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Dear Readers,
Wish you a Happy New Year!
A very important way to ensure achievement of outcome is through monitoring. This helps to highlight areas of concern instead of at the end during evaluation when corrections are less possible. Monitoring is the process of being aware of the state of the system. To do this it is important we need to identify the right indicators to be monitored.
Standard protocols help us to know the correct process to follow. Whereas benchmarks help us to know where we are in comparison to the best.
Tools used in monitoring can be downloaded and you should test its practicality and application in your setting. Resources used for clinical monitoring as well as project monitoring are also shared.
The featured organisation is LIONS ARAVIND INSTITUTE OF COMMUNITY OPHTHALMOLOGY.
Wish you a productive reading!

Happy reading!
Regards,
Vision 2020 e-resource team
The Issue Features...
Monitoring In Eye Care
Vol. 5 No. 12 December 2008 and Vol.6 No.01 January 2009
•   Monitoring in Hospitals
•   Indicators
•   Standards and Benchmark
•   Tools Used Monitoring
•   Clinical Monitoring
•   Project Monitoring
•   Featured Organization

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      Monitoring in Eye care is an integral part of Hospital Management. Monitoring is about collecting information that will help us to answer questions about our organization. It is important that this information is collected in a planned, organized and routine way. We can use this information to report on our organizational process and outcome standing and it helps us to evaluate the overall performance, which is useful for us to identify the deviations from the established plan and finding quick practical solutions.
  • A FRAMEWORK AND INDICATORS FOR MONITORING VISION 2020

  • Abstract
    This article describes about indicators used for disease control like, indicators for disease burden, Cataract, Trachoma, Onchocerciasis, Refractive errors, Low vision care and childhood blindness.

  • NATIONAL INDICATORS FOR ROUTINE MONITORING OF QUALITY OF HEALTH SERVICES AT CENTRAL HOSPITAL

  • Abstract
    This link takes you to various Indicators used by Central hospital for Routine Monitoring of Quality of Health Services in their hospital.

  • MONITORING

  • Abstract
    This presentation covers overview of Monitoring, Importance of Information for monitoring, how to identify information required for monitoring and leverage IT for effective monitoring.

  • MONITORING AND EVALUATION

  • Abstract
    This presentation covers Methods for Monitoring and Supervision, Indicator steps and different ways of selecting indicators.

  • MONITORING AND CONTROL PROCESSES

  • Abstract
    This article defines how the information and processes will be used to monitor and control the project progress, quality and risks.

  • MONITORING PARTNERS ROAD TO SUSTAINABILITY

  • Abstract
    This presentation covers Overview and Importance of Monitoring and also deals with identifying information required and leveraging for effective monitoring

  • MONITORING AND EVALUATION

  • Abstract
    This information sheet looks at effective ways to monitor your work, evaluate what you do, and share results with your organisation's partners, funders and staff. It is increasingly becoming a standard requirement of most funding bodies to demonstrate how well organisations are doing, and what's working for them. It is often seen as time-consuming, and unrewarding; but done well, it can be another creative and enjoyable aspect of your work, and an invaluable system for improving your services. By following the guide, you will be able to treat it as an integral part of what you do, using resources and skills you already have.

  • APPLYING BENCHMARKING IN HEALTH

  • Abstract
    This article provides as a guide for learning the Benchmarking technique in Health Care. This article mainly focus on the benchmarking done after the Quality Assurance project handled by the Health Care Managers of Center for Human Resources.

  • MICROBIOLOGICAL EVALUATION OF VARIOUS PARAMETERS IN OPHTHALMIC OPERATING ROOMS. THE NEED TO ESTABLISH GUIDELINES

  • Abstract
    Postoperative infections can be caused by a contaminated environment, unsterile equipment, contaminated surfaces, and infected personnel as well as contaminated disinfectants. In order to establish guidelines for microbiological monitoring, a detailed microbiological surveillance was carried out in an ophthalmic hospital.

