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Newsletter European Association of Eye Hospitals Number 3 / 2013 P2 / Third European Association of Eye Hospitals (EAEH) newsletter! P3 / Short introduction - The Department of Ophthalmology, Helsinki University Central Hospital, Finland P4 / First meeting of the international exchange in infection control P5 / Seeing the SurgiCube in action P6 / Patient pathway for patients in day surgery at Moorfields Eye Hospital, London P7 / Cataract surgeries in Sweden P8 / News from our members Newsletter European Association of Eye Hospitals Number 3 / 2013 Third European Association of Eye Hospitals (EAEH) newsletter! This edition starts with a short introduction from one of the members of the EAEH, the University of Helsinki - department of Ophthalmology in Finland. It also includes an update about the international exchange in infection control that was covered in the last newsletter, and reports on three visits within the EAEH in recent months. Contact information is included at the end of each article, so please don’t hesitate to get in touch for more information. Please remember that the aim of the EAEH board is to promote the international exchange of knowledge between eye hospitals. For this, there is a budget of € 1000 per exchange, provided that the objectives of the EAEH are met. These objectives and contact information are available on the last page of this newsletter. Content of this newsletter: • Short introduction of the University of Helsinki department of Ophthalmology in Finland • First meeting of the international project group exchange in infection control • Seeing the SurgiCube in action - Visit by London to Rotterdam • Patient pathway for patients in day surgery EAEH-exchange visit between Rotterdam and London • Cataract surgeries in Sweden - EAEH-exchange visit between Rotterdam and Stockholm • News from our members • Upcoming activities: World Sight Day 2013 Kind regards, The Executive Board of the EAEH: J. Pelly, Chairman of the EAEH, CEO of Moorfields Eye Hospital U.F. Hiddema, Secretary of the EAEH, CEO of The Rotterdam Eye Hospital J.C.A. Sol, Treasurer of the EAEH, CFO of The Rotterdam Eye Hospital Keyfeatures • • • Benchmark Related to AAEEH / The ASEAN-EYE Hospitals Global association Members • • • • • • • VISSUM Instituto Oftalmológico de Alicante, Alicante University of Helsinki - department of Ophthalmology, Helsinki University Hospitals Leuven, Leuven Moorfields Eye Hospital, London The Rotterdam Eye Hospital, Rotterdam Singapore National Eye Centre (SNEC), Singapore St. Eriks Eye Hospital, Stockholm 2 Newsletter European Association of Eye Hospitals Number 3 / 2013 Short introduction - The Department of Ophthalmology, Helsinki University Central Hospital, Finland In this newsletter, we get to know The Department of Ophthalmology, Helsinki University Central Hospital, Finland, finding out what kind of subspecialties the hospital offers, its capacity , and its research and education activities. The Department of Ophthalmology, Helsinki University Central Hospital, was founded in 1871 and is the largest and oldest eye department in Finland. It is the only department in Finland with a full complement of subspecialties, including medical and surgical retina, cornea, anterior segment surgery, paediatric ophthalmology, glaucoma, neuro-ophthalmology, oculoplastics, uveitis, visual rehabilitation, eye banking, ocular oncology and ophthalmic pathology, electrophysiology, and continuous emergency service. The department strives to be a leading academic centre of ophthalmology and eye care in its region, recognised throughout Europe. Its catchment area covers 1.5 million people, and specialized services are provided for the entire Finnish population of 5.4 million. The department is part of the Institute of Clinical Medicine where research is performed. In 2011, taking international and Finnish publications together, the Research Database of the University of Finland (TUHAT), listed 71 publications for the Department of Ophthalmology: https://tuhat.halvi.helsinki.fi/portal/en/ organisations/silmaklinikka%28b3850ddc-2fa6-4a9d-b002-5ab1f016abd5%29/publications.html?page=0&pageSize=all On top of that, the department trains about 140 medical students a year, and a number of trainee nurses and allied health professionals, and runs a regular Continuous Medical Education programme for Finnish ophthalmologists. Professor and Chair of the Department of Ophthalmology is Tero Kivelä, MD, FEBO, who is responsible for research, teaching and international affairs. He is supported by Timo Tervo, MD, who is the Professor of Applied Ophthalmology and Erna Kentala, MD, who is the Administrative Chief in charge of the daily functioning of the Department of Ophthalmology. The department is housed jointly with the Department of Otorhinolaryngology in the Eye and Ear Hospital at the Meilahti Campus. It occupies 8,000 m2, including 8 main and 2 outpatient operating theatres, 4 wards of which 3 are for day case surgeries, more than a dozen outpatient clinical and 10 permanent hospital beds for inpatients. Around 70,000 outpatients visit the hospital every year, and there are 277 employees. The academic hospital is publicly funded. Clinical services are run by a league of regional communities. The State of Finland finances the research and residency training through special funds. Research is also financed by a number of private non-profit foundations. 