Impact of systematic capacity building on cataract surgical service development in 25 hospitals

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dc.contributor.authorJudson, Katherine
dc.contributor.authorCourtright, Paul
dc.contributor.authorRavilla, Thulsiraj
dc.contributor.authorKhanna, Rohit
dc.contributor.authorBassett, Ken
dc.date.accessioned2021-10-08T06:54:45Z
dc.date.available2021-10-08T06:54:45Z
dc.date.issued2017
dc.description.abstractBACKGROUND: This study measured the effectiveness and cost of a capacity building intervention in 25 eye hospitals in South Asia, East Africa and Latin America over 4 years. The intervention involved eye care non-governmental organizations or high-performing eye hospitals acting as "mentors" to underperforming eye hospitals- "mentees" in 10 countries. Intervention activities included systematic planning and support for training and key equipment purchases as well as hospital-specific mentoring which focused on strengthening leadership, increasing the volume and equity of community outreach, improving surgical quality and volume, strengthening organizational and financial management and streamlining operational processes. METHODS: This is a before and after observational study of the impact of this multi-dimensional process on hospital and individual productivity and financial sustainability after 4 years. Mentee hospitals reported data monthly using a standardized template. Key indicators included cataract surgery volume, cataract operations per surgeon, the proportion of direct paying cataract surgical patients, intervention program costs per additional surgery and cost per mentor. RESULTS: By the end of the study period, the hospitals experienced a 69% average increase (range: -63% to 690%) in cataract surgical volume over baseline with 12 hospitals showing increases over 100%. Twenty-three hospitals experienced a 59% average increase in the number of cataract surgeries per surgeon with 10 hospitals showing increases over 100%. The proportion of paying patients increased in 8 of the 14 hospitals reporting this data. The average mentoring cost per additional surgery for these 25 hospitals was $5.39. An average of $36,489.99 was spent per mentor per year to support their work with mentees. CONCLUSIONS: The intervention resulted in proportionally similar increases in cataract surgical volume and productivity across diverse settings in three distinct geographic regions. Its wide applicability and moderate cost make it an attractive means to rapidly and substantially increase eye care services to meet VISION2020 goals.
dc.identifier.apacitationJudson, K., Courtright, P., Ravilla, T., Khanna, R., & Bassett, K. (2017). Impact of systematic capacity building on cataract surgical service development in 25 hospitals. <i>BMC Ophthalmology</i>, 17(1), 174 - 177. http://hdl.handle.net/11427/34328en_ZA
dc.identifier.chicagocitationJudson, Katherine, Paul Courtright, Thulsiraj Ravilla, Rohit Khanna, and Ken Bassett "Impact of systematic capacity building on cataract surgical service development in 25 hospitals." <i>BMC Ophthalmology</i> 17, 1. (2017): 174 - 177. http://hdl.handle.net/11427/34328en_ZA
dc.identifier.citationJudson, K., Courtright, P., Ravilla, T., Khanna, R. & Bassett, K. 2017. Impact of systematic capacity building on cataract surgical service development in 25 hospitals. <i>BMC Ophthalmology.</i> 17(1):174 - 177. http://hdl.handle.net/11427/34328en_ZA
dc.identifier.issn1471-2415
dc.identifier.ris TY - Journal Article AU - Judson, Katherine AU - Courtright, Paul AU - Ravilla, Thulsiraj AU - Khanna, Rohit AU - Bassett, Ken AB - BACKGROUND: This study measured the effectiveness and cost of a capacity building intervention in 25 eye hospitals in South Asia, East Africa and Latin America over 4 years. The intervention involved eye care non-governmental organizations or high-performing eye hospitals acting as "mentors" to underperforming eye hospitals- "mentees" in 10 countries. Intervention activities included systematic planning and support for training and key equipment purchases as well as hospital-specific mentoring which focused on strengthening leadership, increasing the volume and equity of community outreach, improving surgical quality and volume, strengthening organizational and financial management and streamlining operational processes. METHODS: This is a before and after observational study of the impact of this multi-dimensional process on hospital and individual productivity and financial sustainability after 4 years. Mentee hospitals reported data monthly using a standardized template. Key indicators included cataract surgery volume, cataract operations per surgeon, the proportion of direct paying cataract surgical patients, intervention program costs per additional surgery and cost per mentor. RESULTS: By the end of the study period, the hospitals experienced a 69% average increase (range: -63% to 690%) in cataract surgical volume over baseline with 12 hospitals showing increases over 100%. Twenty-three hospitals experienced a 59% average increase in the number of cataract surgeries per surgeon with 10 hospitals showing increases over 100%. The proportion of paying patients increased in 8 of the 14 hospitals reporting this data. The average mentoring cost per additional surgery for these 25 hospitals was $5.39. An average of $36,489.99 was spent per mentor per year to support their work with mentees. CONCLUSIONS: The intervention resulted in proportionally similar increases in cataract surgical volume and productivity across diverse settings in three distinct geographic regions. Its wide applicability and moderate cost make it an attractive means to rapidly and substantially increase eye care services to meet VISION2020 goals. DA - 2017 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - BMC Ophthalmology LK - https://open.uct.ac.za PY - 2017 SM - 1471-2415 T1 - Impact of systematic capacity building on cataract surgical service development in 25 hospitals TI - Impact of systematic capacity building on cataract surgical service development in 25 hospitals UR - http://hdl.handle.net/11427/34328 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34328
dc.identifier.vancouvercitationJudson K, Courtright P, Ravilla T, Khanna R, Bassett K. Impact of systematic capacity building on cataract surgical service development in 25 hospitals. BMC Ophthalmology. 2017;17(1):174 - 177. http://hdl.handle.net/11427/34328.en_ZA
dc.language.isoeng
dc.publisher.departmentDivision of Ophthalmology
dc.publisher.facultyFaculty of Health Sciences
dc.sourceBMC Ophthalmology
dc.source.journalissue1
dc.source.journalvolume17
dc.source.pagination174 - 177
dc.source.urihttps://dx.doi.org/10.1186/s12886-017-0492-5
dc.subject.otherAfrica
dc.subject.otherCapacity building
dc.subject.otherLatin America
dc.subject.otherOphthalmology
dc.subject.otherSouth Asia
dc.subject.otherAfrica, Eastern
dc.subject.otherAsia, Southeastern
dc.subject.otherCapacity Building
dc.subject.otherCataract Extraction
dc.subject.otherHealth Care Costs
dc.subject.otherHealth Services Needs and Demand
dc.subject.otherHumans
dc.subject.otherLatin America
dc.subject.otherRetrospective Studies
dc.titleImpact of systematic capacity building on cataract surgical service development in 25 hospitals
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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