Top 10 Tips: For Eyecare Services

Cataracts/Ophthalmology

Tip one: team’s engagement

A co-ordinated focussed group of professionals and patients can overcome obstacles together to deliver effective, high quality services.

Develop a shared vision of how eye care services should look in the future. The vision should ideally be developed and endorsed by the main stakeholders including, Consultants, Nurses, Optometrists, Orthoptists, a GP representative, managers, and patients. An ideal method of developing a shared vision is to arrange a ‘Time Out’ day whereby all members of the multi disciplinary team (MDT) spend time together agreeing the way forward for the unit.

Ensure a mechanism is put in place whereby meaningful, regular communication can take place between all members of the MDT.

Identify skills, knowledge and local champions within the team and also plan strategies to fill the knowledge/skills gaps. Plan innovative ways to deliver training to encourage the uptake.

Grow your own - develop and train existing staff. Better-trained and educated staff provide a better quality of service to patients.

Identify a clinical leader(s) – a local champion that will be both objective, but dedicated to service improvement.

Tip Two: Good Access is a key part of Quality Care

Examine the processes that support your Eye Care Services outpatient clinics. Implement the Step-by-Step Guide to Improving Outpatient Services (Dept of Health July 2002).

Regularly validate waiting lists and integrate with the Access, Booking and Choice agenda.

Ensure a balance is established between the various elements of service provision – new outpatient appointment slots, follow-up appointment slots and capacity for nurse led clinic slots.

Promote ‘pooled’ waiting lists for inpatients and day cases.

Promote cataracts only (service) lists. This can increase flow of cases and the whole team are geared up to one type of procedure.

Consider reducing consultant follow-up appointments by:

* Developing nurse-led clinics or nurse-led follow-up;
* Utilising a telephone follow up service eg for post cataract surgery.
* Using telephone or written feedback for certain investigations.
* Developing the skills of the optometrists enable them to provide one stop clinics for patients.

Tip Three: Know your processes

Process map the patient pathway from the patients’ first contact in primary care to their eventual discharge from secondary care. Don’t rely on anecdote otherwise you may put a lot of effort into solving the wrong things.

Identify bottlenecks and streamline into a new service model. See the Improvement Leaders’ Guide to Process Mapping, Analysis and Redesign .