Importance of and strategies to follow up pediatric ophthalmology patients

1. Importance of and strategies to follow up pediatric ophthalmology patients Preethi Pradhan Sr Faculty, LAICO Aravind Eye Care System

2. 4 stages of sight restoration Accepts Doctors advice Early detection Eye examination Good quality treatment Follow-up care Quality eye care Regular follow up Visits the hospital for a check up Courtesy: Dr Muhit Childhood Cataract: Home to Hospital, CEH Vol 17, No 50, 2004

3. For Doctor Why follow up is important? For Patient • Patients are dependent on caregivers to take them to the hospital for check up • Serves to surface any other concern as children do not complain of worsening vision • They can meet the same doctor who carried out the intervention • Outcome of the surgery or intervention whether it is good they can assess • Can help to schedule their work better • Can provide better patient satisfaction Giving a specific follow up date helps the patient to remember when to come back

4. Follow up Rate Follow Up Rate = No of patients who came for follow up Total no of patients who were asked to come for follow up

5. First: You need to measure the Follow up Rate • To screen children in private schools and provide them cards– If you are not measuring you wont know and you can’timprove

6. Scenario 1: You receive this report - what do you do?

7. Two weeks after cataract surgery at home, one morning the father notices his child’s eye is reddish. What should I do now? Should I go back to the eye hospital or can I consult local ophthalmologist?

8. My son’s follow-up check up is on the same date as my sister’s wedding Would it be possible for me to change the date? Will the doctor be available then? When date should I go?

9. Reasons for irregular follow up

10. Strategies for Overcoming these Barriers

11. Strategies to address issues related to School Studies Follow up card addressed to teachers

12. Strategies to address issues related to School Examinations • Consult with parents before giving follow up date • Double check if they will be able to come on that date

13. Strategies to address issues related when child falls ill Remind parents about the importance of the follow up Reschedule the appointment

14. Strategies to address issues related to lack of following instructions

15. Strategies to address issues related to Poor Communication • Lack of communication between the child’s parents and their relatives • Identify the key decision maker • Are we addressing communication to all? • Need to communicate whether outcome of surgery is good or bad need to come for follow up • Provide instruction in a print or written format

16. Review patients waiting time to be reduced • Review patients are seen by senior Medical officer and disposed as early as possible. • Separate vision room for > 5 years & < 5 years -

17. Tips to ensure follow up • Ensure convenient date & time for the parents and the child • Avoid exam dates, festivals, inauspicious days etc • Provide printed instructions • Follow up cards • Appointment cards • Reminders • Text message • Phone calls • Postcards

18. 2010 Data on Follow up

19. Thank You !!!