1. «Ensuring earlier visual rehabilitation for patients with visual loss» Mona Nordvik Nurse and Quality coordinator Department of Ophthalmology Haukeland University Hospital Bergen, Norway

2. WHAT IS VISUAL REHABILITATION? Restoring functional ability, and improving quality of life and independence in an individual who has lost visual function through illness or injury Low vision: visual impairment which cannot be fully recovered with glasses, medical treatment or surgery 2/3 of people with visual impairment are over 65 years Examples of patient target groups: AMD, glaucoma, cataract, diabetic retinopathy, retinitis pigmentosa, stroke, injury

3. BACKGROUND In Norway it has been estimated that it takes up to 5 years before the patient starts visual rehabilitation Referral pathways for visual rehabilitation are not straight forward Visual rehabilitation offered outside of the hospital system in Norway

4. AIMS Facilitate earlier visual rehabilitation Increase awareness and knowledge about rehabilitation options amongst healthcare professionals at our clinic

5. METHODS Quality improvement project: Patient focused redesign Current patient care pathway was described and analyzed, improved pathway designed and our guidelines updated Multidisiplinary team of hospital personell and external cooperation partners from the service of visual rehabilitation

6. RESULTS: Development of a multi-purpose form for our electronic health record system Guide health care professionals to the right rehabilitation option for a particular patient Acts as a common referral form and includes all information needed for the different rehabilitation options

7. IS THIS PATIENT IN NEED OF VISUAL REHABILITATION?

8. SCREENING OF VISUAL FUNCTION

9. REFERRAL AND CONTACT INFORMATION

10. IMPLEMENTATION OF THE NEW REFERRAL PATHWAY INCREASED AWARENESS AND KNOWLEDGE ABOUT REHABILITATION OPTIONS Webpage about Visual rehabilitation options and referral Development of an electronic learning program about visual rehabilitation for healthcare professionals Updated guidelines in the electronic quality handbook at the ophthalmology department

11. VISUAL LOSS AND MENTAL HEALTH Patient feedback from a quality improvement project carried out by our Head of Department: «In the footsteps of the patient» Application for funding to a interdisciplinary quality improvement project about visual loss and mental health, including nurses trying out self-reported measures of mental health in subgroups of patients.

12. THANK YOU:  The Norwegian Directorate of Health  The Ophthalmology Department, Haukeland University Hospital  The Research and development department (FoU), Haukeland University Hospital  The Norwegian association of the blind and partially sighted (NABP)  Centre of Habilitation and Rehabilitation in Western Norway  Community nursing, Bergen municipality  Visual and auditory services Hordaland (SAPT)  Statped Western Norway  Adult teaching service, Bergen municipality