Impact of practicing internal benchmarking on continuous improvement of cataract surgery outcomes: a retrospective observational study at Aravind Eye Hospitals, India
Objective We aim to assess the effectiveness of a cataract surgery outcome monitoring tool used for continuous quality improvement. The objectives are to study: (1) the quality parameters, (2) the monitoring process followed and (3) the impact on outcomes.Design and procedures In this retrospective...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/6/e071860.full |
| _version_ | 1797746182894649344 |
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| author | Sachin Gupta Thulasiraj D Ravilla Helen Mertens Frits van Merode Ganesh-Babu Subburaman Balu Ravindran D Ravilla Carroll Webers Shyam Vasudeva Rao |
| author_facet | Sachin Gupta Thulasiraj D Ravilla Helen Mertens Frits van Merode Ganesh-Babu Subburaman Balu Ravindran D Ravilla Carroll Webers Shyam Vasudeva Rao |
| author_sort | Sachin Gupta |
| collection | DOAJ |
| description | Objective We aim to assess the effectiveness of a cataract surgery outcome monitoring tool used for continuous quality improvement. The objectives are to study: (1) the quality parameters, (2) the monitoring process followed and (3) the impact on outcomes.Design and procedures In this retrospective observational study we evaluated a quality improvement (QI) method which has been practiced at the focal institution since 2012: internal benchmarking of cataract surgery outcomes (CATQA). We evaluated quality parameters, procedures followed and clinical outcomes. We created tables and line charts to examine trends in key outcomes.Setting Aravind Eye Care System, India.Participants Phacoemulsification surgeries performed on 718 120 eyes at 10 centres (five tertiary and five secondary eye centres) from 2012 to 2020 were included.Interventions An internal benchmarking of surgery outcome parameters, to assess variations among the hospitals and compare with the best hospital.Outcome measures Intraoperative complications, unaided visual acuity (VA) at postoperative follow-up visit and residual postoperative refractive error (within ±0.5D).Results Over the study period the intraoperative complication rate decreased from 1.2% to 0.6%, surgeries with uncorrected VA of 6/12 or better increased from 80.8% to 89.8%, and surgeries with postoperative refractive error within ±0.5D increased from 76.3% to 87.3%. Variability in outcome measures across hospitals declined. Additionally, benchmarking was associated with improvements in facilities, protocols and processes.Conclusion Internal benchmarking was found to be an effective QI method that enabled the practice of evidence-based management and allowed for harnessing the available information. Continuous improvement in clinical outcomes requires systematic and regular review of results, identifying gaps between hospitals, comparisons with the best hospital and implementing lessons learnt from peers. |
| first_indexed | 2024-03-12T15:33:19Z |
| format | Article |
| id | doaj.art-5a719909a34d4900b84ac6b8007db8e4 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-12T15:33:19Z |
| publishDate | 2023-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-5a719909a34d4900b84ac6b8007db8e42023-08-09T18:15:08ZengBMJ Publishing GroupBMJ Open2044-60552023-06-0113610.1136/bmjopen-2023-071860Impact of practicing internal benchmarking on continuous improvement of cataract surgery outcomes: a retrospective observational study at Aravind Eye Hospitals, IndiaSachin Gupta0Thulasiraj D Ravilla1Helen Mertens2Frits van Merode3Ganesh-Babu Subburaman Balu4Ravindran D Ravilla5Carroll Webers6Shyam Vasudeva Rao73 SC Johnson College of Business, Cornell University, Ithaca, New York, USA1 LAICO, Aravind Eye Care System, Madurai, India5 Maastricht University Medical Centre+, Maastricht, The Netherlands2 Care and Public Health Research Institute (CAPHRI), Maastricht Medical Centre+, Maastricht University, Maastricht, The Netherlands1 LAICO, Aravind Eye Care System, Madurai, India4 Chairman, Aravind Eye Care System, Madurai, India5 Maastricht University Medical Centre+, Maastricht, The Netherlands5 Maastricht University Medical Centre+, Maastricht, The NetherlandsObjective We aim to assess the effectiveness of a cataract surgery outcome monitoring tool used for continuous quality improvement. The objectives are to study: (1) the quality parameters, (2) the monitoring process followed and (3) the impact on outcomes.Design and procedures In this retrospective observational study we evaluated a quality improvement (QI) method which has been practiced at the focal institution since 2012: internal benchmarking of cataract surgery outcomes (CATQA). We evaluated quality parameters, procedures followed and clinical outcomes. We created tables and line charts to examine trends in key outcomes.Setting Aravind Eye Care System, India.Participants Phacoemulsification surgeries performed on 718 120 eyes at 10 centres (five tertiary and five secondary eye centres) from 2012 to 2020 were included.Interventions An internal benchmarking of surgery outcome parameters, to assess variations among the hospitals and compare with the best hospital.Outcome measures Intraoperative complications, unaided visual acuity (VA) at postoperative follow-up visit and residual postoperative refractive error (within ±0.5D).Results Over the study period the intraoperative complication rate decreased from 1.2% to 0.6%, surgeries with uncorrected VA of 6/12 or better increased from 80.8% to 89.8%, and surgeries with postoperative refractive error within ±0.5D increased from 76.3% to 87.3%. Variability in outcome measures across hospitals declined. Additionally, benchmarking was associated with improvements in facilities, protocols and processes.Conclusion Internal benchmarking was found to be an effective QI method that enabled the practice of evidence-based management and allowed for harnessing the available information. Continuous improvement in clinical outcomes requires systematic and regular review of results, identifying gaps between hospitals, comparisons with the best hospital and implementing lessons learnt from peers.https://bmjopen.bmj.com/content/13/6/e071860.full |
| spellingShingle | Sachin Gupta Thulasiraj D Ravilla Helen Mertens Frits van Merode Ganesh-Babu Subburaman Balu Ravindran D Ravilla Carroll Webers Shyam Vasudeva Rao Impact of practicing internal benchmarking on continuous improvement of cataract surgery outcomes: a retrospective observational study at Aravind Eye Hospitals, India BMJ Open |
| title | Impact of practicing internal benchmarking on continuous improvement of cataract surgery outcomes: a retrospective observational study at Aravind Eye Hospitals, India |
| title_full | Impact of practicing internal benchmarking on continuous improvement of cataract surgery outcomes: a retrospective observational study at Aravind Eye Hospitals, India |
| title_fullStr | Impact of practicing internal benchmarking on continuous improvement of cataract surgery outcomes: a retrospective observational study at Aravind Eye Hospitals, India |
| title_full_unstemmed | Impact of practicing internal benchmarking on continuous improvement of cataract surgery outcomes: a retrospective observational study at Aravind Eye Hospitals, India |
| title_short | Impact of practicing internal benchmarking on continuous improvement of cataract surgery outcomes: a retrospective observational study at Aravind Eye Hospitals, India |
| title_sort | impact of practicing internal benchmarking on continuous improvement of cataract surgery outcomes a retrospective observational study at aravind eye hospitals india |
| url | https://bmjopen.bmj.com/content/13/6/e071860.full |
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