Maximising safety of cataract surgery training: Improving patient safety by reducing cataract surgery complication rates

摘要

Purpose - Cataract surgery is a highly successful, high-volume surgery, hence reducing surgicalrncomplications are imperative for organizations to deliver cost-effective, high-quality services that meetrnthe needs of patients. This paper aims to describe 18-month results of a sustainable program tornmaximize the safety of cataract surgery training.rnDesign/methodology/approach - Modifications to the comprehensive cataract-training programrnand tested were developed in a controlled, interventional case series to evaluate their effect on traineerncomplication rates. Data collection and interpretation were performed in a prospective and blindrnmanner.rnFindings - Prior to intervention, PCR rates for trainee-surgeons averaged 3.34 per cent cf international published figures of 4.6-10 per cent. This compared with 1.89 per cent PCR rate for trained cataract surgeons (p < 0.002, Mann Whitney test). Multiple interventions were introduced and enforced to maximize cataract surgery training safety. After 18 months follow-up data were consistent with a statistically significant reduction in trainee PCR rates (1.53 per cent, p < 0.007, Wilcoxon Signed Ranks test) compared with trained cataract surgeons (1.23 per cent, p < 0.074, Wilcoxon Signed Ranks test). Parameters of training efficacy were improved or maintained during this period. Research limitations/implications - Limitations included using trained cataract surgeons as controls as apposed to a similar group of trainee surgeons. In addition, multiple interventions were simultaneously instituted, making identification of a single influential factor impossible to identify. Practical implications - Maximally safe and effective cataract surgery training is achieved in Singapore without compromising service and quality markers. Similar training goals can be extrapolated to other surgical disciplines.rnOriginality/value - This is the first study to demonstrate maximally safe and effective cataract surgery training in a large patient group, over sustained periods.