A Simple Screening Tool Reduces Unnecessary Preoperative Evaluation for Cataract Surgery.
Thomas R Hickey1, James Kempton, Daniel G Federman
1Author Affiliations: Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut, and VA Connecticut Healthcare System, West Haven, Connecticut (Dr Hickey); Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut, and VA Connecticut Healthcare System, West Haven, Connecticut (Dr Kempton), and Department of Medicine, Yale University School of Medicine, New Haven, Connecticut, and VA Connecticut Healthcare System, West Haven, Connecticut (Dr Federman).
A new screening tool significantly reduced unnecessary preoperative evaluations for cataract surgery patients. This process improvement lowers healthcare costs without impacting patient outcomes.
Area of Science:
- Ophthalmology
- Healthcare Management
- Process Improvement
Background:
- Cataract surgery is a common procedure with low inherent risk.
- Preoperative evaluations and testing have not demonstrated improved patient outcomes but increase healthcare costs.
- Unnecessary preoperative primary care evaluations for cataract surgery represent a significant area for cost reduction.
Purpose of the Study:
- To implement and assess a process improvement initiative aimed at reducing unnecessary preoperative primary care evaluations for patients undergoing cataract surgery.
- To evaluate the effectiveness of a simple screening tool in streamlining preoperative care pathways.
Main Methods:
- A screening tool was developed, involving a brief chart review and patient conversation to determine the necessity of preoperative primary care evaluations.
- A retrospective chart review of 100 patients was conducted, comparing 50 patients before and 50 patients after the intervention's implementation.
Main Results:
- The implemented screening tool led to a substantial decrease in primary care provider referrals, dropping from 100% to 4%.
- Preoperative primary care evaluations decreased significantly, from 94% to 6% of patients after the screening tool was introduced.
Conclusions:
- A simple screening tool effectively reduced unnecessary primary care preoperative testing for cataract surgery.
- Process improvements focusing on targeted preoperative evaluations can lead to significant cost savings in ophthalmic surgery pathways.
