No abstract

No abstract

Purpose Improving adherence to practice guidelines can improve patient safety and quality of care. We sought to establish a regional glaucoma physician collaborative to evaluate and improve adherence to the American Academy of Ophthalmology’s Primary Open-angle Glaucoma (POAG) Preferred Practice Pattern (PPP) guidelines. Design Prospective interventional study. All consecutive POAG new patient visits were reviewed from each study site to determine physician adherence to the 13 major exam elements of the PPP. Methods The collaborative consisted of 13 glaucoma specialists from three practices in Michigan. In phase 1 of the study, physician adherence rates for each of the recommended examination elements were combined and averaged for all groups. Averages for the collaborative were reported to each site, and each physician received his/her individual adherence rates. Physicians discussed strategies to improve overall adherence to the PPP. Adherence rates were collected in phase 2 to determine if feedback and sharing of strategies resulted in improved adherence. Results 274 new POAG patient visits from phase 1 and 280 visits from phase 2 were reviewed. After accounting for multiple comparisons, overall improvement approached statistical significance for the evaluation of visual function (91.2% to 96.1%, p<0.02) and target intraocular pressure determination (73.7% to 83.2%, p<0.01). Improvement for other measures that had a high rate of adherence at baseline (e.g. ocular history, pupil exam and central corneal thickness measurement) was not statistically significant. Conclusions It is feasible to establish a regional glaucoma physician collaborative to improve standardization of care for patients with newly diagnosed POAG.

<p>A monthly case study, featured in <CITE>Journal of Pediatric Ophthalmology & Strabismus</CITE>, showing encounters in the field of Pediatric Ophthalmology.</p>