Hong Kong Eye Hospital 2012 Quality Assurance Forum Standardization of A&K Measurement Record 22 March 2012 PAPDNS APN CHIU Wai Yee.

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Presentation transcript:

Hong Kong Eye Hospital 2012 Quality Assurance Forum Standardization of A&K Measurement Record 22 March 2012 PAPDNS APN CHIU Wai Yee

Background Cataract extraction and IOL implantation is the most common surgery in HKEH. (~ 6200 cases / year) A&K measurement record is one of important clinical and legal documents. 3 professions involve in measurement of the power of IOL (Orthoptist, Optometrist & nurse) Different professions produce different formats of measurement records More than 5 types of machines are used to measure axial length.

Challenge Potential medical incident: wrong IOL insertion  post-op refraction surprise Time consuming in “Time-out” procedure  lengthen operative time Reprint A&K record according to surgeon’s preference on OT day   interruption of service Need manual calculation if IOL of other model is required peri- operatively  calculation error

Review of Old A&K measurement

Using Canon within one department

Using Nidex by different departments

Using different types of machine within one department

Using IOL Master by different staffs within one department

Improvement work A work group was formed and leaded by Dr NM Lam and L Wong. Members comprised of all concerned parties, e.g. orthoptist, optometrist, DSU nurse, PAPD nurse The 1st meeting was held on 15 July st version of standardized A&K measurement record was used from September nd version of standardized record was used by all departments of HKEH and UEC from Jan 2012 to present.

Aims of Standardization 1.  Patient safety Correct IOL model and diopter is implanted into the correct eye 2.  Efficiency  confusion caused by different format of print out  the checking time of IOL model & diopter Facilitate “Time out” procedure

Aims of Standardization 3.  Smoothness of service  the frequency of changing IOL on table  choice of IOL models at printout  ad hoc reprint IOL 4. Better communication between all staffs (surgeon, day ward nurse, OT nurse, Shroff) 5. Proper documentation

1st version of standardized A&K Measurement Record

2nd version

Reprint A&K form

Print-out by IOL Master

Print-out by IOL Master