Quality indicators in a community optometrist led cataract shared care scheme

Area of Science:

• Ophthalmology
• Public Health
• Healthcare Management

Background:

• Cataract shared care schemes demonstrate considerable practice variability.
• Accountability among stakeholders in these schemes requires enhancement.

Purpose of the Study:

• To evaluate the effectiveness of defined key performance indicators (KPIs) in improving accountability within cataract shared care schemes.
• To assess outcomes of direct cataract referrals from community optometrists against agreed KPIs.

Main Methods:

• Prospective study over nine months at a UK public hospital.
• Evaluation of consecutive direct cataract referrals against two KPIs: 85% first consultation listing rate and 90% postoperative feedback return.
• Analysis of referral triage, surgical listing, and postoperative feedback return rates.

Main Results:

• 86% of 733 direct cataract referrals were listed for surgery, with failure to meet visual thresholds being the primary reason for non-listing.
• 71% of 569 cataract surgeries resulted in same-day discharge for community optometrist follow-up.
• A 93% postoperative feedback return rate was achieved from 374 patients.

Conclusions:

• Direct referrals from accredited community optometrists facilitate prompt clinical decisions.
• Community-based postoperative follow-up enhances patient convenience and reduces hospital visits.
• Service-level agreements with KPIs improve stakeholder accountability in cataract shared care.