Developing realistic benchmarks for glaucoma care delivery.

Area of Science:

• Ophthalmology and Optometry
• Healthcare Quality Improvement
• Clinical Auditing

Background:

• Glaucoma care delivery requires realistic benchmarks for effective clinical practice audits.
• Existing benchmarks for monitoring and improving glaucoma care in optometry are lacking.
• The iCareTrack study previously audited glaucoma care appropriateness in Australian optometry practices.

Purpose of the Study:

• To develop realistic benchmarks for glaucoma care delivery in optometry.
• To benchmark optometry practice performance against these new standards.
• To identify specific aspects of care for quality improvement initiatives.

Main Methods:

• Benchmarks were derived from the iCareTrack dataset using the Achievable Benchmarks of Care (ABC) method.
• The ABC method utilizes the top 10% of best-performing practices, adjusted for patient numbers.
• Glaucoma care appropriateness was assessed against 37 clinical indicators in 420 patient records from 42 practices.

Main Results:

• Benchmarks were established for 34 of 37 clinical indicators.
• For 26 indicators, benchmarks exceeded 90% appropriateness, demonstrating high achievable standards.
• Sub-optimal performance was noted in peripheral anterior angle assessment, applanation tonometry, and visual field assessment.

Conclusions:

• Realistic and top achievable performance benchmarks for optometry glaucoma care have been established.
• High appropriateness levels are achievable and expected in optometrists' glaucoma care.
• Benchmarking effectively identifies areas for targeted quality improvement in glaucoma management.