June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Characterizing hospital-based patients with ophthalmic concerns. How many could be seen in the office?
Author Affiliations & Notes
  • Jacob Fondriest
    Department of Ophthalmology, Rush University Medical Center, Chicago, Illinois, United States
  • Thomas A Deutsch
    Department of Ophthalmology, Rush University Medical Center, Chicago, Illinois, United States
  • Footnotes
    Commercial Relationships   Jacob Fondriest None; Thomas Deutsch None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 3084. doi:
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      Jacob Fondriest, Thomas A Deutsch; Characterizing hospital-based patients with ophthalmic concerns. How many could be seen in the office?. Invest. Ophthalmol. Vis. Sci. 2023;64(8):3084.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose :

Ophthalmic care in the emergency room or hospital has limitations compared to office-based care, yet the volume and reasons for patients receiving bedside care who may be suitably seen in the office is not well described. As this topic has implications from a process improvement perspective, we performed a retrospective chart review on the first 10 months of data after the creation of a new ophthalmology hospitalist service, characterizing our patients’ access to office-based ophthalmic care.

Methods : Data from a list of ophthalmology consults consisting of 425 patients across 10 months at Rush University Medical Center were reviewed. Included were all patients evaluated in the ED or hospital. Excluded were those evaluated in the ophthalmology clinic, those who refused evaluation, or were sent to the hospital by an ophthalmologist. For each patient, broad data was collected, including demographics, ophthalmologic diagnosis, location evaluated, need for clinic based ophthalmic equipment (formal visual acuity testing, formal visual fields performed by an expert ophthalmic technician, OCT, fluorescein angiography), and medical stability for clinic-based examination.

Results : 16% of all consult requests were for evaluation in the emergency room for medically stable patients for whom the ocular concern was their principal concern, and who did not ultimately require hospitalization. 72% of consultation requests were for inpatients for whom their ocular issue was the principal problem for their encounter. Of this group, only 42% were medically stable enough for evaluation in the ophthalmology clinic. There were no statistically significant associations linking stability for outpatient evaluation with patient diagnosis, age, or sex.

Conclusions :

Ophthalmic evaluation of patients in the Emergency Department and hospital is limited by practical and other barriers to complete evaluation as would be possible in the ophthalmology clinic. Optimizing ophthalmic care for these patients requires a combination of triaging medically stable patients to the outpatient clinic, and improvement of tools used for bedside evaluation.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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