Task sharing in the eye care workforce: Screening, detection, and management of diabetic retinopathy in Pakistan. A case study

Shah, Mufarriq; Noor, Ayesha; Deverell, Lil; Ormsby, Gail; Harper, C Alex; Keeffe, Jill

doi:10.1002/hpm.2508

Cited by 11 publications

(16 citation statements)

References 17 publications

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“…In Takeo Province, initial steps have been established to improve the referral of patients with diabetes . Similarly in Pakistan, preliminary research demonstrates the possible role of task sharing within the eye care workforce . While this research did not specifically assess this concern, the issue was raised during field visits; therefore, a couple of indicators are included to prompt planners of the concern.…”

Section: Discussionmentioning

confidence: 99%

Formative research for the development of an Eye Health Strategic Planning and Evaluation Framework and a Checklist: A health systems approach

Ormsby

2019

Health Planning & Management

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Summary This formative research process aimed to develop an Eye Health Strategic Planning and Evaluation Framework and indicator Checklist. The research process utilized a multi‐phased multiple methods approach including literature review, initial expert review (n = 27), findings from a Cambodian Avoidable Blindness Initiative demonstration project (2009‐2012), observation and analysis of four rural sites of the Indian LV Prasad Eye Institute Pyramid Model (n = 21), and finally, a critique by Cambodian government eye health professionals/staff (n = 15), health center staff and community representatives (n = 77) and patients (n = 62). Results from three Cambodian population‐based surveys (KAP n = 599, patient follow‐up n = 354, and RAAB 4650) also informed the development of the Framework and the Checklist. The Framework domains include: situation analysis, determinants of accessibility, service delivery systems, operation systems, networks and linkages, outcomes, and impact. Domains were subdivided into 59 components. The Checklist consists of 253 indicator items. The Eye Health Strategic Planning and Evaluation Framework and the Checklist can assist policy makers, program planners, and evaluators to develop a comprehensive whole of systems approach to eye health care to improve coverage and utilization of services.

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Section: Discussionmentioning

confidence: 99%

Formative research for the development of an Eye Health Strategic Planning and Evaluation Framework and a Checklist: A health systems approach

Ormsby

2019

Health Planning & Management

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“…24-29 41 ► Shared care and communication. 30 31 33 34 37 40 41► Interprofessional trust. 22 30 ► Patient's perspective on shared care.…”

Section: Type Of Issuementioning

confidence: 99%

“…30 31 Involving optometrists and other healthcare professionals in the assessment of patients with diabetic retinopathy contributes to a more efficient utilisation of the workforce, especially given the shortage in the number of ophthalmologists. 30 Shared models of care have been shown to give patients quicker access to assessment appointments and allowed routine follow-up sessions to be scheduled more conveniently. 22 By working together, hospital-based ophthalmologists and community-based optometrists were shown to affect waitlist issues by providing patients with localised, more accessible care options.…”

Section: Patient-related Issuesmentioning

confidence: 99%

Evaluation of a hospital-based integrated model of eye care for diabetic retinopathy assessment: a multimethod study

et al. 2020

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ObjectivesDiabetic eye disease is a leading cause of blindness but can be mitigated by regular eye assessment. A framework of issues, developed from the literature of barriers to eye assessment, was used to structure an examination of perceptions of a new model of care for diabetic retinopathy from the perspective of staff using the model, and health professionals referring patients to the new service.DesignMultimethod: interviews and focus groups, and a separate survey.SettingA new clinic based on an integrated model of care was established at a hospital in outer metropolitan Sydney, Australia in 2017. Funded jointly by Centre for Eye Health (CFEH) and the hospital, the clinic was equipped and staffed by optometrists who work alongside the ophthalmologists in the existing hospital eye clinic.ParticipantsFive (of seven) hospital staff working in the clinic (ophthalmologists and administrative officers) or referring to it from other departments (endocrinologists); nine optometrists from CFEH who developed or worked in the clinic; 10 community-based optometrists as potential referrers.ResultsThe new clinic was considered to have addressed known barriers to eye assessment, including access, assistance for patients unable/unwilling to organise eye checks and efficient management of human resources. The clinic optimised known drivers of this model of care: providing clear scope of practice and protocols for shared care between optometrists and ophthalmologists, good communication between referrers and eye professionals and a collegial approach promoting interprofessional trust. Remaining areas of concern were few referrals from general practitioners, fewer referrals from hospital endocrinologists than expected and issues with stretched administrative capacity. There were also perceived mismatches between the priorities of hospital management and aims of the clinic.ConclusionsThe new model was considered to have addressed many of the barriers to assessment. While there remain issues with the model, there were also unexpected benefits.

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“…It is necessary to realize the potential role that optometrists and mid‐level eye care workers can play as part of an eye care team in DR screening, detection, and referral for management. Task sharing among these cadres could provide a crucial bridge between the ophthalmologist and the community in eye care and prevention of vision loss through increased access to eye care services …”

Section: Introductionmentioning

confidence: 99%

“…As reported in the literature, there are some conflicts and issues regarding the practice of task sharing . These include lack of defining the specific skills and the scope of practice that a health worker could perform correctly . This study aimed to develop a checklist of tasks, based on the opinion of eye care professionals, to be possibly shared by optometrists and mid‐level eye and health care workers in eye care delivery for people with diabetes.…”

Section: Introductionmentioning

confidence: 99%

Task sharing: Development of evidence‐based co‐management strategy model for screening, detection, and management of diabetic retinopathy

Shah

Noor

Ormsby

et al. 2018

Health Planning & Management

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Task sharing in the eye care workforce: Screening, detection, and management of diabetic retinopathy in Pakistan. A case study

Abstract: Participants were accepting task sharing approach and believed that task sharing could improve access to eye care services for people with diabetes and better utilise the services of eye and healthcare providers.

Cited by 11 publications

References 17 publications

Formative research for the development of an Eye Health Strategic Planning and Evaluation Framework and a Checklist: A health systems approach

Formative research for the development of an Eye Health Strategic Planning and Evaluation Framework and a Checklist: A health systems approach

Evaluation of a hospital-based integrated model of eye care for diabetic retinopathy assessment: a multimethod study

Task sharing: Development of evidence‐based co‐management strategy model for screening, detection, and management of diabetic retinopathy

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