Shortened cataract surgery by standardisation of the perioperative protocol according to the Joint Commission International accreditation: a retrospective observational study. Issue 6 (14th June 2019)

• Record Type: Journal Article
• Authors: Okumura, Yuichi; Inomata, Takenori; Iwagami, Masao; Eguchi, Atsuko; Mizuno, Ju; Shiang, Tina; Kawasaki, Shiori; Shimada, Akie; Inada, Eiichi; Amano, Atsushi; Murakami, Akira
• Is Part Of: BMJ open. Volume 9:Issue 6(2019)
• Publication Date: 2019-06-14
• Subjects: cataract and refractive surgery -- organisational development -- quality in health care -- risk management; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2018-028656
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: To investigate the impact of standardisation of the perioperative protocol based on the Joint Commission International (JCI) accreditation guidelines for operating time in cataract surgery. Design: Retrospective observational study. Setting: Single centre in Japan. Participants: Between March 2014 and June 2016, 3127 patients underwent cataract surgery under topical anaesthesia including 2581 and 546 patients before and after JCI accreditation, respectively. Primary and secondary outcomes: We compared three time periods, comprising the preprocedure/surgery time (pre-PT), PT and post-PT, and total PT (TPT) of cataract surgery between patients before and after JCI accreditation, by regression analysis adjusted for age, sex and cataract surgery-associated confounders. Results: The main outcomes were pre-PT, PT, post-PT and TPT. Pre-PT (19.8±10.5 vs 13.9±8.5 min, p<0.001) and post-PT (3.5±4.6 vs 2.6±2.1 min, p<0.001) significantly decreased after JCI accreditation, while PT did not significantly change (16.8±6.7 vs 16.2±6.3 min, p=0.065). Consequently, TPT decreased on average by 7.3 min per person after JCI accreditation (40.1±13.4 vs 32.8±10.9 min, p<0.001). After adjusting for confounders, pre-PT (β=−5.82 min, 95% CI −6.75 to −4.88), PT (β=−0.76 min, 95% CI −1.34 to −1.71), post-PT (β=−0.85 min, 95% CI −1.24 to −0.45) and TPT (β=−7.43 min, 95% CI −8.61 to −6.24) were significantly shortened after JCI accreditation. Conclusion: Perioperative protocol standardisation, based on JCI accreditation, shortened TPT in cataract surgery under local anaesthesia.