Dataset Information

A Quality Assurance Audit of an Orthoptic-Led Virtual Neuro-Ophthalmology Clinic.

ABSTRACT:

Introduction

Neuro-ophthalmology is experiencing increasing demand. There is a lack of literature relating to how we deal with the capacity and demand issues, and the use of virtual clinics. Virtual clinics are well-recognised in other subspecialties to help deal with capacity and demand issues, with reports of non-medical-led clinics, and are supported by the National Health Services Long Term Plan and People Plan. We present a quality assurance audit of our orthoptic-led neuro-ophthalmology virtual clinic.

Methods

The virtual clinic was developed in October 2014 to help deal with capacity and demand issues, however, only since 2019 have orthoptists been trained to virtually review. This paper provides a summary of a quality assurance audit that was completed to determine concurrence between orthoptic and consultant virtual reviews.

Results

From January to August 2021, all patients attending the virtual clinic were reviewed by a trained orthoptist and then audited for concordance by a consultant neuro-ophthalmologist; 163 patients were identified. There was 100% agreement between orthoptic reviewers and consultants regarding visual function status and optical coherence tomography interpretation. Of the patients reviewed, 100% of patients were satisfied and 96% of patients would be happy to be seen in the virtual clinic again.

Conclusions

Current demands on the neuro-ophthalmology speciality mean that we need to explore new ways of working. Our outcomes demonstrate a high level of agreement between orthoptists and ophthalmologists, and excellent patient satisfaction results. We hope this highlights where orthoptists can play an invaluable role in the care of neuro-ophthalmic patients and help deal with capacity and demand issues.

SUBMITTER: Smith J

PROVIDER: S-EPMC10000316 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Publications

A Quality Assurance Audit of an Orthoptic-Led Virtual Neuro-Ophthalmology Clinic.

Smith Joe J Hirst Nicola N Yagan Ali A

The British and Irish orthoptic journal 20230310 1

<h4>Introduction</h4>Neuro-ophthalmology is experiencing increasing demand. There is a lack of literature relating to how we deal with the capacity and demand issues, and the use of virtual clinics. Virtual clinics are well-recognised in other subspecialties to help deal with capacity and demand issues, with reports of non-medical-led clinics, and are supported by the National Health Services Long Term Plan and People Plan. We present a quality assurance audit of our orthoptic-led neuro-ophthalm ...[more]

PMID: 36909675

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Project description:BackgroundPercutaneous kidney biopsies are essential for diagnosis and management of kidney diseases. However, post-procedural bleeding is a significant risk associated with biopsies. At the McGill University Health Center, the 2 main hospitals, the Royal Victoria Hospital and the Montreal General Hospital, have different observation protocols for outpatient native kidney biopsies. Currently, patients are admitted for a 24-hour inpatient observation at the Montreal General Hospital, whereas patients biopsied at the Royal Victoria Hospital are discharged after 6 to 8 hours of observation at the end of the day. Most Canadian centers do not admit patients for an overnight observation, and it was unclear why this practice continued at the Montreal General Hospital.ObjectiveOur objective was to determine the incidence of complications post-renal biopsy over the past 5 years at both hospital sites, and compare them to each other, as well as to established rates in the available literature.DesignThis assessment was designed as a quality assurance audit.SettingThis audit was conducted from a local registry of renal biopsies performed at the McGill University Health Center between January 2015 to January 2020.PatientsWe included all adult patients (between the ages 18 and 80) with outpatient native kidney biopsies performed at the McGill University Health Center between 2015 and 2020.MeasurementsWe collected the included patients' baseline demographics and risk factors at the time of biopsy, including age, BMI, creatinine, estimated glomerular filtration rate, pre- and post-biopsy hemoglobin, platelet, urea, coagulation profile, blood pressure, kidney side/size as well as needle size, and number of passes made.MethodsWe compared the incidence of both minor and major bleeding complications at the Montreal General and the Royal Victoria Hospital. Variables that were measured included hemoglobin before and after biopsy, incidence of minor bleeding complications (defined by hematomas and gross hematuria), and incidence of major complications (defined by post-biopsy bleeding requiring either transfusions or another procedure to stop the bleeding), as well as the incidence of admissions post-biopsy.ResultsThe incidence of major complications was 2.87% over 5 years (5/174 patients), which is comparable with that reported in the literature. Our transfusion incidence was 1.72% (3/174 patients) and our embolization incidence was 2.3% (4/174 patients) over the 5 study years. Our total number of major events was low and the patients who had major events had significant risk factors for bleeding. All events occurred within 6 hours of observation.LimitationsThis was a retrospective study with a low event number. Additionally, since the events included only those recorded at the McGill University Health Center, it is possible that the events of interest may have occurred at other hospital sites without the author's knowledge.ConclusionsBased on the results of this audit, all major bleeding events occurred within 6 hours of a percutaneous kidney biopsy, suggesting that patients should be monitored for 6 to 8 hours following biopsy. The next step after this quality assurance audit is a quality improvement project and a cost-effectiveness analysis to assess whether post-biopsy practices should be amended at the McGill University Health Center.

Dataset Information

A Quality Assurance Audit of an Orthoptic-Led Virtual Neuro-Ophthalmology Clinic.

Introduction

Methods

Results

Conclusions

Publications

A Quality Assurance Audit of an Orthoptic-Led Virtual Neuro-Ophthalmology Clinic.

Similar Datasets

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