importance of and strategies to follow up pediatric ophthalmology patients
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Importance of and strategies to follow up pediatric ophthalmology patients. Preethi Pradhan Sr Faculty, LAICO Aravind Eye Care System. 4 stages of sight restoration. Accepts Doctors advice. Early detection Eye examination Good quality treatment Follow-up care. Quality eye care. - PowerPoint PPT PresentationTRANSCRIPT
A2Z Child Blindness Program Regional Capacity Building Workshop
April 29 -30, 2011
Preethi Pradhan
Sr Faculty, LAICO
Aravind Eye Care System
Importance of and strategies to follow up
pediatric ophthalmology patients
4 stages of sight restoration
Quality eye care
Visits the hospital for a check up
Accepts Doctors advice
Regular follow up
1. Early detection
2. Eye examination
3. Good quality treatment
4. Follow-up care
Courtesy: Dr Muhit Childhood Cataract: Home to Hospital, CEH Vol 17, No 50, 2004
Why follow up is important?
For Patient Patients are dependent on
caregivers to take them to the hospital for check up
Serves to surface any other concern as children do not complain of worsening vision
They can meet the same doctor who carried out the intervention
For Doctor Outcome of the surgery
or intervention whether it is good they can assess
Can help to schedule their work better
Can provide better patient satisfaction
Giving a specific follow up date helps the patient to remember when to come back
A to Z Child Blindness Program Regional Capacity Building Workshop
April 29 – 30, 2011
Follow up Rate Follow Up Rate =
No of patients who came for follow up Total no of patients who were asked to come for follow up
First: You need to measure the Follow up Rate
To screen children in private
schools and provide them cards –
Total no. of schools screened 8
Total no. of students screened 16982
Total no. of students with defective vision
1269 (7.5%)
Total no. students who came for check up at the hospital on Sunday
460 (36%)
If you are not measuring you wont know and you can’t improve
A to Z Child Blindness Program Regional Capacity Building Workshop
April 29 – 30, 2011
Scenario 1: You receive this report - what do you do?
S.No. Date Counselor Surgery Follow up
1 05-01-2007R.M. 92%
2 06-01-2007TC.S. 85%
3 07-01-2007S M.L. 98%
4 19-01-2007M.S. 82%
5 20-01-2007UP.R. 63%
6 21-01-2007VM.K. 57%
7 21-01-2007N. 96%
8 21-01-2007DU.G. 98%
9 21-01-2007R.S. 90%
10 21-01-2007S.R. 95%
11 21-01-2007C K.V. 93%
12 23-01-2007MS.B. 71%
A to Z Child Blindness Program Regional Capacity Building Workshop
April 29 – 30, 2011
Two weeks after cataract surgery at home, one morning the father notices his child’s
eye is reddish.
What should I do now? Should I go back to the
eye hospital or can I consult local
ophthalmologist?
A to Z Child Blindness Program Regional Capacity Building Workshop
April 29 – 30, 2011
My son’s follow-up check up is on the same date as my sister’s wedding
Will the doctor be available then?
When date should I go?
Would it be possible for me to change the date?
A to Z Child Blindness Program Regional Capacity Building Workshop
April 29 – 30, 2011
School studies
School Examinatio
ns
Child falls ill
Improper follow up of instructions
Poor communicatio
n
Reasons for irregular follow up
Counseling Training of Trainers Workshop
April 15-17, 2011
Strategies for Overcoming these Barriers
A to Z Child Blindness Program Regional Capacity Building Workshop
April 29 – 30, 2011
Strategies to address issues related to School Studies
Follow up card addressed to teachers
A to Z Child Blindness Program Regional Capacity Building Workshop
April 29 – 30, 2011
Consult with parents before giving follow up date
Double check if they will be able to come on that date
Strategies to address issues related to School Examinations
A to Z Child Blindness Program Regional Capacity Building Workshop
April 29 – 30, 2011
Strategies to address issues related when child falls ill
Remind parents about the
importance of the follow up
Reschedule the appointment
A to Z Child Blindness Program Regional Capacity Building Workshop
April 29 – 30, 2011
Encourage them to come any way
Reinforce importance of compliance and the consequence of not following up
Strategies to address issues related to lack of following instructions
A to Z Child Blindness Program Regional Capacity Building Workshop
April 29 – 30, 2011
Lack of communication between the child’s parents and their relatives Identify the key decision
maker Are we addressing
communication to all?Need to communicate
whether outcome of surgery is good or bad need to come for follow up
Provide instruction in a print or written format
Strategies to address issues related to Poor Communication
A to Z Child Blindness Program Regional Capacity Building Workshop
April 29 – 30, 2011
Review patients waiting time to be reduced
Review patients are seen by senior Medical
officer and disposed as early as possible.
Separate vision room for > 5 years & < 5
years -
A to Z Child Blindness Program Regional Capacity Building Workshop
April 29 – 30, 2011
Ensure convenient date & time for the parents and the childAvoid exam dates, festivals, inauspicious days
etcProvide printed instructions
Follow up cardsAppointment cards
RemindersText messagePhone callsPostcards
Tips to ensure follow up
A to Z Child Blindness Program Regional Capacity Building Workshop
April 29 – 30, 2011
Post surgical follow up
Appointment
same date
other date Total
Same date% Total %
Jan 70 38 20 58 54 83Feb 53 43 6 49 81 92Mar 67 54 8 62 81 93April 117 84 22 106 72 91may 96 60 22 82 63 85june 73 38 30 68 52 93July 82 70 8 78 85 95Aug 71 56 8 64 79 90Sep 70 59 6 65 84 93oct 57 41 12 53 72 93Nov 72 48 17 65 67 90Dec 52 31 10 41 60 79Total 880 622 169 791 71 90
2010 Data on Follow up
A2Z Child Blindness Program Regional Capacity Building Workshop
April 29 -30, 2011
Thank You !!!