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Alex Ferdi, Vuong Nguyen, Chameen Samarawickrama, Stephanie L Watson; Implementing the Save Sight Keratoconus Registry in the hospital setting. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5455.
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© ARVO (1962-2015); The Authors (2016-present)
The Save Sight Keratoconus Registry (SSKR) collects real world outcomes on keratoconus and its treatment. Public hospitals have large patient numbers with limited resources which places a burden on the health system and can compromise patient care. The use of the SSKR has the potential to increase the efficiency of these clinics and improve clinical care. Weaim to report the impact of implementation of the SSKR on routine clinical practice across two hospitals in Sydney, Australia.
A time-motion observational study was conducted at Sydney Eye and Westmead hospitals. During the pre-implementation phase doctors administered standard care. Post-implementation doctors administered care in the same manner, however in addition they input a small amount of routinely collected clinical data (approximately 6 values) into the SSKR’s web based data system.An observer logged time spent by doctors on each clinical activity. For example time spent 1) writing paper notes, 2) entering data into the SSKR, 3) direct patient care i.e. examining/explaining.The effect of SSKR use on time spent on clinical activities was assessed using mixed effects linear regression.
15 doctors were observed pre and post-implementation during 77 patient visits. No difference was observed in the overall mean time in minutes taken to review patients with (12.1, 5.3SD) or without (12.3, 5.3SD) the registry (p=0.84). There was no difference in the time taken in minutes for each of the main activities pre or post-implementation (control; SSKR): direct patient care (5.9, 2.8SD; 5.4, 2.8SD, p=0.51), indirect patient care (record keeping) (3.2, 2.2SD; 4.6, 2.9SD, p=0.16), indirect patient care (reading) (3.1, 1.8SD; 2.0, 1.3SD, p=0.09) (Figure 1).
Implementation and use of the SSKR in routine clinical practice had no effect on the time taken or activities undertaken in managing keratoconus patients. This supports routine use of the SSKR in clinical practice.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
Bar chart displaying mean time taken to review each patient in the clinic. Total time and time broken down for each main activity with and without use of the registry is displayed. Differences were not statistically significant.
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