CLINIC AND O U TPATIE NT CLINIC
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1 CLINIC AND O U TPATIE NT CLINIC FO R O PH TH ALM O LO GY
2 FACTS AND FIGURES Clinic and Outpatie nt Clinic for Oph th alm ology Fe rdinand- Saue rbruch - Straße Gre ifs w ald Te le ph one : 03834/ Te le fax: 03834/ E- m ail: oph uni- gre ifs w ald.de H om e page : h ttp://w w w.m e dizin.uni- gre ifs w ald.de /auge n/ H e ad of de partm e nt: Se nior ph ys icians : H e ad of nurs ing s taff: QM re pre s e ntative : Univ.- Prof. D r. m e d. S. Cle m e ns Prof. D r. m e d. F. Tos t OÄ D r. m e d. B. Boh l OÄ D r. m e d. S. H e rfurth I. Bie ble r Univ.- Prof. D r. m e d. S. Cle m e ns Spe cialis ts Univ.- Prof. D r. m e d. S. Cle m e ns W h ole fie ld of oph th alm ology Spe cialis e d in: Vitre ore tinals urge ry, cataract s urge ry, k e ratoplas ty, glaucom a s urge ry. Introduction of ne w s urgical conce pts in th is fie ld. Prof. D r. m e d. F. Tos t W h ole fie ld of oph th alm ology Spe cialize d in: Cataract s urge ry, glaucom a, oculoplas tic s urge ry, lacrim al ducts, orbita. QUALITY REPORT FOR PATIENTS 2006 UNIVERSITY CLINIC GREIFSW ALD
3 OÄ D r. m e d. S. H e rfurth Angiology, m ode rn im aging te ch niq ue s for re tinaldiagnos tics, com ple te range of inje ction proce dure s to tre at age - re late d m aculopath y, organization of th e inte rnationa ly acclaim e d cours e for angiograph y and las e r in Gre ifs w ald D r. m e d. P. Rie be ling Strabology, ne urooph th alm ology, h e ad of th e Acade m y for Orth optics (only one in M e ck le nburg - W e s te rn Pom e rania) D r. m e d. D. H übne r H e ad of organ bank re s e arch M e th ods for corne a pre s e rvation, optim izing am nion pre paration, s e rum e ye drops, e xtraction of s cle ra and adaptation to diffe re nt s urgicalproce dure s Th e Clinic and Outpatie nt Clinic for Oph th alm ology h as 25 be ds available. In th e ye ar of th e re port patie nts re ce ive d inpatie nt tre atm e nt and patie nts re ce ive d outpatie nt tre atm e nt. UNIVERSITY CLINIC GREIFSW ALD QUALITY REPORT FOR PATIENTS 2006
4 T M ED ICAL CARE SERVICES h e oph th alm ology clinic offe rs a w ide range of cataract ope rations (gre y cataract), als o in com bination w ith glaucom a proce dure s. Th e s e are com ple m e nte d by corne algrafting (k e ratoplas ty), ope rations on th e vitre ous body (vitre ctom y), as w e las s pe cialim plantation proce dure s in cas e s of pae diatric cataract and corne algrafting w ith s te m ce lgrafting unde r unfavourable pre conditions. Oth e r s pe cialitie s of th e clinic include re tinalvitre ous s urge ry, including m acular grafting and trans s cle rale n block re s e ction of pos te rior ch oroid tum ours. Th e clinic als o offe rs ph otodynam ic and intravitre altre atm e nts of age - re late d m acular dis e as e s and dys functions (m aculopath y). M ore ove r, m ultifocalerg, ultras ound, biom icros copy, e ndos copy of th e lacrim alducts, outpatie nt diabe te s diagnos tics w ith fluore ce in and indocyanin angiograph y and e ye e xam inations us ing H RT and OCT are pe rform e d. Th e contact le ns e s cons ultation is re s pons ible for th e rape utic le ns e s and pure ly re fractive s oft and s table h ard contact le ns e s. QUALITY REPORT FOR PATIENTS 2006 UNIVERSITY CLINIC GREIFSW ALD
