Improving efficiency
Shared care can optimise management of glaucoma patients


Roibeard O’hEineachain
Published: Wednesday, March 1, 2017

Shared care can improve quality and increase capacity, and provides a better cost-benefit ratioThe examinations they perform include visual acuity testing, intraocular pressure measurement, visual field examination, optic disc and nerve fibre layer imaging (Heidelberg Retinal Tomography/HRT), optical coherence tomography and optic disc photographs. Based on pre-set criteria, the specially trained personnel make a decision of whether they warrant further examination. “They don’t need to do subjective interpretations of these tests, they just have to check whether the patients pass these objective criteria or not,” Dr Stalmans said. If a patient fails in any of the preset parameters, their chart is sent to the specialist who then decides whether it is necessary to see the patient at that point. The glaucoma specialist gives feedback to the person at the Glaucoma Post, helping them to improve their expertise, she noted. “It is very important that these people get a continuous learning process and this is very well appreciated by them as well,” she said. They validated the system based on some key performance indicators in a review of the charts since the introduction of the Glaucoma Posts in 2012. For example, they found that after just one year the number of patients they saw at their outpatient clinics rose from 6,000 to 8,000. In addition, the waiting time for first appointments fell from four-and-a-half months to two-and-a-half months. The number of glaucoma surgeries also increased. SHARING IDEAS She noted that many centres have mobilised in this way to improve the efficiency of glaucoma care. In addition, several members of the World Association of Eye Hospitals (WAEH) convened to compare their approaches. Their analysis revealed many similarities and many differences in their approaches. However, based on the evidence, they reached a consensus that the availability of specific training is really crucial to success. The sharing of ideas and experience should also be continuous, Dr Stalmans said. Ingeborg Stalmans: ingeborg.stalmans@mac.com
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