1. ARAVIND EYE CARE SYSTEM Aravind Eye Hospital & Postgraduate Institute of Ophthalmology ARAVIND EYE CARE SYSTEM Aravind Eye Hospital & Postgraduate Institute of Ophthalmology DEPARTMENT OF COUNSELLING Importance of counselling in community outreach programme

2.  Outreach plays a vital role in reaching out the unreached poor blind people in rural areas  The main objective of the camp is to create awareness among the people which pares the way for intervention to clear the backlog of avoidable blindness  Every patient has hundreds of questions to ask while they undergo screening for eye problems and later treatment  Counselling helps the patients tremendously to take decision on accepting surgical or medical treatment Cont…

3.  A doctor or paramedical staff cannot spend more time, with the patient to explain the nature of the eye problems, clear their doubts and educate them to follow up the required medication  It is a phychological, process that patient wants the doctor to spend more time whether it is a base hospital or a rural eye screening camp to attend their problems. Clarify the doubts and fulfill their needs  Hence it is the responsibility of counsellors to communicate to the patient the need and importance of eye care etc

4. The concept of introducing patient – counselling has the following major aspects  Health education in eye care  Increase the level of patient satisfaction  Optimum utilization of resources

5. Role of counsellor in outreach programs  In a screening eye camp, the patient undergo various clinical examinations and finally the ophthalmologist advise for  Cataract Surgery  A pair of Spectacles  Medicines  Speciality treatment in base hospital

6.  The medical team attending the screening eye camp should have a place for counselling and a a counsellor is a part of the medical team  Reducing the work load of the doctors and Mid Level Ophthalmic Personnel (MLOP), to enable them to spend their time more efficientlly in clinical activities  Not willing handling  Patients satisfaction  Surgery acceptance rate  Spectacles acceptance rate  Specially referral acceptance rate  Surgery follow up acceptance rate

7. The productivity of the camp in terms of number of admissions, acceptance of spectacles and speciality referrals highly depends upon the counsellor’s communication skills.

8. Responsibilities of a counsellor in base hospital   Counsellor is to continue the counselling in the base hospital also in different stages of in patients services   More importantly, they should talk to the group of admitted patients just prior to surgery regarding the duration and type of surgery in order to reduce their fear and anxiety   Counselling should be continued even after surgery in the ward regarding the post operative medication during their stay in the hospital Cont…

9.  They should also talk to them how to maintain the hygiene to prevent any kind of infections after they go back to their villages  The counsellors have to be aware of discharge details and follow up details  Usually follow up is done after 4 weeks of surgery  The counsellors should make a point on the date and venue of follow up to the discharge summary for all the patients Cont…

10.  During the post operative stay, they should explain the importance of follow up which will help to attain a high level follow up acceptance rate  If any one is not co - operated upon the counsellor has to collect the valid reason and record the information  Surgery drop out is one of the important factors which influence the cost of surgery Cont….

11.  The counsellor should be able to collect and submit the particular to outreach payment after each camp  The medical records or cash sheets are the main source of information  On the arrival at the base hospital, the counsellor should refer all the case sheets and categorise the information of report generation

12. The following information should be collected for each camp to evaluate the quality and productivity of the camp This also helps to match with pre-set performance indicators  The number of patients screened on the camp day (includes defective and normal patients who attend the camp as out-patients)  Age and Gender break up of out patients  Diagnosis details (disease wise category of out patient) Cont….

13.  The number of patients advised for cataract surgery. (The cataract condition may be early immature or mature stage. It is good to have immature and mature cataract patient noted separately)  Cataract surgery acceptance rate (number of patients advised for cataract V s number of patients admitted for surgery)  The reasons of patients for not accepting surgery  The number of patients advised for spectacles and spectacles acceptance rate Cont…

14.  Patients diagnosed with speciality problems like glaucoma, retina, childhood blindness etc  The number of patients attended the camp with eye defects (cataract, refractive errors and speciality problem together)  The number of patients required and advised for further medical intervention in the base hospital  The number of patients who agreed to come to the base hospital for speciality treatment Cont…

15.  Details of patients operated on and discharged  The number of operated patient who attend the follow up camp and follow up acceptance rate ( if should be furnished after the follow up camp is conducted) All the above information is interpreted to monitor the performance of outreach activity in a very scientific manner. This significant role of counsellor helps to improve the total quality management of outreach eye care services