Eyeworld

32 | EYEWORLD | DECEMBER 2023 ATARACT C by Mitchell Weikert, MD Cataract Editor As physicians, one of our greatest respon- sibilities is to maintain accurate records of our patients' health information. Given the sheer volume and complexity of data that we must manage, it's not surprising that this process can be prone to errors. Plus, in this age of electronic health records, these issues may be magnified by the unprecedented access that patients have to their medical information. John Bartlett, MD, Steve Christensen, and Dagny Zhu, MD, take a detailed look at this high-stakes arena. In ad- dition to highlighting the most common causes of documentation errors, they note the various ways they can negatively impact patients, physi- cians, and the physician-patient relationship. On the practical side, they offer several recommen- dations on how to minimize errors and create collaborative processes that promote accurate data collection and retention. Hopefully, you'll reap the benefits of these "lessons learned" and enter the new year ready to face new challenges but better equipped to avoid some of these potential problems. L ooks like we're ready to break out a new calendar as we say goodbye to 2023 and hello to 2024. As we reflect on the passage of another year, it seems appropriate that this issue's theme is "Lessons learned." The cataract- centered articles in this issue of EyeWorld are full of great lessons, most learned the hard way. You may find that you've already experienced a few yourself, but I'm sure you'll learn, as I have, several new strategies that will help you avoid these common pitfalls. In this issue, Rom Kandavel, MD, Mitra Nejad, MD, and Amandeep Rai, MD, FRCSC, ex- amine the various factors that help us determine when to proceed with cataract surgery. Front and center is the concept of patient-centered care, meaning the decision to proceed with surgery should be tailored to each individual. Interview techniques that foster patient trust are offered, as are specific questions that can help to assess the impact of cataracts on patients' qual- ity of life. They also discuss the impact of the COVID-19 pandemic on their cataract practice, such as delayed surgery with patients presenting with more severe pathology. This segues into important discussions on the timing of cataract surgery, the assessment of patient goals, and the setting of appropriate expectations. I think we all can agree that a calm and comfortable patient is a major ingredient in the recipe for successful cataract surgery. Anxious patients not only have a personal experience that is less than optimal, but they are also at higher risk for complications due to unexpected movements and decreased cooperation. Rosa Braga-Mele, MD, and Shawn Lin, MD, present a comprehensive review of the risk factors for patient agitation, as well as a list of recommen- dations for its prevention and management. In addition to covering the various ways in which patient anxiety can present, they discuss how to mentally prepare patients prior to surgery to set appropriate expectations. The nuances of anes- thesia, both medical and "verbal," are discussed, and particular attention is paid to the unique experience of the second eye. Lessons learned: strategies to avoid common pitfalls LESSONS LEARNED D. Brian Kim, MD, shared a personal case with a valuable lesson he learned on the importance of the preoperative discussion and ensuring that the patient and their family fully understand the procedure they are undergoing. Dr. Kim treated a patient in his 70s who presented seemingly normal. After doing a YAG capsulotomy, the patient was extremely upset and was complaining of debilitating floaters. Dr. Kim was unable to reason with the patient and ultimately realized that he had undiagnosed demen- tia. Take note if you suspect a patient does not fully understand what you are saying during the preoperative discussion, Dr. Kim said. To read more about this case, visit www.eyeworld.org/ online-exclusives. ONLINE EXCLUSIVE

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