David Charles Broadway1,2, Karen Tibbenham3. 1. Directorate of Ophthalmology, Norfolk & Norwich University Hospital NHS Foundation Trust Colney Lane, Norwich, NR4 7UY, UK. davidbroadway@waitrose.com. 2. School of Pharmacy, University of East Anglia, Norwich Research Park, Norwich, NR45 7TJ, UK. davidbroadway@waitrose.com. 3. Directorate of Ophthalmology, Norfolk & Norwich University Hospital NHS Foundation Trust Colney Lane, Norwich, NR4 7UY, UK.
Abstract
BACKGROUND/ OBJECTIVES: to determine whether mass case review, carried out by glaucoma sub-specialist consultants, for patients for whom there was insufficient clinic capacity, could aid reduction of the glaucoma clinic appointment backlog. SUBJECTS/ METHODS: patient hospital notes were reviewed by a glaucoma fellowship trained consultant and a decision was made as to whether the planned review was appropriate. Decisions were made with respect to timing, clinic-type and necessity for follow-up, together with an assessment as to whether visual field testing was required. RESULTS: in a 3-year study a total of 9290 cases were included in the study. After consultant review, 5521 (59.5%) patients were kept within the hospital eye service (HES) and an additional 1350 (14.5%) had their next appointment delayed, 384 (4%) were discharged to specialist community glaucoma optometrists and 2035 (22%) were discharged to their standard community optometrists. Overall, therefore 26% of patients were discharged from the HES. Of the planned 9290 appointments, simultaneous visual field testing had been planned for 5393 patients (58%), but after consultant review only 65% (n = 3482) of these were considered necessary, reducing the number of required visual field tests by 35% (n = 1911). CONCLUSIONS: the authors suggest that ophthalmology departments experiencing significant clinic appointment backlog issues, consider utilising trained glaucoma sub-specialist consultants to review planned follow-up management of patients within a backlog deficit.
BACKGROUND/ OBJECTIVES: to determine whether mass case review, carried out by glaucoma sub-specialist consultants, for patients for whom there was insufficient clinic capacity, could aid reduction of the glaucoma clinic appointment backlog. SUBJECTS/ METHODS:patient hospital notes were reviewed by a glaucoma fellowship trained consultant and a decision was made as to whether the planned review was appropriate. Decisions were made with respect to timing, clinic-type and necessity for follow-up, together with an assessment as to whether visual field testing was required. RESULTS: in a 3-year study a total of 9290 cases were included in the study. After consultant review, 5521 (59.5%) patients were kept within the hospital eye service (HES) and an additional 1350 (14.5%) had their next appointment delayed, 384 (4%) were discharged to specialist community glaucoma optometrists and 2035 (22%) were discharged to their standard community optometrists. Overall, therefore 26% of patients were discharged from the HES. Of the planned 9290 appointments, simultaneous visual field testing had been planned for 5393 patients (58%), but after consultant review only 65% (n = 3482) of these were considered necessary, reducing the number of required visual field tests by 35% (n = 1911). CONCLUSIONS: the authors suggest that ophthalmology departments experiencing significant clinic appointment backlog issues, consider utilising trained glaucoma sub-specialist consultants to review planned follow-up management of patients within a backlog deficit.
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