  • MEASURING HOSPITAL PERFORMANCE TO IMPROVE THE QUALITY OF CARE IN EUROPE: A NEED FOR CLARIFYING THE CONCEPTS AND DEFINING THE MAIN DIMENSIONS

  • Abstract
    This report introduced the concept of stewardship, stating that governments should ensure that their countrys health care system provides the optimal health services for its population


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      Indicators are variables that help to measure changes. They can do so directly or indirectly. The following should be considered when choosing indicators:
  • Validity implies that the indicator measures what it is supposed to measure.
  • Reliability implies that, even if the indicator is used by different people at different times and under different circumstances, the results will be the same.
  • Sensitivity implies that the indicator should be sensitive to changes in the situation or phenomenon concerned.
  • Specificity means that the indicator reflects the changes only in the situation or phenomenon concerned.

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      Standardising the clinical protocols be it for performing cataract surgery or any other diagnostic tests, in any setting-group practise or eye camp, makes high quality easier to ensure and guarantees the same standard of care for every patient. Furthermore, in a standardised setting, when an improvement or investigation needs to be made, implementing the change or the research is easy because everyone is doing the same procedure.
  • STANDARDIZED CLINICAL PROTOCOLS - CATARACT SURGICAL PROTOCOLS

  • Abstract:
    This article lists out the clinical protocols that have to be followed in the surgical procedures followed during the cataract surgery.

  • STANDARDIZED CLINICAL PROTOCOLS - OPD AND REFRACTION PROTOCOLS

  • Abstract:
    This article lists out standardized procedures that have to be followed by the OPD and the Refraction department of the Aravind Eye Hospitals.

  • DIABETIC RETINOPATHY SCREENING - CLINICAL STANDARDS

  • Abstract:
    This document introduces the NHS Quality Improvement Scotland (NHS QIS) Clinical Standards for Diabetic Retinopathy Screening. The standards focus on specific elements of screening for diabetic retinopathy and are set in the context of the Clinical Standards for Diabetes.

  • STANDARDIZED CLINICAL PROTOCOLS - OUTREACH PROTOCOLS

  • Abstract:
    This article provides the checklist of items to be taken to the camp site before leaving the hospital. It also suggests the Clinical procedure protocols that have to follow in the camp site Organized by Aravind Eye Hospitals, Madurai.

  • STANDARDIZED CLINICAL PROTOCOLS - STANDARDIZED MEDICAL RECORDS

  • Abstract:
    This article lists out the Medical record formats that have to be followed by the Medical Record Department in the Aravind Eye Hospitals.

  • STANDARDIZED CLINICAL PROTOCOLS - STERILIZATION PROTOCOLS

  • Abstract:
    This article lists out the different sterilization procedures that have to be followed in using the equipments, other clinical utilities that have to be utilized before and after surgery and also during treating the patients for eye care. It also suggests the cleaning and hygienic procedures that have to be followed by the eye care personnel while treating the patients.

  • STANDARDIZED PERSONNEL MANAGEMENT PROCEDURES

  • Abstract:
    This article lists out the procedures that have been followed by the personnel Department of Aravind Eye Hospitals while recruiting the employees in various Departments.

  • STANDARDIZED PROCEDURES FOR PURCHASE, STORES, FINANCE & ACCOUNTING

  • Abstract:
    This article lists out the standardized procedures that a have been followed during the materials management in Aravind Eye Hospitals, Madurai.

  • STANDARD CATARACT SURGICAL KIT

  • Abstract:
    This cataract kit contains the minimum and desirable equipments and medicines needed for five surgeries. The Items needed, their brand option, manufacturer, category & use, and quantity for ECCE and SICS for preoperative, intraoperative and postoperative care is given in detail that enables the user to prepare for a surgery.


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      Currently there is no proper tool available for monitoring the Eye hospital. Many hospitals are struggling without adequate tools for monitoring their hospital effectively. This can be avoided by developing such standardised Monitoring tools. This will help the hospital to achieve better results. Here are some resources on Monitoring tools for our readers.
  • VISION 2020 TOOLKIT

  • Abstract:
    This toolkit provides all relevant information to develop a VISION 2020 action plan for a district, province or a country. It will take the user stepwise through the entire planning process. At every step, links are provided to relevant documents, articles, websites, slide shows, etc. and, if relevant, a checklist is given with action to be taken. All material on this CD can be viewed, printed and shared.

  • MONITORING CATARACT SURGICAL OUTCOMES: METHODS AND TOOLS

  • Abstract:
    This article details the methods of assessing cataract surgical outcomes and the tools used for this along with guidelines for quality assessment.

