Analysis of Novel Physician-Led Team-Based Care Model for Treatment of Glaucoma
Purpose
A novel physician-led team-based care model was implemented at our institution for the treatment of patients with glaucoma. Our purpose was to retrospectively study the efficacy of this model for improving compliance with the American Academy of Ophthalmology Preferred Practice Patterns for glaucoma management.
Methods
A total of 600 patients with a new diagnosis of glaucoma based on ICD-9 codes were studied before and after protocol implementation from 2005-2010 and this data was compared to a control site without a glaucoma care process model over the same time period. Charts were divided into sub-groups for analysis based on provider type including optometry, general ophthalmology, and glaucoma specialists. Outcomes included completion of testing and recording of a specific diagnosis. Glaucoma severity at time of diagnosis was also analyzed by sub-group.
Results
The control site had no significant changes in testing completion over the time period studied, and glaucoma type and severity were similar between locations. The team care group at the intervention site had a global improvement in testing completion, with the largest improvement in fundus photos (29% increase), gonioscopy (27% increase) and recording target IOP (24% increase).
Conclusion
Implementation of a physician-led care model at our institution resulted in significant improvement in compliance with the American Academy of Ophthalmology Preferred Practice Patterns for glaucoma treatment. This is the largest study of this type to date and our protocol has the potential for widespread adoption to improve glaucoma care.