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Shared care delivery model may improve glaucoma management
Shared care increased overall patient capacity by nearly 2,000 patients in 1 year at a Belgium hospital.
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Proper optimization of resources, better observation of patients and increased training of employees in a new model of shared care delivery for glaucoma management resulted in increased patient volume and greater patient satisfaction, according to a presenter at the European Glaucoma Society Congress.
Care delivery for patients with glaucoma needs to be improved, as the number of patients is exponentially growing worldwide, according to Ingeborg Stalmans, MD, PhD, head of the Glaucoma Unit at Leuven University Hospital, Belgium.
Optimal track of care
Using evidence from literature on the ideal flow, organizing patient focus groups and identifying weak points of glaucoma management, Stalmans and colleagues crafted and installed a new shared care model in their glaucoma unit and designed an “optimal tract” for their glaucoma patients.
“We tried to use that information to optimize flow management, and we also introduced the glaucoma post, a model of shared care between physicians and non-physicians. The aims were to focus the expertise of glaucoma specialists on newly diagnosed and unstable patients, reduce waiting times for appointments and start the medical or surgical treatment sooner,” Stalmans said at the meeting.
Stalmans and colleagues addressed the weak points of the current system with their shared care model, such as long waiting times and poor flow of care.
Patients were split into two groups: stable patients who alternated between seeing the glaucoma post and a glaucoma specialist, and patients who needed frequent exams, she said.
Training is key
Staffing in the shared care model depended more on specific training than it did an employee’s diploma, Stalmans said, and continuous didactic and practical teaching given by the glaucoma specialist was a specific key to the model’s success.
“We looked at personnel. Who should manage these patients? We ended up concluding that their diploma is not so crucial, but what really counts is adequate training from us. So, that is why we organized a training program. They have to go through practical tests, theoretical tests, to obtain this certificate of training to be allowed to work in the glaucoma post. They work with very strict standards ... and they participate in a continuous learning process. The glaucoma specialist gives them feedback on individual patients,” she said.
For example, non-physicians in the model underwent training to be able to take care of patients’ monitoring, she said.
Improved waiting time
The shared care model improved waiting time for a first appointment for patients, reducing the wait from 4.5 months to 2.5 months. Additionally, the system increased the annual patient capacity to 8,000, up from 6,000 patients the year before.
“This was because shared care freed space in the consultations of glaucoma specialists, and we could take on more first appointment patients. The number of surgical procedures also increased,” Stalmans said.
The model provided a positive financial balance and improved patient satisfaction, employee satisfaction and specialist satisfaction, she said. – by Michela Cimberle and Robert Linnehan
- Reference:
- Stalmans I. Innovative care delivery: how to provide most appropriate care at different stages? Presented at: European Glaucoma Society Congress; June 19-22, 2016; Prague.
- For more information:
- Ingeborg Stalmans, MD, PhD, can be reached at Ophthalmology Department, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium; email: ingeborg.stalmans@mac.com.
Disclosure: Stalmans reports no relevant financial disclosures.