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Clinical care standard indicators: Cataract

Identifying and definitional attributes

Metadata item type:Help on this termIndicator Set
Indicator set type:Help on this termOther
METeOR identifier:Help on this term711408
Registration status:Help on this termAustralian Commission on Safety and Quality in Health Care, Standardisation pending 26/09/2019
Description:Help on this term

The Australian Commission on Safety and Quality in Health Care has produced the Cataract Clinical Care Standard indicators to assist with local implementation of the Cataract Clinical Care Standard (ACSQHC 2019).

A clinical care standard is a small number of quality statements that describe the clinical care that a patient should be offered for a specific clinical condition. The indicators included in this specification are each intended for local monitoring of compliance with a quality statement and are numbered accordingly. The quality statements that are included in the Cataract Clinical Care Standard are as follows:

1. Primary care assessment and referral: A patient with visual problems and suspected cataract has an initial assessment in primary care of their visual impairment, vision-related activity limitations, comorbidities and willingness to have surgery. When referral is appropriate based on these criteria, the patient is referred for consideration for cataract surgery and this information is included in the referral form.

2. Patient information and shared decision making: A patient with suspected or confirmed cataract receives information to support shared decision making. Information is provided in a way that meets the patient’s needs and is easy to use and understand. The patient is given the opportunity to discuss the likely benefits and potential harms of the available options, as well as their needs and preferences.

3. Access to ophthalmology assessment: A patient who has been referred for consideration for cataract surgery is prioritised for ophthalmology assessment according to clinical need, based on a locally approved protocol and following receipt of a detailed referral.

4. Indications for cataract surgery: A patient is offered cataract surgery when they have a lens opacity that limits their vision-related activities and causes clinically significant visual impairment involving reduced visual acuity of 6/12 or worse, or disabling glare or contrast sensitivity.

5. Prioritisation for cataract surgery: A patient is prioritised for cataract surgery according to clinical need. Prioritisation protocols take into account the severity of the patient’s visual impairment and vision-related activity limitations, the potential harms of delayed surgery, any relevant comorbidity and the expected benefits of surgery.

6. Second-eye surgery: Options for a patient with bilateral cataract are discussed when the decision about first-eye surgery is being made. Second-eye surgery is offered using similar criteria as for the first eye, but the potential benefits and harms of a delay in second-eye surgery are also considered, leading to a shared decision about second-eye surgery and its timing.

7. Preventive eye medicines: A patient receives an intracameral antibiotic injection at the time of cataract surgery, according to evidence-based guidelines. After surgery, a patient receives antibiotics or anti-inflammatory eye drops only when indicated.

8. Postoperative care: A patient receives postoperative care that ensures the early detection and treatment of complications of cataract surgery and the patient’s complete visual rehabilitation. Postoperative care is provided by the operating ophthalmologist or a designated team member. The patient is informed of the arrangements for postoperative care.

Relational attributes

Related metadata references:Help on this term

See also Clinical care standard indicators: antimicrobial stewardship Health, Standard 12/09/2016

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See also Clinical care standard indicators: heavy menstrual bleeding Health, Standard 17/10/2018, Australian Commission on Safety and Quality in Health Care, Candidate 04/09/2018

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Indicators linked to this Indicator set:Help on this term

Cataract clinical care standard indicators: 1-A locally approved protocol in place to allocate appointments for patients considering cataract surgery based on standardised referral criteria and according to clinical need Australian Commission on Safety and Quality in Health Care, Standardisation pending 26/09/2019

Cataract clinical care standard indicators: 2 - Proportion of referrals for possible cataract surgery received that include required information (as defined by the local protocol) Australian Commission on Safety and Quality in Health Care, Standardisation pending 26/09/2019

Cataract clinical care standard indicators: 3 - Proportion of referrals not meeting referral criteria for an appointment for cataract surgery Australian Commission on Safety and Quality in Health Care, Standardisation pending 26/09/2019

Cataract clinical care standard indicators: 4 - Proportion of patients referred for cataract surgery who progress to cataract surgery Australian Commission on Safety and Quality in Health Care, Standardisation pending 26/09/2019

Cataract clinical care standard indicators: 5 - Protocol in place to prioritise patients for cataract surgery according to clinical need Australian Commission on Safety and Quality in Health Care, Standardisation pending 26/09/2019

Cataract clinical care standard indicators: 6 - Proportion of patients who received intracameral administration of antibiotics at the end of surgery Australian Commission on Safety and Quality in Health Care, Standardisation pending 26/09/2019

Collection and usage attributes

National reporting arrangement:Help on this term

The Indicator specification: cataract clinical care standard has been developed to assist with the local implementation of the Cataract Clinical Care Standard (ACSQHC 2019). These indicators are intended for local use by primary health care providers/ networks, specialists, hospitals and local hospital networks. There are no benchmarks set for any of the indicators in this specification. For all indicators, health service providers using the indicators can monitor their own results over time or compare them with those from other providers, with whom they have made such arrangements.

The data required by the indicator specifications cannot be sourced from routine collections. Local health services will need to conduct prospective collections or retrospective medical records audits of all patients referred with cataracts, for a specific time period. The time frame over which data are collected, or sourced, will be guided by the expected sample size. Samples need to be large enough to identify a change in compliance with the quality statement that is deemed meaningful between audit periods. This will vary by indicator.

Some indicators refer to local arrangements, process or protocols . These may include clinical guidelines, protocols, care pathways or any other documentation providing guidance to clinicians on the care of patients cataracts.

Source and reference attributes

Submitting organisation:Help on this term

Australian Commission on Safety and Quality in Health Care

Reference documents:Help on this term

ACSQHC (Australian Commission on Safety and Quality in Health Care) 2019. Cataract clinical care standard. Sydney: ACSQHC.

 

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