Department of Radiology
Eye Diseases | Health and Medical Administration | Health Services Administration | Health Services Research | Ophthalmology | Surgery | Surgical Procedures, Operative
OBJECTIVES: To investigate the impact of standardisation of the perioperative protocol based on the Joint Commission International (JCI) accreditation guidelines for operating time in cataract surgery.
DESIGN: Retrospective observational study.
SETTING: Single centre in Japan.
PARTICIPANTS: Between March 2014 and June 2016, 3127 patients underwent cataract surgery under topical anaesthesia including 2581 and 546 patients before and after JCI accreditation, respectively.
PRIMARY AND SECONDARY OUTCOMES: We compared three time periods, comprising the preprocedure/surgery time (pre-PT), PT and post-PT, and total PT (TPT) of cataract surgery between patients before and after JCI accreditation, by regression analysis adjusted for age, sex and cataract surgery-associated confounders.
RESULTS: The main outcomes were pre-PT, PT, post-PT and TPT. Pre-PT (19.8+/-10.5 vs 13.9+/-8.5 min, p < 0.001) and post-PT (3.5+/-4.6 vs 2.6+/-2.1 min, p < 0.001) significantly decreased after JCI accreditation, while PT did not significantly change (16.8+/-6.7 vs 16.2+/-6.3 min, p=0.065). Consequently, TPT decreased on average by 7.3 min per person after JCI accreditation (40.1+/-13.4 vs 32.8+/-10.9 min, p < 0.001). After adjusting for confounders, pre-PT (beta=-5.82 min, 95% CI -6.75 to -4.88), PT (beta=-0.76 min, 95% CI -1.34 to -1.71), post-PT (beta=-0.85 min, 95% CI -1.24 to -0.45) and TPT (beta=-7.43 min, 95% CI -8.61 to -6.24) were significantly shortened after JCI accreditation.
CONCLUSION: Perioperative protocol standardisation, based on JCI accreditation, shortened TPT in cataract surgery under local anaesthesia.
cataract and refractive surgery, organisational development, quality in health care, risk management
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DOI of Published Version
BMJ Open. 2019 Jun 14;9(6):e028656. doi: 10.1136/bmjopen-2018-028656. Link to article on publisher's site
Okumura, Yuichi; Inomata, Takenori; Iwagami, Masao; Eguchi, Atsuko; Mizuno, Ju; Shiang, Tina; Kawasaki, Shiori; Shimada, Akie; Inada, Eiichi; Amano, Atsushi; and Murakami, Akira, "Shortened cataract surgery by standardisation of the perioperative protocol according to the Joint Commission International accreditation: a retrospective observational study" (2019). Open Access Articles. 3872.
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This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License
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