| Maximising safety of cataract surgery training: improving patient safety by reducing cataract surgery complication rates. | |
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MedLine Citation:
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PMID: 19725373 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Cataract surgery is a highly successful, high-volume surgery, hence reducing surgical complications are imperative for organizations to deliver cost-effective, high-quality services that meet the needs of patients. This paper aims to describe 18-month results of a sustainable program to maximize the safety of cataract surgery training. DESIGN/METHODOLOGY/APPROACH: Modifications to the comprehensive cataract-training program and tested were developed in a controlled, interventional case series to evaluate their effect on trainee complication rates. Data collection and interpretation were performed in a prospective and blind manner. FINDINGS: Prior to intervention, PCR rates for trainee-surgeons averaged 3.34 per cent cf international published figures of 4.6-10 per cent. This compared with 1.89 per cent PCR rate for trained cataract surgeons (p < 0.002, Mann Whitney test). Multiple interventions were introduced and enforced to maximize cataract surgery training safety. After 18 months follow-up data were consistent with a statistically significant reduction in trainee PCR rates (1.53 per cent, p < 0.007, Wilcoxon Signed Ranks test) compared with trained cataract surgeons (1.23 per cent, p < 0.074, Wilcoxon Signed Ranks test). Parameters of training efficacy were improved or maintained during this period. RESEARCH LIMITATIONS/IMPLICATIONS: Limitations included using trained cataract surgeons as controls as apposed to a similar group of trainee surgeons. In addition, multiple interventions were simultaneously instituted, making identification of a single influential factor impossible to identify. PRACTICAL IMPLICATIONS: Maximally safe and effective cataract surgery training is achieved in Singapore without compromising service and quality markers. Similar training goals can be extrapolated to other surgical disciplines. ORIGINALITY/VALUE: This is the first study to demonstrate maximally safe and effective cataract surgery training in a large patient group, over sustained periods. |
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Authors:
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E-Shawn Goh |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: International journal of health care quality assurance Volume: 22 ISSN: 0952-6862 ISO Abbreviation: Int J Health Care Qual Assur Publication Date: 2009 |
Date Detail:
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Created Date: 2009-09-03 Completed Date: 2010-09-30 Revised Date: 2011-08-25 |
Medline Journal Info:
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Nlm Unique ID: 8916799 Medline TA: Int J Health Care Qual Assur Country: England |
Other Details:
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Languages: eng Pagination: 535-46 Citation Subset: H |
Affiliation:
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Department of Ophthalmology, Tan Tock Seng Hospital, Singapore. eshawng@yahoo.co.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Case-Control Studies Cataract Extraction / adverse effects*, education Data Collection Education, Medical, Continuing / standards, statistics & numerical data* Education, Medical, Graduate / standards, statistics & numerical data* Humans Ophthalmologic Surgical Procedures / adverse effects, statistics & numerical data Postoperative Complications / epidemiology* Program Development Program Evaluation* Prospective Studies Risk Management Safety / standards, statistics & numerical data* Singapore Single-Blind Method |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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