Survey on allied health personnel in Canadian ophthalmology: the scalpel for change.

OBJECTIVE: To determine the recruiting and training needs for ophthalmic medical personnel (OMP), assess the value of their certification, and compare the ophthalmic practice productivity and performance of non-certified and certified OMP, as rated by both ophthalmologists and OMP. DESIGN: Comparative analysis. PARTICIPANTS: One hundred and sixteen Canadian ophthalmologists and 98 OMP. METHODS: An invitation to complete an online survey on OMP recruitment, training, certification, and productivity performance in a clinical setting was sent to 1081 ophthalmologists and OMP. RESULTS: Fifteen percent of ophthalmologists and 31% of OMP completed the survey. Ophthalmologists (61%) reported difficulty hiring OMP; employee referrals was the best method (40%). Awareness of formal OMP training programs was high and 50% of respondents supported developing additional training programs; 55% of OMP were encouraged by their employers to obtain certification. Personal challenge and achievement (79%) and improved skills (71%) were the main reasons for OMP to obtain certification. The majority of OMP and ophthalmologists felt that certified OMP enhanced most practice productivity measures. Higher wages associated with certification were reported by 73% of respondents. CONCLUSIONS: Training of qualified OMP was identified as a need by ophthalmologists. Ophthalmic practices can increase their overall productivity by adding certified OMP to their staff.

A comparative study of the impact of certified and noncertified ophthalmic medical personnel on practice quality and productivity.

PURPOSE: To compare ophthalmic practice productivity and performance attributes, as rated by employing ophthalmologists, of noncertified and three levels of certified ophthalmic medical personnel. METHODS: Three hundred eighty-five American and Canadian ophthalmologists in a clinic-based, stratified, random sample were surveyed regarding productivity performance and attributes of the ophthalmic medical personnel they employ. Instrument scales assessed 14 desirable professional attributes and 10 practice productivity measures. The attributes were credibility, reliability, competence, quality assurance, quality of patient care, knowledge base to make adjustments, increased skills (expertise), ability to work independently, broader knowledge base, ability to detect errors, ability to be trained to perform multiple roles in the practice, professional image, good judgment, and initiative and drive. The productivity measures were patient satisfaction, doctor productivity, trouble-shooting rapport, triage screening, effective patient flow, reduced patient complaints, increased referrals, number of patients per hour, revenue per patient, and patient follow-up. Participants indicated whether certified personnel more often showed these attributes and contributed to practice productivity measures as compared to noncertified personnel or whether there was no difference. Results were analyzed with a chi-square goodness-of-fit test. Survey reliability and validity were evaluated. RESULTS: Significantly more ophthalmologists responded that the three levels of certified personnel contributed more to 5 of the 10 practice productivity measures (i.e., doctor productivity, trouble-shooting rapport, triage screening, effective patient flow, and number of patients per hour). A statistically significant number of ophthalmologists also believed that certified personnel showed more of all 14 of the personal attributes considered desirable compared to noncertified ophthalmic medical personnel. CONCLUSIONS: Compared to noncertified personnel, the employment of certified ophthalmic personnel enhances the quality and productivity of an ophthalmic practice. Overall practice productivity is increased with certified ophthalmic medical personnel.

Strategies to better engage, educate, and empower patient compliance and safe lens wear: compliance: what we know, what we do not know, and what we need to know.

PURPOSE: To assess the extent of noncompliant behavior of contact lens wearers and to develop strategies of engaging and educating patients to increase compliance with safe contact lens practices. METHODS: The literature regarding noncompliance with medical regimens, contact lens wear, and cleaning was reviewed. One hundred eleven contact lens wearers from a college campus, a dental clinic, and ophthalmology clinics were surveyed in a pilot study regarding their contact lens knowledge, attitudes, and practices. Statistical analysis of the results was performed with SPSS software. RESULTS: A review of the literature found overall rates of noncompliance with medical regimens varies from 24.8% to 44%, and the rates reported for contact lens wearers varies from 50% to 99%. Noncompliant behavior affecting the safety of contact lenses is more common than behavior affecting lens comfort. This study found that many lens wearers thought they were compliant, but actually reported a wide variety of noncompliant behaviors. CONCLUSIONS: Although there have been remarkable advances in contact lens science, noncompliance with lens-wearing schedules, replacement schedules, and lens care regimens remains a significant problem of contact lens complications and lens failure. Noncompliant behavior is a complex phenomenon that involves knowledge, attitudes and beliefs, and available resources. Data regarding strategies for increasing compliance are scant. Noncompliance must be considered in the development of future lens care products and must be addressed by eye care professionals when patients are fitted with contact lenses and at each follow-up appointment.