Sarar Mohamed

Case 1 (IV: 1) The proband was the first born of a consanguineous couple and a product of uneventful pregnancy and full-term, spontaneous vaginal delivery (Figure, A). The family history was remarkable for 3 cousins with a similar disease and other 3 cousins with confirmed genetic diagnosis of mucopolysaccharidosis type IVA (Figure, A). She was small for gestational age, with low birth weight of 1.9 kg (z score = −2) and no NICU admission.

Implementation of clinical practice guidelines (CPGs) has been shown to reduce variation in practice and improve health care quality and patients' safety. There is a limited experience of CPG implementation (CPGI) in the Middle East. The CPG program in our institution was launched in 2009. The Quality Management department conducted a Failure Mode and Effect Analysis (FMEA) for further improvement of CPGI. This is a prospective study of a qualitative/quantitative design.