Abstract
Background The treatment of macular edema with intravitreal injections has revolutionized the
treatment of associated diseases in ophthalmology. However, with a few exceptions,
this is a chronic treatment where patients require many injections and usually need
to stay in treatment for years. Patient adherence and control of patient flow are
critical to treatment success. In this manuscript, we describe the development of
a patient-oriented organization management for intravitreal injections in a university
hospital.
Material and Methods In 2015, the intravitreal treatment in our clinic was switched to the treat-and-extend
regime. At the same time, the optimization of the previous organizational processes
in perioperative management was evaluated. For the period 2015 to 2018, we analyzed
and gradually optimized the procedures of our intravitreal injection therapy in a
survey with a specialized service provider.
Results Through the analysis of the original processes, the patient appointment was optimized,
work processes were summarized, spatially reorganized and there was only a slight
increase in the number of staff involved compared with the significant increase in
the number of injections. Through these measures, the total in-hospital-time of the
patients could be drastically reduced and at the same time the number of patients
on one operation day could be multiplied.
Conclusion In the context of chronic treatment with intravitreal injections, the care of an
increased number of patients is a logistical challenge. By optimizing processes, existing
resources can be better used to meet the increased demands. An optimized system offers
the patient greater adherence and a better visual outcome largely independent of the
medication used.
Key words anti-VEGF - macular edema - intravitreal injections - treat-and-extend - patient management
- retina