5 T SPECIAL AREAS OF M ED ICAL CARE h e clinic runs a s ch oolfor orth optics, a corne a bank and an outpatie nt de partm e nt. W e offe r angiograph y cons ultations, uve itis cons ultations and outpatie nt tre atm e nt for vis ua ly h andicappe d patie nts. Re s e arch topics of th e clinic are th e de ve lopm e nt of ne w conce pts to tre at diabe te s - re late d re tinaldis e as e s and th e im prove m e nt of trans plantation ch aracte ris tics of corne altrans plants. M ore ove r, w e do re s e arch w ork for pre ve ntion of re tinal de tach m e nt and w e ak - s igh te dne s s re late d to s trabis m, to de ve lop proce dure s to pre ve nt s e cond cataract (cataracta s e cundaria), to im prove th e h old of th e le ns and w e try to furth e r de ve lop adjus table le ns e s, plas tic le ns e s us e d in cas e s of gre y cataract and im m unoth e rapy of e ndoge nous inflam m ations of th e e ye. Cataract s urge ry, cos m e tic re parative proce dure s and lacrim alduct ope rations are pe rform e d as outpatie nt proce dure s. Our nurs ing s taff provide s our patie nts w ith w alk ing aids, ro lators, w h e e lch airs and m obility s coote rs, h e lps patie nts to find th e ir w ay around th e clinic and to m ove around th e h ous e, h e lps to put on bandage s and s upport s tock ings, provide s h e lp in th e tre atm e nt of e cze m a and zos te r and ve nous ins ufficie ncie s in th e low e r le g. Pe riope rative bandage ch ange s are pe rform e d in pre s e nce of a s pe cialis t, als o in oth e r file ds, as oralm axi lo- facials urge ry or ne uros urge ry. Nurs ing care s e rvice s include th e pos itioning and care of patie nts, h e lp w ith w as h ing, pe rs onalh ygie ne and e ating, cons ultation, die t inform ation, diabe te s training, carboh ydrate e xch ange table s, us e of diffe re nt antidiabe tics. Th is is com ple m e nte d by k ine s ioth e rapy, inh alation, gym nas tics and pre parations for s urge ry w ith e ye com pre s s e s, drops and ointm e nts, e ye bath s. Our nurs e s adm inis te r drugs to th e e ye, s upe rvis e th e ge ne raltak ing of drugs, tre at dry e ye s, apply cooling com pre s s e s and bandage s to re gulate th e inte rnale ye pre s s ure afte r glaucom a s urge ry. Furth e rm ore, nurs ing care s e rvice s include anti- UNIVERSITY CLINIC GREIFSW ALD QUALITY REPORT FOR PATIENTS 2006
6 s e ptic w ound tre atm e nt afte r cos m e tic plas tic s urge ry, ph ototh e rapy, clim ate th e rapy, orth optic e xe rcis e s for th e e ye m us cle fo low ing s trabotom y and as tre atm e nt for s q uint- re late d w e ak - s igh te dne s s. W e are ope n to th e patie nts w is h e s and s ugge s tions, as w e w ant th e m not only to re cove r but to fe e lcom fortable w ith us. Th e clinic offe rs die t food, adjus te d pos itioning, a le rgy m anage m e nt, e nte rtainm e nt, audio book s, TV, appointm e nts at th e h airdre s s e r s, praye r room, re com m e ndations for re lative s w anting to s tay ove rnigh t, pos s ibilitie s for s h opping and public trans port, organize d trips, s ocial e m e rge ncy s e rvice, h ous e h old h e lpe rs in conne ction w ith s ocialw ork e rs. W e offe r s pe cialaccom m odation for patie nts w ith m ultiple dis e as e s, s m a lch ildre n, accom panying pe rs ons, m oth e r- and- ch ild units and accom m odation for fam ily m e m be rs. M EASURES FOR INTERNAL QUALITY ASSURANCE