Abstract
ObjectivesTo investigate the impact of standardisation of the perioperative protocol based on the Joint Commission International (JCI) accreditation guidelines for operating time in cataract surgery.DesignRetrospective observational study.SettingSingle centre in Japan.ParticipantsBetween March 2014 and June 2016, 3127 patients underwent cataract surgery under topical anaesthesia including 2581 and 546 patients before and after JCI accreditation, respectively.Primary and secondary outcomesWe compared three time periods, comprising the preprocedure/surgery time (pre-PT), PT and post-PT, and total PT (TPT) of cataract surgery between patients before and after JCI accreditation, by regression analysis adjusted for age, sex and cataract surgery-associated confounders.ResultsThe main outcomes were pre-PT, PT, post-PT and TPT. Pre-PT (19.8±10.5 vs 13.9±8.5 min, p<0.001) and post-PT (3.5±4.6 vs 2.6±2.1 min, p<0.001) significantly decreased after JCI accreditation, while PT did not significantly change (16.8±6.7 vs 16.2±6.3 min, p=0.065). Consequently, TPT decreased on average by 7.3 min per person after JCI accreditation (40.1±13.4 vs 32.8±10.9 min, p<0.001). After adjusting for confounders, pre-PT (β=−5.82 min, 95% CI −6.75 to −4.88), PT (β=−0.76 min, 95% CI −1.34 to −1.71), post-PT (β=−0.85 min, 95% CI −1.24 to −0.45) and TPT (β=−7.43 min, 95% CI −8.61 to −6.24) were significantly shortened after JCI accreditation.ConclusionPerioperative protocol standardisation, based on JCI accreditation, shortened TPT in cataract surgery under local anaesthesia.