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CLINICAL OUTCOME RESULTS

Clinical audit was introduced by the founding Medical Director of the Singapore National Eye Centre (SNEC), the late Professor Arthur Lim. It was his belief that, “a patient's eye is not for experimentation.” He placed high importance on a patient's well-being and therefore implemented several quality assurance initiatives in an effort to develop a culture of excellence at SNEC.

The Clinical Audit Department was set up as part of SNEC's focus on quality assurance, commitment to the highest standards of clinical governance and ensuring the delivery of safe and high-quality ophthalmic care.

The goals of the clinical audit process are to:

  • review and evaluate the process and outcomes of patient care and clinical performance against prescribed targets and standards
  • ensure that the highest standard of eye care is provided to all patients
  • provide data to SNEC's doctors for training, education, research, presentations and publications
  • ensure regular compilation and reporting of statistics for the Quality Assurance Committee

All major surgeries performed at SNEC are videorecorded for training and education, and the outcomes are audited.

The Clinical Audit Department

The Clinical Audit Department comprises 10 staff who support the Head of Clinical Quality, Adjunct Associate Professor Quah Boon Long, who is responsible for coordinating the clinical governance activities at SNEC. Adjunct Associate Professor Quah was also Head of the Paediatric Ophthalmology and Adult Strabismus Department for 11 years. He has now passed on leadership of the department to aid in the development of a new generation of leaders at SNEC.

Standard operating procedures for clinical audit and sources of information

The Clinical Audit Department audits more than 10,000 case notes annually. It currently tracks more than 30 indicators in the following subspecialties: cataract surgery, surgical retina, medical retina, laser refractive surgery (LASIK [laser in-situ keratomileusis]), corneal surgery, glaucoma surgery, paediatric ophthalmology and strabismus surgery, oculoplastic surgery, neuro-ophthalmology and ophthalmic pathology.

The surgical outcomes at SNEC's branches and affiliates, i.e. SNEC Eye Clinic@Changi General Hospital, the Alexandra and Balestier branches and KK Women's and Children's Hospital Eye Clinic, are also audited in the same way to ensure maintenance of a high standard of ophthalmic care for all patients across SNEC's affiliated institutions and branches in Singapore.

The information is primarily collected from various sources, such as theatre lists, log books, case notes and data forms (from operating theatres and clinics). The data are then evaluated and processed, with the output of the clinical audit being in the form of presentations, reports, statistics and data for research. Recommendations for improvement in the standard of delivery of care can be derived from the outcome data and statistics. This wealth of collected data serves as a valuable resource for audit, benchmarking and research when further analysed. These audit reports are presented to all clinical, nursing, allied health and key administrative staff at the annual Quality Assurance Seminars. This is part of a clinician's training and education for improved patient care and also serves to reinforce clinical quality and patient safety.

OUTCOME RESULTS

Cataract Procedure

Corneal Procedures

Vitreo-Retina Procedure

Glaucoma Procedures

Paediatric Ophthalmology & Adult Strabismus Procedures

LASIK Procedure

Oculoplastic & Aesthetic Eyeplastic Procedures

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