Report Summary

Title: Healthcare Inspection - Evaluation of Cataract Surgeries and Outcomes in VHA Facilities
Report Number: 11-02487-158
Issue Date: 3/28/2013
VA Office: Veterans Health Administration (VHA)
Report Author: Office of Healthcare Inspections
Report Type: Healthcare Inspections
Release Type: Unrestricted
Summary: The OIG assessed: (1) whether cataract surgery care complied with VHA policies related to informed consent, time-outs, operative report timeliness, and resident supervision; (2) whether cataract surgery patients had improved visual acuity after surgery; (3) selected comorbid conditions and postoperative complications within 30 days of surgery; and (4) whether quality management processes were in place to review care and improve outcomes. We found compliance with the documentation of informed consents and resident supervision, timeliness of operative reports, and verification of the patient’s correct identity and procedural site during the time-out process. We found that patients without diabetes, glaucoma, or macular degeneration had better visual acuity after cataract surgery than patients who had one or more of these three comorbidities. However, VHA should continue to monitor and ensure consistent documentation of IOL implant verification in the EHRs for cataract surgeries. We noted the completion of the Ophthalmic Surgery Outcomes Database (OSOD) pilot project and suggest that ophthalmology leaders analyze OSOD results and disseminate associated quality improvement methods, if any, to VA cataract surgery facilities. We recommended that the Under Secretary for Health monitor and ensure consistent verification and documentation of preoperative intraocular lens implant verification in the electronic health record for all cataract surgeries and ensure analysis of OSOD data and dissemination of associated quality improvement processes to VA cataract surgery facilities.