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Vision Centres in India – Supportive practices and enabling environments

Aravind Eye Hospitals in South India run a very effective network of 80 Vision Centres which are attended by approximately 700,000 patients annually. Each vision centre is staffed by a team of two, who are not only competent but are deeply committed to providing eye care to everyone in the community served by the Vision Centre. Their motivation and commitment could be attributed to the following, which have ensured high performance, patient satisfaction and low attrition:

  • Clarity of what is expected of staff. Their tasks and clinical protocols are very well-defined. They have all the equipment and technology required to perform these tasks. There is a monthly routine to ensure that equipment is in good working condition. The annual attrition rate is typically between 5% and 10%.
  • The staff are from the community that they serve. The opportunity to serve their own people adds to their commitment as well as giving them a status in the community. Such respect is maintained by providing good care which is appreciated by the community. This social reinforcement is motivating.
  • Such respect is sustained only when they provide good quality care and this subtle community pressure helps.
  • There is continuous ongoing support and feedback on every patient seen though telemedicine consultation and monthly benchmarked feedback on performance and patient satisfaction.
  • Staff have access to career development training that enriches their work. For example, technicians now routinely do fundus photography and use cloud-based artificial intelligence support for instant interpretation images.
  • Patient satisfaction is measured daily on a 10% sample of patients. These are compiled every month and presented to each Vision Centre along with the satisfaction scores of other Vision Centres. This provides some intrinsic motivation for continuous improvement and also leads to appropriate enhancements to training. More than 99% of patients rate the service as good or excellent.
  • Each Vision Centre sees an average of 30 outpatients each day. A technician undertakes a comprehensive eye examination, records all the findings in an electronic medical record, and engages with the patient in a live telemedicine consultation with an Aravind ophthalmologist in the base hospital. The technician is supported by an administrator who is responsible for all non-clinical activities.