一项旨在减少三级眼科护理中心住院医师实施白内障手术取消率的干预措施提议。

A Proposed Intervention to Decrease Resident-Performed Cataract Surgery Cancellation in a Tertiary Eye Care Center.

作者信息

Mayro Eileen L, Pizzi Laura T, Hark Lisa A, Murchison Ann P, Wisner Douglas, Koka Anish, Leiby Benjamin E, Dabbish Nooreen, Okulate Adedoyin, Dessy Alexa, Green Caitlin, Bailey Robert

机构信息

Research Coordinator, Department of Research, Wills Eye Hospital, Philadelphia, PA, and Student, Sidney Kimmel Medical College, Thomas Jefferson University (TJU), Philadelphia.

Professor and Director, Center for Health Outcomes, Policy, and Economics, Rutgers University, Piscataway, NJ.

出版信息

Am Health Drug Benefits. 2018 Dec;11(9):480-487.

PMID:30746019

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6322594/

Abstract

BACKGROUND

Cataracts are the leading cause of preventable blindness globally. As a result, competence in cataract surgery is an important component of ophthalmology residency training. Residency programs must optimize the number of cataract surgery cases to train proficient physicians. However, the rate of cataract surgery cancellations is high, and some are canceled because of preventable causes.

OBJECTIVE

To evaluate the effect of mandatory on-site preadmission testing, including having a physical examination, on resident-performed cataract surgery cancellation rates.

METHODS

For this study, patients scheduled for cataract surgery at the Wills Eye Hospital resident cataract clinic between January 2015 and November 2015 were enrolled and randomized into 2 groups: usual care or intervention. The patients randomized to the usual care group were instructed to complete preadmission testing and to have a physical examination with their primary care physician. The patients randomized to the intervention group were escorted to a Wills Eye Hospital-affiliated cardiologist to complete preadmission testing and to have a physical examination. Patients in both groups received a reminder call before the cataract surgery.

RESULTS

A total of 441 patients were included in the study-240 patients in the usual care group and 201 patients in the intervention group. The overall cataract surgery cancellation rate was 14.5%; the rate was 12.4% in the intervention group and 16.3% in the usual care group ( = .28). The patients receiving the intervention were more likely to have preadmission testing and a physical examination than the patients in the usual care arm ( <.001).

CONCLUSIONS

Facilitating the completion of preadmission testing for patients decreased the rates of resident-performed cataract surgery cancellation at a Wills Eye Hospital resident clinic and has the potential to improve patient outcomes and prevent blindness.

摘要

背景

白内障是全球可预防失明的主要原因。因此，白内障手术能力是眼科住院医师培训的重要组成部分。住院医师培训项目必须优化白内障手术病例数量，以培养熟练的医生。然而，白内障手术取消率很高，有些是由于可预防的原因而取消的。

目的

评估强制性入院前现场检查（包括体格检查）对住院医师实施的白内障手术取消率的影响。

方法

在本研究中，纳入了2015年1月至2015年11月在威尔斯眼科医院住院医师白内障诊所计划进行白内障手术的患者，并将其随机分为两组：常规护理组或干预组。随机分配到常规护理组的患者被指示完成入院前检查，并由其初级保健医生进行体格检查。随机分配到干预组的患者被护送至威尔斯眼科医院附属的心脏病专家处完成入院前检查并进行体格检查。两组患者在白内障手术前均接到提醒电话。