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

Abstract

This audit is a useful tool to evaluate glaucoma service provision, assist in resource planning for the service and bring about change in a non-confrontational way. It can be widely applied and adapted for use in other medical specialities.

An Initiative to Improve Follow-up of Patients with Glaucoma

“…8 Our overall LTF rate (11%) is comparable to other studies of patients followed for glaucoma and related diagnoses (Table 3). [1][2][3][4] Notably, studies with lower rates of LTF tend to be carried out in settings of universal healthcare, such as the United Kingdom and South Korea. 3,4 Differences in definition of LTF may also partially explain the difference in the rate of LTF between these studies.…”

“…Adherence to recommended follow-up for glaucoma has historically been poor, especially among asymptomatic patients or those with mild disease, with rates of "lost to follow-up" (LTF) as high as 46%. [1][2][3][4] The Coronavirus Disease 2019 (COVID-19) pandemic has increased the likelihood that patients with glaucoma will become LTF. In the first 6 weeks after the announcement of a statewide stayat-home order in Massachusetts in response to the outbreak of COVID-19, total ophthalmology volume at our academic, multispecialty group practice decreased 86% and glaucoma visits, in particular, decreased 94%.…”

A Scoping Review of Process Indicators for Measuring Quality of Care in Glaucoma

“…Among the 18 selected documents, 9 were articles published in specialized journals, [22][23][24][25][26][27][28][29][30] 7 were major guidelines [31][32][33][34][35][36][37] developed by nationally or internationally recognized organizations, and 2 were sets of quality standards 38,39 provided by NICE and the Royal College of Ophthalmologists. Two documents (1 guideline 37 and 1 quality standard 38 ) were both developed by NICE; therefore, these were analyzed as a single item since they contained repeated information.…”

“…Royal College of Ophthalmologists (RCO) 39 UK Quality Standard Self-Assessment Tool-Evaluation of a small number of key areas of service provision, not outcomes, to support learning and improvement Batra et al 22 UK A tool to evaluate the quality and capacity of a glaucoma service National Institute for Health and Care Excellence (NICE)-QS7 38 UK Glaucoma in adults: quality standards-describes markers of high-quality and cost-effective care that should contribute to improving the effectiveness, safety and experience of glaucoma care National Institute for Health and Care Excellence (NICE)-NG81 37 UK Guidelines-glaucoma: diagnosis and management Elam et al 23 USA Comparison in receipt glaucoma care between Medicaid and a commercial health insurance throughout a set of indicators Liang et al 26 China Theoretical developing of new indicators Winkler et al 28 USA Assessment of a team-based model for glaucoma care American Academy of Ophthalmology (AAO) 32 USA Guidelines-preferred practice pattern Scottish Intercollegiate Guidelines Network (SIGN)-144 35 Scotland Glaucoma referral and safe discharge: a national clinical guideline European Glaucoma Society (EGS) 31 Europe Terminology and guidelines for glaucoma Fung et al 24 UK Frequency of visual field test as an indicator of performance Castejón-Cervero et al 27 Spain Assessment of compliance with EGS guidelines in Spain, using a set of indicators identified and chosen by the authors National Health and Medical Research Council (NHMRC) 34 Australia Guidelines for the screening, prognosis, diagnosis, management and prevention of glaucoma Canadian Ophthalmological Society (COS) 33 Canada Evidence-based clinical practice guidelines for the management of glaucoma in the adult eye Friedman et al 25 USA Glaucoma management within an insurance plan Finnish Medical Society Duodecim (FMSD) 36 Finland Finnish current care guideline for glaucoma Fremont et al 29 USA Describe current patterns of care for glaucoma in managed care plans Lee et al 30 USA Rates of annual eye examinations in Medicaid as a proxy to deliver good care Each document is referenced at the end of the article, through the numbers in superscript. 36 Fremont et al 29 Winkler et al 28 RCO 39 SIGN-144 35 Castejón-Cervero et al 27 Friedman et al 25 Fung et al ...…”