Journal of Clinical and Experimental Ophthalmology
Open Access

Abstract

Improving Patient Access to Intravitreal Anti-Vascular Endothelial Growth Factor Treatment through an Integrated Collaborative Team Care Approach

Jiyeon Kim, John Ah-Chan and Greig Russell

Aim: Intravitreal anti-vascular endothelial growth factor (Anti-VEGF) has become a mainstream treatment for many ophthalmic conditions. Consequently, the demand for the treatment has significantly increased. The significant resource constrained environment necessitated the Palmerston North Hospital Eye Department (PNHED) to introduce solutions to address this increased demand. The two main initiatives adopted were: senior nurse-led macular review clinic (MRC) and nurse-led intravitreal injection clinic. This article will review our current service accessibility and to directly compare it to the results shown in the previous two audits.
Method: The data were collected on an updated macular review clinic patient prospective database and Zeiss optical coherence topography (OCT) forum viewer. The study population was determined by those who have received the intravitreal injection treatment (IVT) between January 2015 and November 2017.
Results: The average waiting times between IVT and subsequent review clinic as well as review clinic and subsequent IVT have been reduced when compared to the previous audit findings. The average period for the unintended delay between the IVT sessions is 6.07 days. The number of IVT given per year has also increased dramatically every year.
Conclusion: PNHED has successfully incorporated both nurses-led MRC clinics and nurse-led IVT clinics. They resulted in a reduction in unintended delays for both reviews and treatment. A secondary benefit of this resource reallocation has been to improve the accessibility of senior medical officer (SMO) clinic appointments. This has reduced the wait time for new patients requiring initial SMO assessment before starting on IVT.