Eye Care in Action: Optometry in Aboriginal health services
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1 Eye Care in Action: Optometry in Aboriginal health services Anna Morse & Luke Arkapaw Public Health Division
2 Brien Holden Vision Institute A multidisciplinary collaborative global research, development, commercialisation and education organisation focused on developing breakthrough solutions that will improve the quality of vision for all. Public Health Division Formerly ICEE (International Centre for Eyecare Education)
3 Overview 1. The Gap in Eye Health 2. Program Overview 3. Key Partnerships 4. Current Research 5. Education Activities 6. Eye Health Promotion
4 A little about ourselves...
5 The Gap in Eye Health Indigenous children: vision loss 5x less common Indigenous adults: Blindness rates: 6.2 x higher 39% cannot read normal sized print
6 Causes of vision loss - blindness Preventable
7 Causes of vision loss - blindness Preventable
8 Causes of vision loss - vision impairment
9 Refractive Error Half of vision loss is due to uncorrected refractive error (simply needing glasses)
10 Blinding cataract Blinding cataract: 12 x more common Range of factors lower rates of cataract surgery, and tendency for surgery to happen later than it should
11 Diabetic Eye Disease 37 % of Indigenous adults reported having diabetes 13% of those with diabetes have visual impairment
12 Trachoma Endemic trachoma still occurs unabated in many outback communities Programs running through CDC WHO photo
13
14 The Gap in Eye Health Overall, 94% of vision loss is preventable or treatable, yet 35% of Indigenous adults have never had an eye exam.
15 Barriers to Eye Care Services Limited accessibility of regular eye & vision care services due to remoteness Workforce distribution Reluctance to access mainstream services in urban settings Cultural insensitivities Public awareness Perceived cost
16 Program Overview Goals & Objectives: Increased awareness of and access to eye care services Contribute to alleviating avoidable blindness and visual impairment in Indigenous communities
17 The Institute s Aboriginal Vision Program
18 The Institute s Aboriginal Vision Program
19 The Institute s Aboriginal Vision Program A model for sustainable and culturally appropriate eye care services in Aboriginal communities: AMS & CHCs Outreach optometry clinics (DIDO / FIFO)
20 The Institute s Aboriginal Vision Program Circuit-style provision of services Funding support through: Visiting Optometrists Scheme (Dept of Health & Ageing) Medicare Office of Aboriginal & Torres Strait Islander Health
21 The Institute s Aboriginal Vision Program The program continues to grow 2011 NSW NT Locations Visited ~110 ~70 Patients Seen Spectacles Dispensed Ophthal. Referrals
22 The Institute s Aboriginal Vision Program * * 2012 until Oct
23 Optometrists Short-term contracted Staff Locum and local Key Partnerships
24 Key Partnerships Regional Eye Health Coordinators Provide cultural link between service providers and communities
25 Key Partnerships Aboriginal Medical Services and Government Health Clinics
26 Key Partnerships Ophthalmologists District Medical Officers Local PHC Staff
27 Other NGOs Key Partnerships Low Cost Spectacle Scheme Research organisations - (Vision CRC)
28 Current Research Vision CRC: Models of vision care delivery for Aboriginal and Torres Strait Islander communities ( ) CRC members official collaborators : AH&MRC (and Aboriginal Health College) Lowitja Institute Optometrists Association Australia Prof. Hugh Taylor VisionCare NSW Vision 2020 Australia
29 People we re working with Other partnerships / consultation with: - AMSANT - ACCHOs (NSW & NT) - IEHU - CSHISCH - ATSIHRTONN - NSW Health - Menzies - NT Dept Health - FHF - OES - NintiOne - AHC - One21Seventy
30 Research Primary Goal is useful, practical tools for improved regional eye care programs in Aboriginal & Torres Strait Islander communities. Primary Outputs: 1. CQI Toolkit for eye & vision care 2. Eye Systems Training Package for health services 3. National Endorsed Training Package for REHCs 4. Advocacy work / position paper on spectacle schemes
31 GUIDING PRINCIPLES Focus on improving system gaps in the eye care pathway Learn about barriers to access from patient perspective to inform the required case management approach Simple, non-complicated guidelines and system changes Link with broader approaches/systems, embed with PHC Keep findings translatable: refine and recommend for broader adoption by other Aboriginal & Torres Strait Islander health services, nationally
32 CQI Approach Continuous Quality Improvement: Tangible framework to operationalise improvements to eye care at PHC level Methodology: working with Menzies (One21Seventy) and directly with CQI staff of ACCHOs for: Baseline data collection & analysis File audits Exploratory data analysis
33 Patient Perspectives Case studies of a selection of cases representing completion and non-completion of pathways of care for: Diabetic retinopathy Cataract Refractive error Linked to audited files (to identify cases) Exact methodology to be jointly developed with NintiOne and their Aboriginal community researchers.
34 Work with ACCHOs in NT & NSW: Regional Models Analyse current practice in eye care Implement improvements staff training CQI System supports for improved referral pathways & case management Measure for effect Refine and recommend for broader adoption Link with broader approaches/mechanisms, e.g.: CSHISC - nationally Accredited ATSIHP training curriculum Medicare Locals regional health service planning One21Seventy CQI tools
35 Education Activities Primary Eye Care Workshops
36 In-Service Training Education
37 Education Cultural Awareness Training
38 Education REHC training programs
39 Education Student Preceptorships
40 Eye Health Promotion Impromptu Promotion..
41 Promotional Posters Health Promotion
42 Health Promotion Banners for visiting clinics
43 Health Promotion I See For Culture Kits Flip-charts (x2) Posters (x2) Model eye Simulator masks Instruction manual
44 Questions?
45
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