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 Y, Inomata T, Iwagami M, Eguchi A, Mizuno J, Shiang T, Kawasaki S, Shimada A, Inada E, Amano A, Murakami A. (2019). Shortened cataract surgery by standardisation of the perioperative protocol according to the Joint Commission International accreditation: a retrospective observational study. Open Access Articles. https://doi.org/10.1136/bmjopen-2018-028656. Retrieved from https://escholarship.umassmed.edu/oapubs/3872
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This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License
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