  • MONITORING CATARACT SURGICAL OUTCOMES: COMPUTERISED SYSTEMS

  • Abstract:
    This article focuses on the need for monitoring cataract surgical outcomes through computerized systems with details on how to monitor it.

  • INFORMATION SYSTEM FOR EFFECTIVE MANAGEMENT, MONITORING AND EVALUATION

  • Abstract:
    This article briefs how the Information Systems paves way for the effective path in effective management, monitoring and evaluating the Ophthalmic Services.

  • RETURN ON INVESTMENT - WEB BASED FINANCIAL PLANNING TOOL FOR PAEDIATRIC DEPARTMENT

  • Abstract:
    To find out the pay back period for the investment made on the paediatric eye department based on its workload and also helps you to estimate the annual patient load required to sustain the project

  • MANAGING INFORMATION SYSTEM KEY TOOLS FOR CEOS

  • Abstract:
    This article tells in detail how the MIS plays a vital role in planning, designing and monitoring the statistical analysis of the organizational performance. It provides hands-on tools for the CEOs of the organization. This article also tells in detail about the key areas the CEOs have to follow in managing the organizational performance

  • FINANCIAL RATIOS MANAGEMENT TOOL

  • Abstract:
    This article describes how the financial ratios helps as Management tool to measure the strengthen and the weakness of the Organization.

Clinical Monitoring
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      Constant monitoring and assessment of various functions maintains quality control. There should be a formal system of evaluation in place. For example, at Aravind eye hospitals, quality checks on surgery are maintained by a detailed computerised record that includes details of a surgeons hourly surgical output and intraoperative complications.
      Holding regular staff meetings to assess and discuss performance and to plan further strategies helps a programme to evolve with the demand. For example, at Aravind, monthly infection control meetings are arranged by the Chief Medical Officer in coordination with the nursing supervisor. The meetings, attended by all doctors and paramedical staff, serve as check to ensure that intraoperative and postoperative complications and infections that arise are within internationally acceptable limits. Each infection is discussed in detail with the nursing supervisor.

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      A project is a series of activities (investments) that aim at solving particular problems within a given time frame and in a particular location. The investments include time, money, human and material resources. Before achieving the objectives, a project goes through several stages. Monitoring should take place at and be integrated into all stages of the project cycle.

Steps for Project Monitoring:
  1. Keep it simple
    Remember monitoring is meant to be a help to good project management and not a burden.
  2. Objectives
    Work out clearly at the beginning the objectives of the project, including a budget of the likely cost (expenditure).
  3. Plan the activities
    • what needs to be done
    • when it should be done
    • who will be involved in doing it
    • what resources are needed to do it
    • how long it will take to do
    • how much it will cost.
  4. Monitoring
    Work out the most appropriate way of monitoring the work - again, keep it simple:
    • meetings
    • diaries
    • reports on progress
    • accounts, reports on finances.

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LIONS ARAVIND INSTITUTE OF COMMUNITY OPHTHALMOLOGY (LAICO)

"Eye care services do not operate in a vacuum. Rather, it should be viewed in the broader context of the society for which it is intended. Hence, development of skilled manpower oriented to the needs of the community is vital in our crusade against needless blindness. In contrast to an individualised health-care system, a community approach to eye care aims at improving the eye health of the entire community."
- Dr. G. Venkataswamy

      Originating from that inspired vision two decades back, Lions Aravind Institute of Community Ophthalmology (LAICO) became a reality in 1992. LAICO, established with the support of the Lions Club International SightFirst Programme and Seva Sight Programme, is Asias first international training facility for blindness prevention workers from India and other parts of the world.
      Driven by a mission to contribute to the prevention and control of global blindness, the institute trains health-related and managerial personnel in the development and implementation of efficient and sustainable eye care programmes. It accomplishes this objective through the broad environment of Aravind Eye Hospitals and Aravind Medical Research Foundation The main activities of the institute are capacity building of other eye hospitals, training programmes: clinical and non-clinical, research activities and projects, publications, advocacy and contribution to eye care programmes at national and international level through the Government and International NGOs.
Consultancy is carried out through the following phase:
  • Needs Assessment Visit
  • Vision Building Workshop
  • Follow-up Visit
  • Monitoring

Visit our website : www.laico.org