Eye care practitioners report that diagnostic incidents lead to the most severe patient outcomes, while administrative incidents occur the most frequently in clinical practice, according to research published in Ophthalmic and Physiological Optics.
Researchers included 56 eye care practitioners (45 optometrists; 7 dispensing opticians; 4 health board representatives or managers) who attended a national eye care conference in February 2020 in the convergent, mixed methods analysis. Using a nominal group technique, participants voted on safety incidents they perceived to cause the most patient harm and incidents seen most frequently in practice. The researchers used framework analysis to identify themes about the nature and outcomes of incidents in eye care.
According to the study, diagnosis and clinical investigation incidents were perceived to be the most severe (38 votes), while administrative incidents were perceived to be the most frequent (39 votes). Within the administration category, incidents resulting from a patient being lost to follow-up received 38 votes.
According to the report, the researchers identified 4 themes from the suggested incidents including inappropriate clinical decision-making, delayed or missed referral of patients to general medical practitioners or ophthalmologists, compromised communication with other practitioners or patients, and delays in receiving eye care.
“This work has identified several priority areas in eye care for further investigations, to improve the safety of patient care,” according to the researchers. “The importance of understanding patient safety in eye care is paramount given the restructuring of eye care services and increasing clinical responsibility for optometrists.”
Study limitations include a small sample size, failure to include patients, possibility of recall bias due to relying on practitioners’ memory, and the potential for volunteer bias.
MacFarlane E, Carson-Stevens A, North R, Ryan B, Acton J. A mixed-methods characterisation of patient safety incidents by primary eye care practitioners. Ophthalmic Physiol Opt. Published online July 31, 2022. doi:10.1111/opo.13030