the diabetic retinopathy eye screening grading tool · virgin care private and confidential where...
TRANSCRIPT
![Page 1: The Diabetic Retinopathy Eye Screening Grading Tool · Virgin Care private and confidential Where we are now •The Grading Tool is now being used in the Surrey Diabetic Eye Screening](https://reader033.vdocument.in/reader033/viewer/2022052804/5f8d74395e235714686f3c1b/html5/thumbnails/1.jpg)
The Diabetic Retinopathy Eye Screening Grading Tool
By Nicholas Barclay
Senior Screener Grader with the Surrey NHS Diabetic Eye
Screening Programme
![Page 2: The Diabetic Retinopathy Eye Screening Grading Tool · Virgin Care private and confidential Where we are now •The Grading Tool is now being used in the Surrey Diabetic Eye Screening](https://reader033.vdocument.in/reader033/viewer/2022052804/5f8d74395e235714686f3c1b/html5/thumbnails/2.jpg)
Virgin Care private and confidential www.virgincare.co.uk
My background
2
• Each month I screen over 400 patients
![Page 3: The Diabetic Retinopathy Eye Screening Grading Tool · Virgin Care private and confidential Where we are now •The Grading Tool is now being used in the Surrey Diabetic Eye Screening](https://reader033.vdocument.in/reader033/viewer/2022052804/5f8d74395e235714686f3c1b/html5/thumbnails/3.jpg)
Virgin Care private and confidential www.virgincare.co.uk3
… and Grade more than 450 patient images
![Page 4: The Diabetic Retinopathy Eye Screening Grading Tool · Virgin Care private and confidential Where we are now •The Grading Tool is now being used in the Surrey Diabetic Eye Screening](https://reader033.vdocument.in/reader033/viewer/2022052804/5f8d74395e235714686f3c1b/html5/thumbnails/4.jpg)
Virgin Care private and confidential www.virgincare.co.uk
What drives me
4
![Page 5: The Diabetic Retinopathy Eye Screening Grading Tool · Virgin Care private and confidential Where we are now •The Grading Tool is now being used in the Surrey Diabetic Eye Screening](https://reader033.vdocument.in/reader033/viewer/2022052804/5f8d74395e235714686f3c1b/html5/thumbnails/5.jpg)
Virgin Care private and confidential www.virgincare.co.uk
My story
2015: attended a Service Improvement Facilitators course run by
Virgin Care, which included Nurses, Managers, Clinicians and me a
Screener Grader.
Aim of the course :
• To develop service improvement ideas that would have significant
benefits for our patients.
• Ensure that good ideas are not lost but developed correctly and
implemented well.
First step: each delegate to come up with their own Service
Improvement idea to use on the course.
5
![Page 6: The Diabetic Retinopathy Eye Screening Grading Tool · Virgin Care private and confidential Where we are now •The Grading Tool is now being used in the Surrey Diabetic Eye Screening](https://reader033.vdocument.in/reader033/viewer/2022052804/5f8d74395e235714686f3c1b/html5/thumbnails/6.jpg)
Virgin Care private and confidential www.virgincare.co.uk
I discussed three ideas with my Programme
Manager and I was inspired by remembering the
digital surveillance idea which was adopted in our
Common Screening Pathway.
6
Yes!
Grading
Tool
My ideas were ...
![Page 7: The Diabetic Retinopathy Eye Screening Grading Tool · Virgin Care private and confidential Where we are now •The Grading Tool is now being used in the Surrey Diabetic Eye Screening](https://reader033.vdocument.in/reader033/viewer/2022052804/5f8d74395e235714686f3c1b/html5/thumbnails/7.jpg)
Virgin Care private and confidential www.virgincare.co.uk7
• Improved occluder – more hygienic and no
moving parts.
Idea 1
![Page 8: The Diabetic Retinopathy Eye Screening Grading Tool · Virgin Care private and confidential Where we are now •The Grading Tool is now being used in the Surrey Diabetic Eye Screening](https://reader033.vdocument.in/reader033/viewer/2022052804/5f8d74395e235714686f3c1b/html5/thumbnails/8.jpg)
Virgin Care private and confidential www.virgincare.co.uk8
• Making it easier for patients
with a disability to fit chin on
chin rest.
Idea 2
![Page 9: The Diabetic Retinopathy Eye Screening Grading Tool · Virgin Care private and confidential Where we are now •The Grading Tool is now being used in the Surrey Diabetic Eye Screening](https://reader033.vdocument.in/reader033/viewer/2022052804/5f8d74395e235714686f3c1b/html5/thumbnails/9.jpg)
Virgin Care private and confidential www.virgincare.co.uk9
• An additional way of measuring key
areas of the retina in place of a ruler
that would work well with our software
measuring tools.
Idea 3
![Page 10: The Diabetic Retinopathy Eye Screening Grading Tool · Virgin Care private and confidential Where we are now •The Grading Tool is now being used in the Surrey Diabetic Eye Screening](https://reader033.vdocument.in/reader033/viewer/2022052804/5f8d74395e235714686f3c1b/html5/thumbnails/10.jpg)
Virgin Care private and confidential www.virgincare.co.uk
We decided on idea 3 an additional manual
measuring tool because:
10
• In some situations when it is difficult to
measure key areas of the retina and we use a
ruler – we felt this could be improved upon
with a more aligned to our service type of
manual measuring tool.
•An additional manual measuring tool would fit
in nicely with our software and Objective 5 of
our Grading Standards to ensure grading is
accurate.
