SCOTTISH DIABETIC RETINOPATHY SCREENING PROGRAMME. Follow up Protocol

Transcription

1 Follow up Protocol Version Authorised by Date of Issue 1.0 Reviewers: working groups: Clinicians Group Board Coordinators Group Service Managers Group Executive 2 nd April Changes: Section 2. Remove suspension on production of referral letter New section 4 Good Practice Reviewed by: Board Coordinators Service Managers 1.2 Updated to reflect changes to Soarian software. Removed manual procedures. 19 th Sept July 2009 Warning Document uncontrolled when printed Page 1 of 5

2 FOLLOW UP PROTOCOL 1. Introduction This document defines the current national protocol for failsafe procedures for the follow-up of eligible people with diabetes for the National Diabetic Retinopathy Screening Programme in Scotland. This is intended to ensure that all eligible patients who have been suspended are either re-included in the retinal screening programme at appropriate times or re-referred to. 2. Process for Referrals Referral to Within the Scottish Diabetic Retinopathy Screening Programme someone with a referable grade of retinopathy as recorded in the National Software Programme Soarian is automatically referred to for assessment and/or treatment by the generation of a letter. The software will at this stage sets the next examination to. Examination The Department shall examine and/or treat the person referred from the screening programme. At the first ophthalmology consultation following referral the ophthalmology department should either enter data directly into the Soarian system or return an outcome report to the Retinal Screening Administration office that referred the person with Diabetes. which includes the date of the examination if laser treatment is required/not required/done Recommendation The Recommendation gives an outcome of one of the following: Return to screening programme and re-call for screening in 12 months Return to the screening programme and re-call for screening in 6 months Continue under care of for Diabetic Retinopathy. If the patient does not attend the first or any subsequent ophthalmology appointment further appointments shall be offered to the patient in accordance with local protocols for non-attendance. Warning Document uncontrolled when printed Page 2 of 5

3 In this circumstance there shall be no change to the status of the patient in Soarian will be made and hence communication with the Service is not required. The following table describes the processes for the follow-up and the failsafes. The Soarian system version processes patient records in accordance with this protocol. Warning Document uncontrolled when printed Page 3 of 5

4 Process Status Next Examination Recall date 1 screening episode (photography or slit lamp) results in referable grade of retinopathy in at least one eye 2 Referral letter to ophthalmology generated from Soarian task list. Ready for Workflow Unchanged Soarian automatically re-sets Status and Next Examination as opposite 3 If patient attends ophthalmology then ophthalmology return a dated report with outcome options (or enters the information directly into Soarian) 1 Discharge to 6 month re-screen 2 Discharge to 12 month re-screen 3 Retain under ophthalmology review 4 If Option 1 Soarian changes as opposite Ready for Workflow Regular Re-screen Or Slitlamp (user option to select) 5 If Option 2 Soarian changes as opposite Ready for Workflow Regular Re-screen Or Slitlamp 6 If Option 3 Soarian changes as opposite Temporarily suspended Under care of ophthalmologist. 7 At subsequent ophthalmology attendances ophthalmology may return a dated report with outcome options as below (or enters the information directly into Soari. Such reports shall be returned at a minimum of once every 12 months 1 Discharge to 6 month re-screen 2 Discharge to 12 month re-screen 3 Retain under ophthalmology review These are processed as in rows 4,5,6 above Suspend until date is ophthalmology review date plus interval of 12 months (user option to select) review date plus 6 months review date plus 12 months Unchanged Warning Document uncontrolled when printed Page 4 of 5 Version 1.2 Date of Issue: 19 th Sept 2008

5 Process Status Next Examination Recall date 8 If the patient does not attend the first or any subsequent ophthalmology appointment further appointments shall be offered to the patient in accordance with local protocols for nonattendance. In this circumstance there shall be no change to the status of the patient in Soarian and hence communication to the Service is not required. 9 Failsafe A B The failsafe shall operate when a patient appears not to have attended an anticipated appointment according to information held in the system. This shall be operate in the following circumstances: On the anniversary of a referral to if no confirmation of attendance at eye clinic and the resulting outcome has been received by the System. The Soarian system shall trigger a re-referral letter on the Result Delivery Task list to the Care Provider as recorded in the patient record in Soarian a letter to the General Practitioner advising them of the re-referral. On expiry of the suspension of a patient temporarily suspended for reason of under the care of. The Soarian system shall: automatically unsuspend the patient and set their status as opposite. trigger a re-referral letter on the Result Delivery Task list to the Care Provider as recorded in the patient record in Soarian. trigger a letter to the General Practitioner advising them of the re-referral. Ready for Workflow Unchanged Ready for Workflow Unchanged Warning Document uncontrolled when printed Page 5 of 5 Version 1.2 Date of Issue: 19 th Sept 2008