Abstract
Purpose
To determine current knowledge and opinion on revalidation, and methods of cataract surgery audit in Scotland and to outline the current and future possibilities for electronic cataract surgery audit.
Methods
In 2010 we conducted a prospective, cross-sectional, Scottish-wide survey on revalidation knowledge and opinion, and cataract audit practice among all senior NHS ophthalmologists. Results were anonymised and recorded manually for analysis.
Results
In all, 61% of the ophthalmologists surveyed took part. Only 33% felt ready to take part in revalidation, whereas 76% felt they did not have adequate information about the process. Also, 71% did not feel revalidation would improve patient care, but 85% agreed that cataract surgery audit is essential for ophthalmic practice. In addition, 91% audit their cataract outcomes; 52% do so continuously. Further, 63% audit their subspecialist surgical results. Only 25% audit their cataract surgery practice electronically, and only 12% collect clinical data using a hospital PAS system. Funding and system incompatibility were the main reasons cited for the lack of electronic audit setup. Currently, eight separate hospital IT patient administration systems are used across 14 health boards in Scotland.
Conclusion
Revalidation is set to commence in 2012. The Royal College of Ophthalmologists will use cataract outcome audit as a tool to ensure surgical competency for the process. Retrospective manual auditing of cataract outcome is time consuming, and can be avoided with an electronic system. Scottish ophthalmologists view revalidation with scepticism and appear to have inadequate knowledge of the process. However, they strongly agree with the concept of cataract surgery audit. The existing and future electronic applications that may support surgical audit are commercial electronic records, web-based applications, centrally funded software applications, and robust NHS connections between community and hospital.
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References
Kmietowicz Z . Revalidation in the UK. BMJ 2005; 330: 1145.
Esmail A . GMC and the future of revalidation: failure to act on good intentions. BMJ 2005; 330: 1144–1147.
Donaldson L . Good doctors, safer patients, 2006. Available from http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4137232.
Department of Health. Trust, assurance and safety: the regulation of health professionals, 2007. Available from http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_065946.
RCOphth. Revalidation of ophthalmologists, 2008. http://www.rcophth.ac.uk.
Joseph A . Revalidation, discretionary points, clinical excellence awards – steps on the same ladder. BMJ 2005; 330: 1446.
Stewart G, Teoh K, Pitts D, Garden O, Rowley D . Continuing professional development for surgeons. J Royal Coll Surg Ed Ire 2008; 6 (5): 288–292.
Beard J, Jolly B, Southgate L, Newble D, Thomas E, Rochester J . Developing assessments of surgical skills for the GMC performance procedures. Ann Royal Coll Surg Engl 2005; 87: 242–247.
Rowe A, Garcia-Barbero M . Regulation and Licensing of Physicians in the WHO European Region. WHO Regional Office for Europe: Copenhagen, Denmark, 2005.
Maisonneuve H, Matillon Y, Negri A, Pallares L, Vigneri R, Young H . Continuing medical education and professional revalidation in Europe: five case examples. J Cont Educ Health Prof 2009; 29 (1): 58–62.
Wentz D . Lessons from comparing CME accreditation in Europe and the United States. Eur J Cancer 2003; 39: 2422–2423.
Vandendael K, Van Hemelryck F . Continuing medical education and its accreditation—an overview of the situation in the European Union and in the United States. Eur J Cancer 2003; 39: 2430–2438.
Johnston R, Taylor H, Smith R, Sparrow J . The Cataract National Dataset Electronic Multi-centre Audit of 55 567 Operations: variation in posterior capsule rupture rates between surgeons. Eye 2010; 24: 888–893.
Narendran N, Jaycock P, Johnston RL, Taylor H, Adams M, Tole DM et al. The Cataract National Dataset Electronic Multicentre Audit of 55 567 Operations: risk stratification for posterior capsule rupture and vitreous loss. Eye 2009; 23: 31–37.
Jaycock P, Johnston RL, Taylor H, Adams M, Tole DM, Galloway P et al. The Cataract National Dataset Electronic Multi-centre Audit of 55 567 Operations: updating benchmark standards of care in the United Kingdom and internationally. Eye 2009; 23: 38–49.
AoMRC Revalidation Project Update – June 2010. http://www.gmc-uk.org/Item_5e___Academy_Progress_Report_July_2010_1_.pdf_33524629.pdf.
The Royal College of Ophthalmologists. Cataract surgery guidelines, 2004. http://www.rcophth.ac.uk/docs/publications/published-guidelines/FinalVersionGuidelinesApril2007Updated.pdf. .
Benzimra JD, Johnston RL, Jaycock P, Galloway PH, Lambert G, Chung AKK et al. The Cataract National Dataset Electronic Multicentre Audit of 55 567 Operations: anti-platelet and anticoagulant medications. Eye 2009; 23: 10–16.
El-Hindy N, Johnston RL, Jaycock P, Eke T, Braga AJ, Tole DM et al. The Cataract National Dataset Electronic Multi-Centre Audit of 55 567 Operations: anaesthetic techniques and complications. Eye 2009; 23: 50–55.
McNeil R . Going paperless using an electronic medical record system. Eye News 2010; 17 (3): 6–10.
Scottish Government Business Case 2010. http://health.caledonianmercury.com/2010/09/24/scottish-government-to-roll-out-eyecare-electronic-referral-programme-nationwide/00897.
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Megaw, R., Rane-Malcolm, T., Brannan, S. et al. Revalidation and electronic cataract surgery audit: a Scottish survey on current practice and opinion. Eye 25, 1471–1477 (2011). https://doi.org/10.1038/eye.2011.203
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DOI: https://doi.org/10.1038/eye.2011.203