3 Newsletter European Association of Eye Hospitals Number 3 / 2013 First meeting of the international exchange in infection control In the last newsletter we informed you about the initiative to create an international infection benchmark to set a standard rate for infections. Beside the benchmark, the purpose of the meeting was also to discuss the potential for sharing ophthalmic infection data and exploring processes for data collection. The following eye hospitals participated in the first meeting: St Erik’s Hospital, The Rotterdam Eye Hospital, University of Helsinki and Moorfields Eye Hospital. The five most important outcomes of this meeting are: 1. Continued sharing of data, exchange of policy, best practice and current clinical practices. 2. The outcome of endolphthalmitis registration after cataract surgery was presented: University of Helsinki 0.25:1000, St Erik’s, Hospital 0.33:1000 (nationwide), Moorfields Eye Hospital 0.48:1000 and The Rotterdam Eye Hospital 0.64:1000. Further steps on sharing information are agreed on. 3. All attendees agreed that 0.5:1000 seems to be the benchmark for endophthalmitis after intravitreal injection. 4. Percentage surgeries performed under general anaesthesia: 10% cataract surgery performed at St Erik’s Hospital, 26% of cataract surgery performed at The Rotterdam Eye Hospital, 1 % of the cases at University of Helsinki and 15% of the cases at Moorfields Eye Hospital. 5. During the meeting, agreement was achieved on the same spectrum of species identified in positive cultures for endophthalmitis cases, but there was some variance in the percentage of negative culture reporting. Moorfields reports an average of 58% of all cases being negative cultures, Rotterdam reports approximately 50% and St Erik’s Hospital around 20%. Agreements on sharing information regarding antimicrobial prescribing policies and protocols were made. Want to know more? If you are interested in participating in the next meeting or want more information, please contact Albertine Sprenger at The Rotterdam Eye Hospital, [email protected] 4 Newsletter European Association of Eye Hospitals Number 3 / 2013 Seeing the SurgiCube in action Visit from the United Kingdom - Moorfields to The Netherlands – Rotterdam On Thursday 5 April 2012, a group of eight managers from Moorfields Eye Hospital visited the Ophthalmology Department of Sint Franciscus Gasthuis (SFG) in Rotterdam in the Netherlands. The aim of the visit was to see the SurgiCube in action since Moorfields is discussing whether to buy a SurgiCube to provide more capacity. The visit was also an opportunity to discuss related issues with clinical staff and with people from sales in Rotterdam. Location The Netherlands – Rotterdam – Ophthalmology Department of Sint Franciscus Gasthuis. The Ophthalmology Department of Sint Franciscus Gasthuis is part of The Eye Care Network in The Netherlands. This network consists of multiple partnerships between ophthalmology departments in different hospitals and The Rotterdam Eye Hospital. The network aims to provide high-quality ophthalmic care throughout The Netherlands. Participating EAEH member-hospitals • Moorfields Eye Hospital Learning points from the exchange: • It was very helpful and interesting to see the Surgicube in action as it made the process much easier to understand. Visitors from Moorfields were very impressed with what they saw and noted both the fast procedure and turnaround times. It was clear that a key part of SFG’s success was due to the design of the entire pathway, not just the operating room. • The visitors were also impressed by the high quality day care environment and the smooth patient flow in and out of the Surgicube • The surgeon present found the angle of operating interesting - whether from the side or the top, and how that might affect the position of trolleys, the phaco machine and the microscope • The managers from Moorfields felt the transition to the Surgicube was an achievement in particular with regards to overcoming the resistance of some surgeons to change practice - a challenge which SFG managed successfully. • The financial benefit was clearly substantial and that must have been a convincing driver for change in practice Want to know more? Please contact Rotterdam: Suzanne Korthorst, [email protected] London: Amelia Price, [email protected] 5 Newsletter European Association of Eye Hospitals Number 3 / 2013 Patient pathway for patients in day surgery at Moorfields Eye Hospital, London EAEH-exchange visit from The Netherlands – Rotterdam to the United Kingdom - Moorfields Eye Hospital On Thursday 19 and Friday 20 July 2012, Carien Eijkman, the nurse team leader and Lara Vankan, intern, from The Rotterdam Eye Hospital visited Moorfields Eye Hospital in London. Their aim was to learn how Moorfields Eye Hospital has organized the patient pathway for patients in day surgery. On Thursday, they learned the pathway for patients at Moorfields’ main hospital in central London. On Friday they visited the satellite centre at Northwick Park Hospital in the London suburbs, which mainly performs cataract surgeries. Location United Kingdom – London – Moorfields Eye Hospital Participating EAEH member-hospitals • Rotterdam Eye Hospital Learning point from exchange: • The team leader in the operating theatre decides when the next patient can be brought for surgery. The phone calls (who and when) are registered to enable a more rapid analysis of the situation should a problem arise 1st row: Amelia Price, Antoinette Flynn, Xiang Yin, Carien Eijkman 2nd row: Lara Vankan, Shannon Anderson, Joyce Morrin • • • • The importance of hand hygiene is more obvious at Moorfields Eye Hospital than at The Rotterdam Eye Hospital. For example, dispensers with