Conformance with preferred practice patterns in caring for children with esotropia.

PURPOSE: To evaluate documentation of the initial evaluation in patients with esotropia, with respect to history, physical examination, care management, and patient education, for the presence of key elements as defined in the American Academy of Ophthalmology's Summary Benchmarks for Preferred Practice Patterns. METHODS: Two hundred charts of patients seen at the Pediatrics Service at the Duke Eye Center for an initial diagnosis of esotropia were reviewed relative to both the 2002 (all patients) and 2007 (for those seen in 2007) Preferred Practice Patterns benchmarks for esotropia. Documentation of key elements as defined in the Preferred Practice Patterns was recorded. RESULTS: The average total score was 85.8% for all evaluations. On average, 63.6% of the initial history key elements, 99.6% of the initial physical examination key elements, and 94.2% of the care management and patient education key elements were documented. For evaluations performed in 2007 and scored according to the 2007 Preferred Practice Patterns, scores were similar, except that the physical examination subset score average decreased to 90.3% and the family history documentation score increased to 45.5%. CONCLUSION: In an academic practice, the process quality of care for strabismus often conforms well to professional practice patterns. However, there are opportunities for improvement in the documentation of key history elements. Additional data are needed from other practice settings and for other conditions to assess the quality of eye care for children.

Duke Scholars

Author Sharon Fridovich Freedman Ophthalmology

Author Paul Pue-Jung Lee Ophthalmology, Glaucoma