Hotel-Dieu Grace’s cataract surgery excellence

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The federal government has identified long wait times for cataract surgery as a priority focus, and the Canadian Ophthalmological Society has stated that 16 weeks is the benchmark medically acceptable wait time. Current data indicates that wait times remain at several months for the surgeryÑbut not at Hotel-Dieu Grace Hospital where current wait times are an impressive three to four weeks, the shortest in the province.

Today, HDGH’s cataract surgery program is considered the gold standard by the province of Ontario.

In the late 1980’s, a cataract surgeon could perform only six to eight procedures daily, using extracapsular cataract extraction, a procedure that took 30 to 60 minutes under general anaesthesia. Since then, cataract surgery techniques have rapidly evolved and in 1991 Dr. Fouad Tayfour, staff ophthalmologist at Hotel-Dieu Grace Hospital, became the first surgeon in Canada to perform the first clear corneal incision procedure under topical anaesthesia. This small-incision technique takes between 5-10 minutes, and no follow-up sutures are required. The Bausch & Lomb Millennium microsurgical system used by our cataract surgery team is the most efficient continuous vacuum system available today.In addition, the cataract surgery program at HDGH has been recognized for the impressive efficiencies our team has achieved through the implementation of faster technology and surgical techniques, streamlined patient care and improved patient flow strategies. By examining surgical and administrative procedures from patient arrival to departure from the hospital and identifying inefficiencies and bottlenecks in patient flow, the team systematically began making improvements.

Today, with six staff ophthalmologists and a dedicated team of support staff, HDGH is the only hospital providing comprehensive ophthalmology services this side of London. Patient satisfaction surveys indicate that nursing care and efficiency, and operating room process and procedure were excellent 90% of the time and satisfactory 10% of the time, and the program continues to serve as a model for eye programs elsewhere. With 30% to 40% of patients coming as referrals from outside of the Windsor and Essex County area, the program has realized a significant per capita reduction in operating room and staffing costs and reduced hospital time for patients. The HDGH Cataract Surgery Unit now performs 40 procedures dailyÉthat’s one surgical procedure every 7 minutesÉa benchmark in the province if not the country, totaling approximately 6,000 cases annually out of one operating room.

The success of the program has attracted teams ofophthalmic surgeons and nurses from other hospitals to visit HDGH to view our model with the hopes of adopting all or part of our procedures and processes into their own institutions or clinics. Most recently, Dr. Tayfour and our cataract surgery team welcomed an ophthalmic team from a Toronto hospital that traveled to Windsor to view first hand and learn from our cataract surgery program. Visibly impressed with the program here, the visiting ophthalmic surgeons commented that, “The fact that Dr. Tayfour can use one operating room and do more surgeries than most of us can do in two rooms at the moment in the country is really unique. It’s important for us to see how team work can allow everything to be done more efficiently.”

“What you see there is like a balletÑthey’re working like a team, where you have anesthesiologists, nurses, the surgeonÉand everything is sort of just happening simultaneously in an orderly fashion the same way pretty well every time. Things go very smoothly. Nobody seems to be rushing.”

Kim Spirou, M.A., is the Vice President, Communications & Development at Hotel-Dieu Grace Hospital. prove care after discharge. Reverend Jim Lee and his wife Debra, a nurse at the Ottawa Hospital, are very aware of the need for support post discharge. “My recovery is wonderful, but I still have challenges, it is nice to know I am not struggling alone,” Jim says.

The Stroke Survivors Association of Ottawa (SSAO) is one of the small organizations across Ontario and Canada that is working to provide community supports for stroke survivors. Sharon Anderson of the SSAO says, “One of the biggest problems identified by professionals working in the community, stroke survivors and caregivers is the lack of current research and information for people after they leave hospital. Chronic disease management models tell us that we need to engage people to manage their own health.”

The Ontario Stroke Strategy is making a difference, but, there is more that can be done. Right now there is no ribbon or wrist band to advocate for stroke. Stroke needs more visibility to ensure that people know what hospitals and rehabilitation can do and what they can do to help themselves.

The association is sponsoring its second stroke recovery conference (www.strokeconference.ca) in August to highlight how they are working together to take stroke recovery to the next level.