disinfecting alcohol are highlighted by orange stripes on the walls. Moorfields Eye Hospital exchanges staff between the main hospital and the satellites, which enables more flexibility to deal with any absences. Moorfields Eye Hospital does not have an “anesthetic holding area” for all operating theatres as happens in Rotterdam. Every operating theater has one anesthetic room, where the patient waits before going into the operating theatre. Patients go to the anesthetic room when the previous patient finishes their surgery, so they spend only a short time there, but it ensures their privacy is maintained and that they receive treatment from the same staff who will be present during surgery. Patients who receive local anesthesia wear only a surgical gown on top of their own clothes. Patients who receive general anesthesia have to change from their own clothes into a surgical gown. In The Rotterdam Eye Hospital all patients, regardless of the type of anesthesia, have to change in to a surgical gown. Want to know more? Please contact Rotterdam: Carien Eijkman, [email protected] London: Amelia Price, [email protected] Musa Sanyang, Bhavin Maru, Carien Eijkman, Xiang Yin, Lara Vankan 6 Newsletter European Association of Eye Hospitals Number 3 / 2013 Cataract surgeries in Sweden EAEH-exchange visit from The Netherlands – Rotterdam to Sweden – St. Erik’s Eye Hospital On 5 March 2012, Onne Creten and Nic Reus, cataract surgeons from the Rotterdam Eye Hospital, visited St. Erik’s Eye Hospital in Stockholm. The purpose of the visit was to find out how to increase the percentage of complex cataract surgeries performed under topical anaesthesia in an environment safe for the patient and without compromising the self-confidence of the surgeon. World Sight Day 2012: I can see clearly now In 2012, some of the EAEH and WAEH hospitals have organized screenings and educational activities during World Sight Day, 11th of October. Location Sweden - Stockholm - St. Erik’s Eye Hospital Participating EAEH member-hospitals • Rotterdam Eye Hospital Learning point from exchange: • In Sweden, the estimated duration of surgery determines the form of anaesthesia; irrespective of the complexity of the surgery, all cataract operations performed in less than 30 minutes are planned under topical anaesthesia. • Only mental comorbidity (ie. dementia), compromising perioperative cooperation and as such, safety, is an indication for general anaesthesia. • If during cataract surgery, topical anaesthesia does not achieve sufficient levels of pain relief, intravenous sedatives can be applied and/or a subtenon block can be given. Want to know more? Please contact Rotterdam: Onne Creten, [email protected] Stockholm: Carina Libert, [email protected] This year we would like to organize the same! Want to join? Please let us know! Contact Maaike van Zuilen – [email protected] if you would like to be part of this worldwide event! 7 Newsletter European Association of Eye Hospitals Number 3 / 2013 News from our members Department of ophthalmology of the University Hospitals Leuven has the best reputation among doctors in Belgium A sample of a Belgian GPs and specialists was asked, “Which hospitals do you think provide the best medical care to a patient with very severe and complex disorder within a particular field?”. For ophthalmology, EAEH-member Department of ophthalmology of the University Hospitals Leuven was awarded the most points and was rated the best. The main goal of the survey was to create a tool to provide information to patients which they can use in conversation with their doctor and can make more informed decisions when choosing a hospital. Three other goals were: promoting the rights of patients to obtain information and participate in decisions, more transparency about the quality of hospitals and encouraging the health system and health care providers to improve services. Participating doctors had to justify their choice of selected hospitals. The four most frequently cited reasons were: 1) The competence and / or specialization of medical staff, 2), the quality of the medical infrastructure, 3) efficiency / proficiency of paramedical staff and 4) the cooperation between doctors of different departments. Congratulations to the Department of ophthalmology of the University Hospitals Leuven for this achievement! Want to participate in an exchange? Criteria for EAEH funding of exchanges: • The exchange group should consist of at least two EAEHmember hospitals • A structured report of the exchange must be developed, which will be shared initially with the guest hospital, followed by communication to all other members: • By newsletter via e-mail • And a short piece on the EAEH-website (or the extranet if information is meant to be internal) Next newsletter • There will also be room in the newsletter to share your experiences of exchanges or visits to other EAEH eye hospitals. Any updates? Contact Do you have any visits planned or other knowledge to share with the other members of the EAEH? Please contact Maaike van Zuilen – coordination of EAEH-activities: [email protected] – 0031-(0)6-456 32 117 Colophon Editors: Lara Vankan (Rotterdam Eye Hospital), Kate Jeffreys (Moorfields Eye Hospital), Maaike van Zuilen (EAEH). Graphic design: Edwin Marks (philogirl) Website www.eyehospital.eu The EAEH will facilitate exchanges with € 1000 per exchange if EAEH-objectives are met. The board would like to support two or three annual EAEH exchanges. To organize these exchanges, the EAEH plans to create an international project group of people working in EAEH-member hospitals. 8