Document Detail


Maximising safety of cataract surgery training: improving patient safety by reducing cataract surgery complication rates.
MedLine Citation:
PMID:  19725373     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
E-Shawn Goh
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
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:
Created Date:  2009-09-03     Completed Date:  2010-09-30     Revised Date:  2011-08-25    
Medline Journal Info:
Nlm Unique ID:  8916799     Medline TA:  Int J Health Care Qual Assur     Country:  England    
Other Details:
Languages:  eng     Pagination:  535-46     Citation Subset:  H    
Affiliation:
Department of Ophthalmology, Tan Tock Seng Hospital, Singapore. eshawng@yahoo.co.uk
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MeSH Terms
Descriptor/Qualifier:
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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