IMPORTANCE OF MEDICAL AUDIT IN A COMMUNITY OPHTHALMIC OUTREACH PROGRAM

Outreach delivery of health care is an important part of Community ophthalmology, especially for Cataract patients. Quality assurance in such programmes, which guarantees every patient of best possible outcomes and fewest possible complications in such programmes of key importance. OBJECTIVES: To study the importance of medical audit in assessing & assuring the quality of surgical services provided to the patients in community ophthalmic outreach programmes. STUDY DESIGN: Cross Sectional Study. SETTING: Tertiary Level Eye Hospital and Locations of Outreach Camps. DURATION OF STUDY: 1 year, April 2010 to March 2011. METHODS & MATERIAL: Patients who had no ocular problems other than cataract & had undergone Cataract surgery as part of Outreach programmes, in 2 months - 1 year postoperative period, were selected at random. Interviewed & examined with Snellen's chart, Hand held Slit Lamp & Direct Ophthalmoscope to assess results of cataract surgery including complications. The data thus obtained was statistically analyzed for assessing the quality & effectiveness of community ophthalmic outreach programmes. RESULTS: Of the 1014 patients surveyed 59% were females. 31.5 % Patients got both eyes operated. Thus total 1334 eyes surveyed. 88% of surgeries in the given year have resulted in Good Vision as per WHO Standards. 11% & 2% surgeries resulted in intermediate and poor vision respectively. Only 2% of patients had to be brought to the hospital for further management. Most commonly encountered undesired effect was watering, noted in 2.7% patients followed by itching, redness, mostly in the early postoperative period. Most patients were satisfied about the services they obtained. CONCLUSION: Medical Audit is the mainstay in assessing & assuring the quality of community ophthalmic outreach programmes, which in turn maintain a public trust in the programme. It also helps in building a long term patient contact & finding out areas and groups where outreach programmes can be extended to fetch more patients.