Description: As Mayo Clinic Arizona (MCA) continues its growth initiatives, going above and beyond for each patient, the Mayo Clinic Enterprise supported advancement of the existing ophthalmology surgery practice. This included addition of a retinal care service line contributing to the goal of ensuring a comprehensive care experience for every patient. Prior to 2017, the surgery department provided ophthalmology care only for patients who presented with anterior chamber pathology, such as cataracts, glaucoma and corneal disease. Patients with posterior chamber pathology received care from established ophthalmology clinics in Phoenix. In early 2017, MCA Ophthalmology hired a retina surgeon and the satellite surgery department began the journey of building the service line. Preparation included collaborative web-based meetings with colleagues in Mayo Clinic Rochester and Florida. These conversations established a needs assessment to develop an education plan. We began classroom education, videos and lectures on pathology and surgical interventions, vendor in-services for microscopes, vitrectomy machines and supplies. In addition we initiated mock set-ups and dry runs. Our ophthalmology team: retina surgeon, surgical assistant, anesthesia providers, pre-op RN’s, post-op RN’s, surgical technologists, OR team lead, OR circulating nurses, vendors and healthcare technology management technician all contributed to the effort. Our supply chain team played a vital role in acquiring supplies, the central services team ensured that all reusable instrumentation was re- processed according to manufacturer’s instructions for use. Since go-live with our first patient, we continue to conduct pre-surgical briefings establishing this practice as essential prior to each procedure. The surgeon reviews the plan of care, including critical steps of the procedure, and the team verifies that all equipment and supplies are available. Debriefings are a useful tool to provide feedback to the team to improve care for future procedures. A designated surgical technologist volunteered to learn the specialty and precept others. Perioperative care for patients undergoing these complex retinal procedures, required tapping into past years of nursing and surgical experience. Everyone on the team enthusiastically embraced this new service line and its associated procedures including brachytherapy for melanoma, vitrectomy, and treatment for macular disease. Perioperative nursing in our outpatient surgery also requires a retinal call team. This is a change that the team continues to develop and collaborate on. Everyone agrees it was very exciting to be a part of establishing a new service line and feels we have grown as a team, sharing this knowledge with new staff. MCA patients now have access to comprehensive ophthalmology care. The ophthalmology surgeons collaborate with the retinal surgeon when the anterior and posterior eye is involved in one surgical procedure.
Co-Authors: Saule Shvarts, Carol Ritchie, Aimee Boden, Robin Georgeff