A new resource developed by the pediatric ophthalmology community is now available on the American Board of Ophthalmology’s Improvement in Medical Practice Menu for Continuing Certification. A customizable template for an amblyopia-focused improvement project can be implemented with or without access to the American Academy of Ophthalmology’s IRIS® Registry database.
Below, American Academy of Pediatric Ophthalmologists (AAPOS) Executive Vice President Christie Morse, MD, and AAPOS Liaison to the ABO Faruk Orge, MD, explain how to use this tool in solo practice or with a group to measure and improve amblyopia outcomes in pediatric patients.
Q. Who is the ideal “user” for this project template?
A. Any pediatric ophthalmologist who sees a significant population of patients with amblyopia is a good match for this project— access is not limited just to AAPOS members. Whether you’re practicing in an academic setting or working in a group or solo practice, this template can work for you. If you don’t typically treat amblyopia or you’re practicing in another subspecialty area, choosing another template or creating your own project would be a better choice.
Q. What will I need to measure?
A. For non-IRIS registry users, the template will ask you to look at 20 consecutive patients with newly diagnosed amblyopia. (Registry users will work with the available system data.) Depending on the outcome measures you select, you’ll be providing baseline data about visual acuity and interocular difference in acuity.
Specifically, the project starts with determining the percentage of newly diagnosed patients with amblyopia with best corrected visual acuity of 20/50 or worse in the amblyopic eye. You’ll then choose one or more of the following scenarios:
· A best corrected interocular visual acuity difference < 2 Snellen/Sloan/Lea/HOTV lines 3-12 months after first diagnosis of amblyopia
· An improvement in the corrected visual acuity of the amblyopic eye of 3 or more Snellen/Sloan/Lea/HOTV lines 3-12 months after first diagnosis of amblyopia
· A final visual acuity in the amblyopic eye equal to 20/40 or better 3-12 months after first diagnosis of amblyopia
Q. What if I don’t have access to the IRIS Registry?
A. All you will need is access to your own data. There are two versions of the project template to help support diplomates who are practicing in different environments, so if you are not plugged into the IRIS Registry, you can still complete this activity using the non-IRIS version of the template.
Q. What kinds of interventions will the project require?
A. Possible intervention strategies include changes in procedures or policies, such as the introduction of scheduled phone check-ins to improve compliance with treatment or follow-up; increased amblyopia treatment education by the ophthalmologist, orthoptist, or clinic staff; or use of a patient portal to message the family of patients who are being treated for amblyopia, with the aim of improving adherence to therapy. Other strategies may include the use of handouts, such as those created by the AAPOS, to educate parents about patching or atropine. You will be asked to describe your proposed interventions and then document the results.
Q. Do I have to demonstrate a certain rate of improvement to receive Continuing Certification credit from the ABO?
A. No, the idea behind this and other Improvement in Medical Practice projects is to help you integrate quality improvement methods into everyday practice. By learning how to measure, introduce interventions, and then re-measure outcomes, you can apply these skills to any aspect of your practice that you may be interested in studying and improving.
Q. Will the ABO or AAPOS share my practice data with others?
A. No. Your template submission will remain confidential unless you give the ABO permission to share your project with other diplomates for reference.
Q. How do I access, edit, and submit the project template?
A. Log into your Status Page on the ABO website and scroll to the Improvement in Medical Practice section. Select the Amblyopia project from the list and complete the online application form. Once your application has been reviewed and accepted, you’ll have access to the second phase of the project template, which is where you will record your final outcomes.
Q. How long will the project take to complete?
A. You’ll select an improvement and re-measurement period that is anywhere from 3-12 months in length, so you’ll want to plan in advance if your certification deadline is approaching. To record the data on the project form and complete a thoughtful analysis of your results, anticipate 1-3 hours of time.
Q. Will I receive any CME credit for completing the project?
A. At this time, CME credit is not available for completing an amblyopia improvement project; however, you will receive full credit for completing one Improvement in Medical Practice Project for ABO Continuing Certification.
Q. I’m not a pediatric ophthalmologist, but I like the idea of this template. Can templates for other specialties be created?
A. Yes, contact your subspecialty society’s leadership team and ask them to work with the ABO to create a similar template relevant to your practice. Alternatively, you can take the lead on creating your own project template and submit it to the ABO.
Q. If I need help filling out the application or working through my data, what should I do?
A. Contact ABO Staff Member Sheila Refile at 610-664-1175 or firstname.lastname@example.org.