Cataract National Data Set
Cataract National Data Set for Adults undergoing routine cataract surgery Published as an ISB inherited Data Set
The Royal College of Ophthalmologists is the content sponsor for the Cataract National Data Set. The data set was approved in April 2010 by the Information Standards Board (ISB) as an inherited information standard based on good evidence of its use a) in electronic cataract care records and b) to support national audit, benchmarking, research, and quality improvement. It is approved for use for those purposes within units providing cataract surgery. However, some amendments are required to fully align the data set with other Information Standards as specified in the Data Dictionary and to make it fit for use to communicate information between systems i.e. for interoperability. The data set specification is also published on the ISB website.
The primary purpose is to provide a data set to cater for the information needs of health care professionals caring for patients with cataract. The full cataract care pathway is covered, including information required at referral (level of vision, co-morbidity, medications), ophthalmological clinical assessment (details of ocular examination), preoperative assessment (ocular biometry, fitness for anaesthesia, fitness for surgery), anaesthesia (type of anaesthetic), surgery (details of procedure, any complications), postoperative treatments and recovery (eye drops, postoperative events) and visual rehabilitation (refractive and visual outcomes).
Indirect benefits will accrue due to the ability of electronic systems to automatically analyse the routinely collected data to risk assess individual patients in terms of the likelihood of a surgical complication. This risk stratification process will facilitate the process whereby the most complex and highest risk surgery is performed by the most experienced surgeons, a strategy which can minimise the absolute numbers of patients who experience a surgical complication.
Secondary uses for the standard will include benchmarking of outcomes for services as a whole and for individual surgeons. These form important clinical governance components in terms of quality assurance at institutional and surgeon levels. Future “Trust Quality Accounts” and revalidation for surgeons would be greatly facilitated by standardised data being collected routinely as a by product of clinical care.
The cataract national data set is intended as a public resource available to all. Maintenance of the content through regular review will be by one of the sponsors: The Royal College of Ophthalmologists. The data set working group of the College IT and Audit Sub-committee is able to undertake this regular review work which should be linked to relevant College Guideline reviews. Future review of the data set alongside the scheduled reviews of the Royal College of Ophthalmologists cataract guideline will ensure that data elements remain relevant and up to date.
There remains a responsibility of suppliers and deploying organisations to ensure that the content of the data set is correctly used in line with NHS information governance, conformance testing and risk management policies.
The Royal College of Ophthalmologists will undertake to review the data set every 3-4 years alongside the updating of its cataract surgery guideline. Changes will be fed through the ISB data set change process. Suppliers and end users will be able to contact the Royal College of Ophthalmologists whose IT and Audit Sub-committee will be responsible for receiving, logging and risk assessing requests for change. Lower risk requests will be considered at the next scheduled review as part of the expert review process linked with review of the College cataract guideline. High risk requests (where patient safety is at issue) will be acted upon without delay through chairman’s action.
The Sub-committee chair (personally or by delegation) will be responsible for ensuring that any reported high risk issues are considered and acted upon promptly without awaiting a scheduled review. Where the expert group considers that change is necessary a change notice will be initiated as usual according to established practice.
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