Prosthetic Eyes - Provision of · Web viewCHHS18/059 Doc Number Version Issued Review Date Area...
Transcript of Prosthetic Eyes - Provision of · Web viewCHHS18/059 Doc Number Version Issued Review Date Area...
CHHS18/059
Canberra Hospital and Health ServicesOperational Procedure Prosthetic Eyes: Provision of Contents
Contents....................................................................................................................................1
Purpose.....................................................................................................................................2
Alerts.........................................................................................................................................2
Scope........................................................................................................................................ 2
Section 1 – Provision of Artificial Eyes......................................................................................2
Procedure..............................................................................................................................2
Information about prosthetic eyes.......................................................................................3
Obtaining Prosthetic Eyes.....................................................................................................3
Implementation........................................................................................................................ 4
Related Policies, Procedures, Guidelines and Legislation.........................................................4
References................................................................................................................................ 4
Search Terms............................................................................................................................ 4
Attachments..............................................................................................................................4
Attachment A – Request to Fund Artificial Eye form.............................................................6
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Do not refer to a paper based copy of this policy document. The most current version can be found on the ACT Health Policy Register
CHHS18/059
Purpose
The purpose of this procedure is to provide information to Ophthalmology staff about the supply and payment process for the provision of prosthetic eyes to ACT residents.
1. ACT Health funds the purchase of the first prosthetic eye, irrespective of where the biological eye was removed.
2. Replacement is funded if the prosthetic eye is more than 5 years old, or is clinically unsatisfactory eg. irritating, poor fit.
3. Funding is provided only if the remaining biologic eye has been examined within the last 2 years, and clinical information about that examination has been provided along with the request for a prosthetic eye.
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Alerts
The choice of supplier is up to the patient although it should be noted that additional expenses for services provided outside the ACT such as travel and accommodation will not be met by ACT Health.
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Scope
This operational procedure pertains to: Residents from the ACT who require prosthetic eyes – NSW residents are ineligible, and
should seek supply from their nearest public hospital Health Directorate staff who assist in sourcing prosthetic eyes Suppliers of prosthetic eyes.
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Section 1 – Provision of Artificial Eyes
Procedure 1. ‘Request to Fund Artificial Eye’ form to be completed by requesting ophthalmologist (see
attachment A).
Note: this can be filled out by an ophthalmologist who works outside the ACT but only for ACT residents.
2. ‘Request to Fund Artificial Eye’ Form is to be sent via email to Executive Director of Surgery and Oral Health for signature as the authorising officer.
3. The signed form is then to be faxed to Surgical Services for processing
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Do not refer to a paper based copy of this policy document. The most current version can be found on the ACT Health Policy Register
CHHS18/059
4. Surgical Services will post the approved request to the patient, who then takes it to the prosthetic eye maker.
5. Copy of approved request will be stored in patient’s clinical record6. If request is not approved-reasons for this would need to be addressed ACT Health Canberra Hospital and Health Services will undertake to purchase a prosthetic eye for ACT residents when: This is recommended by an Ophthalmologist practicing in the ACT Payment for the provision of a prosthetic eye has been authorised by the Division of
Surgery and Oral Health Executive Director or delegate
Notes:1. ACT residents with private health insurance can request remuneration for the difference
between the private health insurance rebate and the total cost of the prosthesis. This will be paid on receipt of adequate documentation to the Division of Surgery and Oral Health Executive Director or delegate.
2. The choice of supplier is up to the patient, although it should be noted that additional expenses for services provided outside the ACT such as travel and accommodation will not be met by the ACT Health.
3. Any requests differing to the procedures outlined in this document should be directed to the office of the Executive Director of Surgical and Oral Health.
Information about prosthetic eyeshttp://artificialeyes.net provides useful guidance for those adjusting to eye loss or who require an artificial eye.
Obtaining Prosthetic EyesProsthetic eyes may be obtained through one of following providers James Morphett
1 Farrell Place Canberra City 2601 (also offices in Parramatta and Sydney)
Ph: 1800 353 528
https://artificialeyes.net/ocularists/australia/sydney-james-morphett/
Kerri Wilson
Ocular Prosthetics5 Mary StreetLilyfield NSW 2040
Tel/Fax: (02) 9818 6764
http://kerriwilsonprosthetics.com.au/about.html
Patrick Loyer
1293 Toorak Road,Camberwell, VIC 3124
Ph: (03) 9809 1404F. 9809-1404
http://www.loyerartificialeyes.com.au
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Implementation
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Do not refer to a paper based copy of this policy document. The most current version can be found on the ACT Health Policy Register
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This procedure will be: available to all staff on the policy register incorporated into the orientation of new staff to the Eye Clinic.
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Related Policies, Procedures, Guidelines and Legislation
Policies Consent and treatment
Legislation Health Records (Privacy and Access) Act 1997 Human Rights Act 2004 Work Health and Safety Act 2011
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References
1. Geelan, P and Geelan, J (2018) Artificial Eye. Available at: http://artificialeyes.net
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Search Terms
Eye, Eyes, Prosthesis, Prosthetic, Ophthalmology, Artificial
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Attachments
Attachment A – Request to Fund Artificial Eye form
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Do not refer to a paper based copy of this policy document. The most current version can be found on the ACT Health Policy Register
CHHS18/059
Disclaimer: This document has been developed by ACT Health, Canberra Hospital and Health Services specifically for its own use. Use of this document and any reliance on the information contained therein by any third party is at his or her own risk and Health Directorate assumes no responsibility whatsoever.
Policy Team ONLY to complete the following:Date Amended Section Amended Divisional Approval Final Approval 10/01/2018 Complete Review ED SOH CHHS Policy Committee
This document supersedes the following: Document Number Document NameTCH11:144L Artificial Eyes- Provision
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Do not refer to a paper based copy of this policy document. The most current version can be found on the ACT Health Policy Register
CHHS18/059
Attachment A – Request to Fund Artificial Eye form
Date: ________________
REQUEST TO DIV. SURGICAL SERVICES TO FUND PROSTHETIC EYE When completed, please fax to Surgical Services on 6244 4630. The approved request will be posted by Surgical Services to the patient, who then takes
it to the prosthetic eye maker.
PATIENT NAME: _____________________________________________________________
PATIENT UR NO: _____________________DOB: ___________________MOB:_____________
MAILING ADDRESS: ___________________________________________________________
____________________________________________________________
REASON FOR NEW PROSTHESIS: Tick one First request Existing prosthesis clinically unsatisfactory
STATUS OF REMAINING BIOLOGIC EYE:Examined within the last 2 years YES/NOClinical information about the examination provided YES/NO
REQUESTING OPHTHALMOLOGIST:
NAME:_____________________________ Provider #: _______________________________
SIGNATURE: _________________________________________________________________
---------------------------------------------------------------------------------------------------------------------------------------------
FOR OFFICE USE ONLY:
APPROVAL GIVEN UNDER THE TERMS OUTLINED IN POLICY NO. 0075:003 -
NAME OF AUTHORISING OFFICER: ___________________________________ (PLEASE PRINT)
SIGNATURE OF AUTHORISING OFFICER: ____________________________________________
OCULARIST: ___________________________ COST: $_______________________________
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Do not refer to a paper based copy of this policy document. The most current version can be found on the ACT Health Policy Register