D ata conce rning th e q uality of cataract s urge rie s are re gis te re d ce ntra ly for th e fe de rals tate M e ck le nburg- W e s te rn Pom e rania, including com plications, planne d pos t- ope rative re fraction value s and th e e ffe ctive s ucce s s e s th rough po ling of re gis te re d GPs, re s pons ible for afte r tre atm e nt. Evaluation is carrie d out by Ph D s tude nts or by s urge ons during cons ultations. Inform ation on th e adjus tm e nt of th e controls ys te m s, ope ration te ch niq ue s, th e m ate rials us e d for im plantations are pas s e d on to th e ope ration s taff and th e s e nior ph ys icians, to th e as s is tants during s urge ry and to th e s taff during s taff training m e as ure s, w h ich are als o ope n for GPs. Quality s tandards re garding re tinals urge ry and re tinal/vitre ous s urge ry are als o conducte d on a re gular bas is. To im prove th e re s ults cons tant agre e m e nts on th e participating doctors, nurs e s and s taff are m ade w ith in th e above - m e ntione d circle. Th us, obs e rvations from th e pe riope rative proce dure s and th e afte r tre atm e nt can flow into th e ope rative proce e dings. D uring QUALITY REPORT FOR PATIENTS 2006 UNIVERSITY CLINIC GREIFSW ALD
7 s pe cialis e d cons ultations fo low ing k e ratoplas ty, las e r tre atm e nt (coagulation) and als o s trabis m us s urge ry according s ucce s s s tandards are com pare d and dis cus s e d. M ain com pe te ncy diagnos e s according to ICD in 2006 RANKING ICD NAM E CASES 1 H 40 Glaucom a H 25 Se nile cataract H 33 Re tinalde tach m e nts and bre ak s H 35 Oth e r re tinaldis orde rs 88 5 S05 Injury of e ye and orbit 65 6 H 50 Oth e r s trabis m us 61 7 H 26 Oth e r cataract 47 8 H 02 Oth e r dis orde rs ofe ye lid 43 9 H 34 Re tinalvas cular occlus ions E11 Non- ins ulin- de pe nde nt diabe te s m e litus 37 Com pe te ncy diagnos e s according to ICD in 2006 ICD H 16 H 04 H 20 H 18 NAM E Ke ratitis D is orde rs of lacrim als ys te m Iridocyclitis Oth e r dis orde rs of corne a C44.1 Oth e r ne oplas m s of s k in: Sk in ofe ye lid, including canth us C44.3 Oth e r ne oplas m s of s k in: Sk in ofoth e r and uns pe cifie d parts offace H 49 H 27 H 17 H 51 H 28 H 36 H 52 Paralytic s trabis m us Oth e r dis orde rs of le ns Corne als cars and opacitie s Oth e r dis orde rs of binocular m ove m e nt Cataractand oth e r dis orde rs ofle ns in dis e as e s clas s ifie d e ls e w h e re Re tinaldis orde rs in dis e as e s clas s ifie d e ls e w h e re Dis orde rs of re fraction and accom m odation Inform ation s tate d h e re are additionalcom pe te nce s for th e m ain diagnos e s m e ntione d above (inde pe nde nt of th e cas e s tre ate d in th e re port ye ar 2006). UNIVERSITY CLINIC GREIFSW ALD QUALITY REPORT FOR PATIENTS 2006
8 M ain proce dure s according to OPS in 2006 RANKING OPS NAM E CASES Surge ry us ing opticalm agnifying de vice s, e.g. m agnifying glas s e s, ope ration m icros cope Le ns e ctom y w ith oute xcis ion of th e crys ta line caps ule Vitre ctom y w ith fo low ing s ubs titution w ith acce s s th rough ciliary body Ope rative de s truction ofaffe cte d re tinalor ch oroidaltis s ue Oth e r ope ration to re -attach th e re tina afte r de tach m e nt Scle ralbuck ling ope ration to re -attach re tina afte r de tach m e ntus ing a s ilicone plom p Oth e r ope ration