Reducing the Waiting Time for Retinopathy of Prematurity Evaluation—A Quality Improvement Interventional Study

Abstract

Aim To reduce the waiting time of babies for retinopathy of prematurity (ROP) evaluation at a tertiary care paediatric centre in Rajasthan and check its impact on follow-up. Methods It was a Quality improvement (QI) interventional study in which a QI team was made. A Fishbone root cause analysis after 1 month of observation was done to understand the reasons for the high waiting time for ROP screening in both IPD and OPD. This was followed by three plan-do-study-act (PDSA) cycles: segregation of the IPD & OPD patients by fixing two separate days and hiring a full-time paediatric ophthalmologist; distribution of informative digital/printed leaflets; timely reporting of staff, dilation of pupils, equipment availability and proper examination order. Average waiting time and maximum waiting time were measured before and after the PDSA cycles. Results After the completion of all PDSA cycles: Overall maximum waiting time for OPD and IPD patients was reduced from 130 and 138 minutes to 96 (26.2%) and 97 minutes (29.7%), respectively. The average waiting time for OPD and IPD patients was reduced from 96.2 and 92.4 minutes to 76.5 (20.5%) and 73.4 minutes (20.6%), respectively. The number of patients coming for ROP follow-up also increased. Conclusion The QI initiative using the point of care QI model (POCQI) was quite effective in reducing the maximum and average waiting time of babies undergoing ROP screening. It also increased their follow-up at our centre.