The National Ophthalmology Audit: John Sparrow

Transcription

1 The College Eye docrs setting standards help patients The National Ophthalmology Audit: John Sparrow Consultant Ophthalmologist Honorary Professor of Ophthalmic Health Services Research and Applied Epidemiology 1

2 Background Sir Bruce Keogh 2008 (Medical Direcr of the NHS) We are no longer asking for permission make public the results of individual surgeons, we are now asking you how this should be done Fully audited and risk adjusted outcomes should be routinely available in the public domain by surgeon; by surgical team; by institution 2

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4 Figure 2: Funnel plot of risk-adjusted rate of stroke/death within 30 days of a carotid endarterecmy, with surgeon figures shown in comparison the national average rate of 2.4%

5 National Tender National Clinical Audit and Patient Outcomes Programme (NCAPOP) 3 Years from September 2014 National Comparative Audit for Cataract Care All NHS funded care in England and Wales Regardless of EMR status Data extraction from commercial EMRs & OpenEyes Feasibility studies of EMR-captured data for Glaucoma Retinal Detachment (inc. collaboration with BEAVRS) AMD Build on the proof of concept work of the RCOphth NOD (National Ophthalmology Database) project 5

6 Patient benefits This project, which is the first of its kind, is leading the way in improving standards in cataract surgery through the recording of patient outcome data. Access this information will help patients make an informed choice about their treatment and enable clinicians risk assess their patients and offer them the most appropriate care based on their individual needs. Clara Eaglen, Policy and Campaigns Manager, Health and Social Care, RNIB From a lay point of view the National Ophthalmology database will be an incredibly valuable source of information for patients and docrs.the empowerment of patients in this respect is a key outcome of the project. Matt Broom, UK Operations Manager VISION 2020 (UK) Ltd 6

7 Audit Team Professor John Sparrow Clinical Lead Kathy Evans Executive Lead Beth Barnes Project Manager Martina Olaitan NOD Project Support Officer Delivery unit: Rob Johnsn, Paul Donachie, Irene Stratn, Peter Scanlon Yvonne Silove Health Quality Improvement Partnership 7

8 Number of Operations 201, , , , , , , , , , , , , ,553 Crude Rate per 1000 population Cataract Surgery in England 350, , , , , , ,

9 Cataract - Risk of What? Surgical Complications ~ 2.0% Vision Loss (harm) ~ 1.25% 9

10 PCR Rupture Rate Proof of Concept 25% 20% Surgical Complications Observed PCR Rate N=283 Surgeons; N=54,319 Surgeon 15% Upper 99.8% Upper 95% 10% 5% 0% No. Operations

11 The National Ophthalmology Database 11

12 Cataract - Risk of What? Surgical Complications ~ 2.0% Vision Loss (harm) ~ 1.25% 12

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15 Surgery Completed

16 National Ophthalmology Audit Wendy Newsom Lead Opmetrist Bedford Member of the National Ophthalmology Audit Steering Committee 16

17 Web Based Entry of Post-op Cataract Outcomes New, secure web portal for feedback direct from community opmetrist practice Post-op data goes direct in the Hospital EMR Each community opm has their own log in/password Unique PIN number for each patient (IG compliant) Bedford and Brisl successful pilot Also pilots in areas with alternative configurations 17

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23 A huge opportunity for LOCs All routine post-op cataract care can be conducted in community opmetrist practice LOCSU post-op cataract pathway All post-ops seen in community since 2005 in Huntingdon Bedford since 2012 Extensive audit data shows no detriment post-op outcomes Easy set up the online portal very good uptake in the pilot areas where opms are paid do the post-op assessment Now is the time talk you HES and CCG about setting up post-op care in the community Potential be expanded for much greater electronic transfer of data/sharing of patient care 23

24 Questions? 24