affe cting th e s cle ra, th e iris, th e ante rior e ye ch am be r or th e ciliary body Surge ry to re duce inte rnale ye pre s s ure Oth e r ope ration affe cting th e iris Tre atm e ntth rough th e inje ction ofdrugs into organs or tis s ue or re m ovalof e ffus ions, e.g. from joints 61 * Th e s urve i lance of vitals igns during ope rations and anae s th e s ia/s e dations, anae s th e s ia on its ow n and blood trans fus ions during th e proce dure s are not s tate d s e parate ly. Com pe te ncy proce dure s according to OPS in 2006 OPS NAM E 5-10 Ope ration ofe ye m us cle s Surge ry to corre ctm alpos ition ofe ye lid w ith inw ard turn and acq uire d m alpos ition of e ye lid w ith outw ard turn Oth e r re cons tructive proce dure s for e ye lids Oth e r proce dure to re cons tructlacrim aldrainage Corne a trans plantation or artificials ubs titution ofcorne a w ith an im plant 5-16 Ope ration ofbony e ye s ock e tand e ye ba l 5-14 Ope ration ofle ns 5-13 Ope ration ofiris, ciliary body, ante rior e ye ch am be r and s cle ra 5-15 Ope ration ofre tina, ch oroids and ciliary body Inform ation s tate d h e re are additionalcom pe te nce s for th e m ain com pe te ncie s m e ntione d above (inde pe nde nt of th e cas e s tre ate d in th e re port ye ar 2006). QUALITY REPORT FOR PATIENTS 2006 UNIVERSITY CLINIC GREIFSW ALD
9 Com parative figure s Outpatie nt cataract ope rations w ith im plantation of artificialle ns e s Ope rations : 1,385 Com plications h e re : 12 = 0.9 % (inte rnationalave rage 2% ) Infe ctions h e re : 0 (inte rnationalave rage 1:1000) Continuous vis ualim pairm e nts due to com plications h e re : 0 Inpatie nt cataract ope rations, als o in com bination w ith glaucom a proce dure s Ope rations : 441 Com plications h e re : 3 = 7% (inte rnationalave rage 15% ) Infe ctions h e re : 0 (inte rnationalave rage 1% ) Continuous vis ualim pairm e nt due to com plications h e re : 0 Proce dure s due to re tinalde tach m e nt and vitre ous h ae m orrh age or m acular dis e as e s Ope rations : 250 Re pe titive proce dure s of th e s e : 50 = 20% (inte rnationalave rage 25% ) Infe ctions h e re : 0 (inte rnationalave rage 1% ) Continuous vis ualim pairm e nts due to com plications h e re : 0 (inte rnat. ave rage 1% ) Proce dure s due to glaucom a, als o in com bination w ith cataract s urge ry or k e ratoplas ty Ope rations : 200 Com plications h e re : 10 = 5% (inte rnationalave rage 25% ) Infe ctions h e re : 0 (inte rnationalave rage 1% ) Continuous vis ualim pairm e nts due to com plications h e re : 0 (inte rnat. ave rage 1% ) Lacrim alduct ope rations Ope rations : 50 Com plications : 0 (inte rnationalave rage 15% ) Infe ctions h e re : 0 (inte rnationalave rage 3% ) Cos m e tic plas tic proce dure s Ope rations : 40 Com lications : 0 (inte rnationalave rage 1% ) Ke ratoplas ty Ope rations : 20 Com plications h e re : 1 = 5% (inte rnationalave rage 20% ) Infe ctions : 0 (inte rnationalave rage 1% ) Continuous vis ualim pairm e nts due to com plications h e re : 0 UNIVERSITY CLINIC GREIFSW ALD QUALITY REPORT FOR PATIENTS 2006
10 RESEARCH In our re s e arch data bas e you can alw ays find curre nt re s e arch re ports of our clinic: h ttp://fodb.uni- gre ifs w ald.de /inde x.ph p. QUALITY REPORT FOR PATIENTS 2006 UNIVERSITY CLINIC GREIFSW ALD
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