The COVID-19 pandemic has changed everything, including the practice of ophthalmology. Board-certified ophthalmologists have always been concerned about preventing the spread of pathogens, such as adenovirus. However, in 2020, infection control and prevention in the ophthalmology office became a potential life or death concern.
Recognizing that most diplomates needed to swiftly implement evidence-based procedures and policies to care for their patients while preventing the spread of the novel virus, the American Board of Ophthalmology (ABO) developed a COVID-19 response project that would satisfy the Improvement in Medical Practice requirement for Maintenance of Certification (MOC). Such projects are intended to help ophthalmologists identify gaps in care and implement best practices in order to improve patient outcomes. Updating infection control measures in light of the pandemic presents an opportunity to achieve this goal.
The response was enthusiastic, with more than 50 ophthalmologists submitting proposals within the first few weeks after the project was introduced. The proposals arrived from doctors in solo, group, multi-specialty, subspecialty, military, and hospital practices, and from all over the country. After 30 or more days, participants will report what worked, what didn’t, and how they made adjustments to achieve their goal of taking the best possible care of patients and staff.
Most of the projects described similar or overlapping initial strategies for reducing the risk of infectious spread, including scheduling only urgent patients, screening those patients for symptoms or travel, checking patients and staff for fever, asking companions to wait outside the office, social distancing, hand washing and sanitizing surfaces, using personal protective equipment properly, prohibiting talking during slit lamp biomicroscopy, offering telemedicine, and avoiding unnecessary procedures that could aerosolize viral particles such as non-contact tonometry.
Each project also contained some personal observations and suggestions. For example, one doctor reported that the hand sanitizer placed outside the office entrance repeatedly disappeared and had to be moved inside. Another described signs above the sinks in staff restrooms with favorite song lyrics to encourage 20-second hand washing. It was apparent that office staff as well as ophthalmologists were engaged in making improvements.
These projects demonstrate an inspiring degree of professionalism and passion for improvement. The ABO plans to share COVID-19 prevention project templates, as well as final project reports so that all diplomates can learn from one another. The ABO shares the diplomates’ heartfelt commitment to the safety of patients, staff, families, and communities.
Jane Bailey, MD
American Board of Ophthalmology Director