calcium, potasium and gamma-glutamyltransferase (gamma-GT). The gamma-GT is the most frequently not performed test. With the experience of this first survey, all the members involved in the survey have been trained well to do future surveys.

Matched MeSH terms: Quality Assurance, Health Care*
Teaching quality assurance in Malaysia: a report on six workshops on quality assurance in patient care services for health care providers in government service

Reerink E, Nafisah bte Alihussein

Med Educ, 1990 Jul;24(4):359-65.
PMID: 2395428 DOI: 10.1111/j.1365-2923.1990.tb02452.x

In the government hospitals of Malaysia quality assurance activities have been introduced since 1985. Local clinicians and other health care workers had been stimulated by the Ministry of Health to pursue these activities, but they found themselves untrained and ill-prepared for the job. With the help of the World Health Organization a programme of training courses has been set up and conducted, most recently, in February 1989. A model for teaching quality assurance was developed, geared towards the needs of the Malaysian clinicians and taking into account the recent progress made in the development of quality assurance approaches worldwide. Moreover, quality assurance results from one Malaysian hospital were used, thus increasing the relevance of the teaching. Results show that Malaysian clinicians have appreciated the training and have relaxed in their attitude towards quality assurance and the government's involvement in it. During the various courses pitfalls have been identified in the teaching of modern quality assurance in health care for audiences from developing and newly industrialized countries.

Matched MeSH terms: Quality Assurance, Health Care*
An integrated MUSA to measure health care service quality from a patient's perspective in a resource-constrained setting

Al-Awlaqi MA, Aamer AM

Int J Health Plann Manage, 2020 Jan;35(1):e119-e132.
PMID: 31670407 DOI: 10.1002/hpm.2943

PURPOSE: Although assessing the quality of health services offered in a least developed country such as Yemen is very important, it is not yet given attention. As a result, Yemeni patients started to look for higher quality of health services abroad. Thus, Yemeni health private providers need to know how to link their patients' satisfaction to the quality of the services offered to end up with more satisfied patients and higher health service quality offered.
METHODOLOGY: Data were collected form 5310 patients in 249 private clinics. The patients evaluated their satisfaction on the quality of service on the basis of nine criteria that comprised 31 subcriteria. We used multicriteria satisfaction analysis (MUSA) to analyze the data.
FINDINGS AND CONCLUSION: The data analysis results showed low level of satisfaction on the health care quality services offered by the private clinics in Yemen. The majority of the criteria and subcriteria showed low level of satisfaction, high demand, and high mandate for improvement.

Matched MeSH terms: Quality Assurance, Health Care/methods*
Cytopathology in malaysia

Jayaram G, Yahya H

Diagn Cytopathol, 2002 Nov;27(5):322-4.
PMID: 12412003
Matched MeSH terms: Quality Assurance, Health Care*
Fulltext Quality in family practice

Rajakumar MK

Asia Pac Fam Med, 2002;1(2&3):74-8.

Quality programs are difficult to implement where social support for healthcare costs are inadequate and there is no institutional support for quality programs to guide and assist the doctor in pratice. ‘Quality’ is not the good intention to do better, but the process of measurement of behavioral change against set targets. For the majority of the doctors of this region who practice under great constraints, this article outlines some quality activities that are entirely within their personal initiative and responsibility, but should make a real difference to the quality of care provided.nd responsibility, but should make a real difference to the quality of care you provide.
Republished in: Republished in: Teng CL, Khoo EM, Ng CJ (editors). Family Medicine, Healthcare and Society: Essays by Dr M K Rajakumar, Second Edition. Kuala Lumpur: Academy of Family Physicians of Malaysia, 2019: 68-74

Matched MeSH terms: Quality Assurance, Health Care