Towards a better cataract surgery efficiency with intracameral injection of a new combination of mydriatics and anaesthetic: LEAN healthcare application

Session Details

Session Title: Moderated Poster Session: Cataract
Session Date/Time: Friday 09/02/2018 | 14:00-15:00
Paper Time: 14:16
Venue: Poster Area


First Author: J.Güell SPAIN
Co Author(s): J. Goemaere  M. Ni Dhubhghaill              

Abstract Details

Purpose:

Lean healthcare is a set of operating methods that increase value for professionals and patients by reducing waste and waits. It aims to fundamentally change organizational thinking and value, which ultimately leads to the transformation of organizational logistics, production processes and culture over time. The aim of the study was to design and test a healthcare process linked to the use of the new intracameral mydriatics and anaesthetic combination (Fydrane®/Mydrane®, Laboratoires Théa, Clermont-Ferrand, France) in cataract surgery, based on quality, safety, efficiency and efficacy using LEAN methodology. Waiting time, total process time, unexpected event management were followed.

Setting:

Ophthalmology departments of 3 private clinics and 2 public University hospitals in Spain were analysed by KaiLean Consultores ®, a consultancy company.

Methods:

Cataract surgery processes were analysed at 5 sites with a variety of characteristics, without and with the use of Mydrane® in the mydriatics protocol. In July 2016, 23 cataract surgeries were analysed without the use of Mydrane® and from September to November 2016, 26 cataract surgeries were analysed using an IC mydriatic protocol with Mydrane®. Surgeries carried out by both experienced surgeons and by residents were observed. Mydriasis with topical eye drops took place at the site in two University hospitals and in one of the private centers and at home in 2 of the private centers.

Results:

The use of Mydrane® reduced time spent in the surgical area by the patient in 45%. As pupil dilatation with eye drops has a bottleneck effect for the first surgery, the first surgery of the day could start 30-40 minutes earlier than the mydriasis protocol with eye drops. Occupation of the surgery preparation zone by the patient was decreased to 15 minutes (-70%). With the new mydriatic protocol using Mydrane®, patients waiting time for surgery could be reduced to only 10-12 minutes.

Conclusions:

Intracameral mydriasis with Mydrane® allows more flexibility for surgeons in the event of unexpected changes during the surgery day. Patient preparation times are reduced and afford more flexibility of the surgical list. The main 3 parties, surgeons, nurses and patients could benefit from the advantages of Mydrane®. Reduction of the nursing workload in surgery preparation will have an impact on decreasing potential errors during the hospital care as well as allowing nurses to perform other activities with a direct impact on the quality of the healthcare. Routine Mydrane® usage induces safe and efficient conditions in private and public settings.

Financial Disclosure:

receives non-monetary benefits from a competing company, research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented