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Hospitals should consider the following actions to optimise the efficient use of clinical staff and patients’ time while maintaining quality of care:^36,50,51

• use of integrated pathways to coordinate the patient journey⁵¹
• use of screening to identify healthy ambulatory local anaesthesia patients for rapid turnover lists. This includes making use of cataract hubs where available...

Research in ophthalmic anaesthesia should be encouraged, and time set aside for this activity. Where appropriate, research projects should include patient and care provider involvement.

Ophthalmic anaesthesia should be included in departmental audit programmes, which may include patient satisfaction, complications and adverse events.^2,44

All serious complications of anaesthesia should be reported, should undergo a ‘root cause analysis’ and dealt with according to locally agreed governance structures.

Multidisciplinary quality improvement initiatives strengthen joint working and develop a cohesive working environment. Time should be set aside for regular joint governance meetings looking at both morbidity and quality issues.

Information about the different clinical management options should be discussed and suitable literature provided to assist patients in making an informed choice. The patient must have an opportunity to weigh up the available options.^52,54

Translations or interpreters should be made available if required.

Information should be made available to patients that gives details of the surgery and local and general anaesthesia for ophthalmic procedures, as well as advice on what to expect on the day of admission. The Royal College of Anaesthetists and the Royal College of Ophthalmologists have a range of booklets available on their websites to help to inform patients.^55,56,57

Written instructions regarding the plan for the perioperative management of existing medications, including if and when to stop anticoagulants, should be given to the patient.

Written information for patients should be easy to read. It should be available in an appropriate language and format for those patients who are visually impaired.^58,59 It may be necessary to provide translations of patient information booklets into languages suitable for the local population.