![Page 11: The Diabetic Retinopathy Eye Screening Grading Tool · Virgin Care private and confidential Where we are now •The Grading Tool is now being used in the Surrey Diabetic Eye Screening](https://reader033.vdocument.in/reader033/viewer/2022052804/5f8d74395e235714686f3c1b/html5/thumbnails/11.jpg)
Virgin Care private and confidential www.virgincare.co.uk
My solution
The Grading Tool
Quick, accurate manual method
Portable
Easy to use
Compliments our grading software
Objective 5 maintained
11
![Page 12: The Diabetic Retinopathy Eye Screening Grading Tool · Virgin Care private and confidential Where we are now •The Grading Tool is now being used in the Surrey Diabetic Eye Screening](https://reader033.vdocument.in/reader033/viewer/2022052804/5f8d74395e235714686f3c1b/html5/thumbnails/12.jpg)
Virgin Care private and confidential www.virgincare.co.uk
Meet the Grading Tool
12
What does it do ...
![Page 13: The Diabetic Retinopathy Eye Screening Grading Tool · Virgin Care private and confidential Where we are now •The Grading Tool is now being used in the Surrey Diabetic Eye Screening](https://reader033.vdocument.in/reader033/viewer/2022052804/5f8d74395e235714686f3c1b/html5/thumbnails/13.jpg)
Virgin Care private and confidential www.virgincare.co.uk13
Measures one disc diameter from centre of
fovea
![Page 14: The Diabetic Retinopathy Eye Screening Grading Tool · Virgin Care private and confidential Where we are now •The Grading Tool is now being used in the Surrey Diabetic Eye Screening](https://reader033.vdocument.in/reader033/viewer/2022052804/5f8d74395e235714686f3c1b/html5/thumbnails/14.jpg)
Virgin Care private and confidential www.virgincare.co.uk
Verifies the boundary of the macular circle
using the outer curve
14
![Page 15: The Diabetic Retinopathy Eye Screening Grading Tool · Virgin Care private and confidential Where we are now •The Grading Tool is now being used in the Surrey Diabetic Eye Screening](https://reader033.vdocument.in/reader033/viewer/2022052804/5f8d74395e235714686f3c1b/html5/thumbnails/15.jpg)
Virgin Care private and confidential www.virgincare.co.uk15
Gauges the area of exudates using the
inner circle
![Page 16: The Diabetic Retinopathy Eye Screening Grading Tool · Virgin Care private and confidential Where we are now •The Grading Tool is now being used in the Surrey Diabetic Eye Screening](https://reader033.vdocument.in/reader033/viewer/2022052804/5f8d74395e235714686f3c1b/html5/thumbnails/16.jpg)
Virgin Care private and confidential www.virgincare.co.uk
Checks the image is to national screening
photographic standards
16
![Page 17: The Diabetic Retinopathy Eye Screening Grading Tool · Virgin Care private and confidential Where we are now •The Grading Tool is now being used in the Surrey Diabetic Eye Screening](https://reader033.vdocument.in/reader033/viewer/2022052804/5f8d74395e235714686f3c1b/html5/thumbnails/17.jpg)
Virgin Care private and confidential www.virgincare.co.uk
Highlights of the Grading Tool Project
• Attending the SIFs course and having my project proposal
approved.
• Seeing the prototype produced and receiving good feedback from
Graders’ trials.
• Producing a Grading Tool Video which was included on Virgin Care
and BARS Website and then receiving enquiries from Screening
Programmes and Hospitals worldwide.
• Receiving an Innovation award from Virgin Care.
• Presenting at BARS.
17
![Page 18: The Diabetic Retinopathy Eye Screening Grading Tool · Virgin Care private and confidential Where we are now •The Grading Tool is now being used in the Surrey Diabetic Eye Screening](https://reader033.vdocument.in/reader033/viewer/2022052804/5f8d74395e235714686f3c1b/html5/thumbnails/18.jpg)
Virgin Care private and confidential www.virgincare.co.uk
Where we are now
• The Grading Tool is now being used in the Surrey Diabetic
Eye Screening Service.
• Virgin Care has registered the design (Public Licence).
• 250 have been kindly supplied by Virgin Care free of charge
for distribution here at the BARS conference. Because they
are still checking whether or not the tool is a medical device,
we are taking a list of names and addresses and they will post
you a grading tool when they have appropriate sign-off in
place.
• Also available to download from Virgin Care website free and
print using a local printer (laser cut).
18
![Page 19: The Diabetic Retinopathy Eye Screening Grading Tool · Virgin Care private and confidential Where we are now •The Grading Tool is now being used in the Surrey Diabetic Eye Screening](https://reader033.vdocument.in/reader033/viewer/2022052804/5f8d74395e235714686f3c1b/html5/thumbnails/19.jpg)
Virgin Care private and confidential www.virgincare.co.uk
What has Nick gained
• I have met so many nice people during the project which has given
me enormous encouragement.
• I have learnt lots of new skills.
• My confidence levels have rocketed.
• I can’t stop thinking of ideas (new occluder).
19
![Page 20: The Diabetic Retinopathy Eye Screening Grading Tool · Virgin Care private and confidential Where we are now •The Grading Tool is now being used in the Surrey Diabetic Eye Screening](https://reader033.vdocument.in/reader033/viewer/2022052804/5f8d74395e235714686f3c1b/html5/thumbnails/20.jpg)
www.virgincare.co.uk
Thank you for listening
Nicholas Barclay
Surrey NHS Diabetic Eye Screening Programme
Farnham Hospital and Centre for Heath
Hale Road
Farnham
GU9 9QL