TY - JOUR
T1 - Optimizing preoperative requirements for outpatient cataract surgery at the Royal Alexandra Hospital
AU - Strungaru, Hermina
AU - Pereira, Nichole
AU - Salmonson, Hilary
AU - Nguyen, Haily
AU - Rudnisky, Christopher J.
AU - Drader, Keith
AU - Harris, Karen
AU - Damji, Karim F.
N1 - Publisher Copyright:
© 2018 Canadian Ophthalmological Society
PY - 2019/6
Y1 - 2019/6
N2 - Objective: To evaluate preoperative testing for cataract surgery, implement stakeholder-driven change, and increase the number of patients who arrived for surgery with complete preoperative requirements, for the purpose of delivering safe, high-quality, and cost-effective care for patients. Design: Quality improvement. Participants: Cataract surgery patients, health care staff in Ophthalmology Day Surgery, an Ophthalmology improvement team, the Clinical Section Heads of Ophthalmology and Anaesthesia, Quality Consultants, and members of the Quality Council participated in this study. Methods: A lean quality improvement approach was used to define and build understanding of the problem. Between July and November 2016, a chart-based reporting system captured all patients who arrived for cataract surgery with expired or incomplete preoperative requirements. A cost analysis was completed, and evidence was reviewed to ensure alignment with best practice preoperative recommendations. Results: On average, 25% (619/2451 over a 17-week period) of patients per day arrived at the Ophthalmology Day Surgery for cataract surgery with incomplete and/or expired physical history forms and ECGs. An improvement team worked to implement a radical improvement idea and relied on an existing questionnaire to ensure patient safety preoperatively. Conclusions: Based on the literature, best practice guidelines, and a cost analysis, it was decided that patients undergoing routine cataract surgery in Edmonton Zone Hospitals under regional anaesthesia would no longer require physician history and physicals and ECGs. Elimination of the preoperative requirements for all but select high-risk patients meant that 100% of patients who arrived for cataract surgery would not have outstanding presurgery requirements.
AB - Objective: To evaluate preoperative testing for cataract surgery, implement stakeholder-driven change, and increase the number of patients who arrived for surgery with complete preoperative requirements, for the purpose of delivering safe, high-quality, and cost-effective care for patients. Design: Quality improvement. Participants: Cataract surgery patients, health care staff in Ophthalmology Day Surgery, an Ophthalmology improvement team, the Clinical Section Heads of Ophthalmology and Anaesthesia, Quality Consultants, and members of the Quality Council participated in this study. Methods: A lean quality improvement approach was used to define and build understanding of the problem. Between July and November 2016, a chart-based reporting system captured all patients who arrived for cataract surgery with expired or incomplete preoperative requirements. A cost analysis was completed, and evidence was reviewed to ensure alignment with best practice preoperative recommendations. Results: On average, 25% (619/2451 over a 17-week period) of patients per day arrived at the Ophthalmology Day Surgery for cataract surgery with incomplete and/or expired physical history forms and ECGs. An improvement team worked to implement a radical improvement idea and relied on an existing questionnaire to ensure patient safety preoperatively. Conclusions: Based on the literature, best practice guidelines, and a cost analysis, it was decided that patients undergoing routine cataract surgery in Edmonton Zone Hospitals under regional anaesthesia would no longer require physician history and physicals and ECGs. Elimination of the preoperative requirements for all but select high-risk patients meant that 100% of patients who arrived for cataract surgery would not have outstanding presurgery requirements.
UR - http://www.scopus.com/inward/record.url?scp=85055035066&partnerID=8YFLogxK
U2 - 10.1016/j.jcjo.2018.07.010
DO - 10.1016/j.jcjo.2018.07.010
M3 - Article
C2 - 31109469
AN - SCOPUS:85055035066
SN - 0008-4182
VL - 54
SP - 306
EP - 313
JO - Canadian Journal of Ophthalmology
JF - Canadian Journal of Ophthalmology
IS - 3
ER -