A hospital in Tipperary leads the way in care for patients with cataracts

The dedicated Cataract Clinic (DCC) for ophthalmology outpatients at Nenagh Hospital has emerged as a leading centre for cataract surgery pre-assessment, with more than 40% of patients having surgery within a month of consultation, and 90% undergoing their operations within four months

A GP-referral service, and the only one of its kind in Ireland, the DCC was established in July 2022 at the hospital’s modern Lough Derg suite alongside five other eye clinics (laser, intra-vitreal injections, post-operative review, pre-op assessment, and a day clinic for routine appointments).

The DCC runs twice monthly, each appointment providing patients with a consolidated, comprehensive range of tests and examinations—including consultant appointment—that traditionally would have required multiple visits.

“We’re very excited about what we’re providing for our patients, which is revolutionising patient care while reducing waiting times,” said Adebusola Owokole, Perioperative Clinical Nurse Manager (CNM2) in the Ophthalmology Department.

She added: “The DCC has brought together and streamlined processes into a single-day, single-location service that raises the standard of surgical pre-assessment excellence, improves the wait time for surgery, and helps ensure a satisfactory outcome.”

Led by Consultant Ophthalmologist Mr Conall Hurley, the DCC’s multidisciplinary team includes a senior medical and nursing staff, an optometrist, healthcare assistants and administrative support.

In its first 12 months, up to July 2023, the DCC organised a total of 23 clinics, seeing approximately 12-15 patients per clinic.
Of the 253 patients who attended, 27 were not called for surgery, and 203 (89.8%) had their surgery within four months. Of these patients:
43.7% had surgery within 1 month of DCC appointment:
- 20.3% - within 1-2 months
- 25.7% - within 2-3 months
- 10.3% - within 3-4 months.

The remaining 23 patients had surgery in more than four months, with the most common reason being delayed anaesthetic pre-assessment, highlighting an area for potential process improvement that has since been solved by providing anaesthetic pre-assessment on the same day of the clinic.

Prior to the implementation of the DCC Model, most cataract patients had average wait times of two to four years for the procedure. Since the opening of the stand-alone, high-volume, consultant-led DCC in Nenagh in July 2022, the total number of patients waiting for a procedure has reduced from 647 to 131.

The number of patients waiting longer than 12 months has decreased from 134 to just 10 and the average wait time for patients on the day case waiting list has reduced to four months - and continues to fall.

Ms Owokole says the comprehensive single-patient process has earned the DCC a unanimously positive reaction from patients. She revealed that recent surveys have delivered a 100% satisfaction rating among respondents.

Consultant Ophthalmologist, Mr Conall Hurley, explained that the DCC service was set-up in July 2022 with a view to streamlining the cataract service.

“The design of the clinics purposely amalgamated three visits into one, thereby making the preparation for cataract surgery much smoother for the patients and reducing workload for staff.

“The design also facilitated the more rapid delivery of the surgery than had been the case for many years heretofore. A recent audit has clearly demonstrated that the intended efficiencies have been delivered to date.

"We will continue to strive to maintain the pace of delivery whilst also continuing with a rolling audit cycle in order to ascertain if further efficiencies can be incorporated into the DCC service.“