Resource Planning in Glaucoma: A Tool to Evaluate Glaucoma Service Capacity.

Area of Science:

• Ophthalmology
• Healthcare Management
• Patient Safety

Background:

• Established glaucoma requires timely follow-up to prevent vision loss, as highlighted by national safety reports.
• Quality standards mandate hospital appointments within 15% of the scheduled follow-up period.
• Previous instances of visual impairment resulted from delayed appointments and patient attrition.

Purpose of the Study:

• To assess adherence to recommended glaucoma follow-up intervals.
• To evaluate the appropriateness of requested appointment intervals against NICE Guidelines.
• To determine the adequacy of glaucoma service capacity.

Main Methods:

• A two-part audit of consecutive patients attending specialist glaucoma clinics.
• Recording reasons for appointment delays in the initial audit.
• Comparing requested follow-up intervals with NICE guidelines and conducting a re-audit after service improvements.

Main Results:

• Initially, 24% of appointments were delayed beyond the 15% threshold due to administrative issues and capacity constraints, impacting two patients' vision.
• Following implementation of an electronic appointment tracker and increased clinical capacity, re-audit showed a significant reduction in delays to 9%.

Conclusions:

• Audits are effective for evaluating glaucoma service provision and aiding resource planning.
• Implementing service changes can non-confrontationally improve appointment timeliness.
• The audit methodology is adaptable for other medical specialties.