Many eye care practices are under prepared for patients who are blind. Go audible! Go digital! Directed to ophthalmology clinicians and staff, this second webinar features the mental shift to a blind person’s point of view. Create a landscape of touch and sound. Chris McMenemy interviews Ann-Chadwell Humphries in a detailed assessment before, during, and after an ophthalmology exam. You will awaken your practice to simple, inexpensive shifts to benefit all patients—sighted or blind. Everybody wins!

Ann-Chadwell Humphries, Columbia, SC is an RN/registered nurse, has a masters in health policy, and graduate courses in Nursing and health facility design. She has practiced as a direct patient care provider, clinical trials research professional, and consultant on creating an ecosystem of patient-centric interactive experience by telephone, in person, and digital platforms. She has retinitis pigmentosa with some light perception. She is an advanced Voice Over user through her Apple iPhone and iPad. She can be contacted through Chris McMenemy.

Chris McMenemy is president of Ortmann Healthcare Consulting Services, a healthcare company that specializes in Ambulatory Surgery: development, licensure, information technology, equipment purchasing, etc. Chris is a member of the ORBIS Medical Advisory Committee and a consultant for accreditation of the Flying Eye Hospital. She attends an ORBIS program annually. Email: [email protected]

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Key Points

Why is this important?

Many eye care practices are under prepared for patients who are blind. Go audible! Go digital! Directed to ophthalmology clinicians and staff, this second webinar features the mental shift to a blind person’s point of view. Create a landscape of touch and sound. You will awaken your practice to simple, inexpensive shifts to benefit all patients—sighted or blind. Everybody wins! Think audible! Think digital! Before an office visit offer to take medical history by phone, online, or invite patients to come early to complete forms together. Provide exact parking locations, including handicap parking. If valet parking is offered, is it free for people with handicap placards?

Office Visit Registration:

During the office visit registration process say “Hello” or “Welcome” as patients approach the desk. Open glass windows. Offer a signature template with a sign-in pen. Pat the counter to indicate its height. Introduce yourself. Blind people cannot read name tags. Place insurance and identity cards in the patient’s hand. Talk directly to the patient. You can include family and friends. Avoid: “What would she like?” or “Here is where she should sign.” Explain everything you ask patients to sign. Consider coming out from behind the counter to return insurance cards or ask for further information. Navigating back to the counter can be tricky without sight.

Examination Process:

Use a welcoming, respectful voice to call patients. Introduce yourself. Offer an elbow or ask, “How may I assist you?” Acknowledge a guide dog by complimenting the dog to the handler. Please do not speak to the guide dog. Let guide dogs do their jobs without distraction. Some handlers give false names of their guides. Pat doorframes and thresholds as you pass them, “Going through a door.” Indicate level changes: “Step up”, “Step down” or “Here is a ramp.” Describe the route, “We are passing the visual field room, restroom, and here we are in exam room four.” When approaching the exam chair, tap the projecting step up to the chair. Do not panic, “Watch it!” Remain calm and understated. Tap or guide the patient’s hand to the arm or seat of the chair. Backing the patient into the chair by the shoulders is undignified. Orient the patient to the room. Make a sound on the counter, coat hook, guest chair, and trash can. Tell the patient when you leave the room. Mention how to contact you or other staff members if help is needed. If the wait is expected to be long, tell the patient but still check-in. When entering the exam room, knock on the door and wait for a response. Clinical staff should address the patient by name and introduce themselves. If other staff members are present, introduce them. If residents or interns are observing, ask the patient permission for them to stay. Face the patient when talking to him or her. Do not face the computer screen. Your voice will project away from patients who see with their ears. Offer the patient to feel the equipment. Provide pre-op, post-op, or discharge instructions in audible or digital format. Please do not dismiss this. You are an eye care facility plus the American Disabilities Act requires it. Patients do not want to rely on sighted people to read what might be private. They can review for themselves; patients want agency for their care.

Delivering a Diagnosis:

Sometimes, the news is hard. Encourage patients. Say, “We’ll get you to someone who can help”, “We will be with you”, “Call us anytime.” Have specific and immediate resources. Patients need help now! Appointments with agencies that serve the blind can be long. There are good non-profits who can fill the gaps. Suggest pastoral or grief counseling, a social worker, Talking Books Library, or a visual occupational therapist. Tell patients there are entire teams of people trained and ready to help. People can live complete and contributing lives with low or no vision. Introduce the idea of a guide dog. Praise returning patients. Ask what they need.

At the check-out counter:

Say a patient’s name. Introduce yourself. Tap the counter. Offer a signature template. Email an appointment date to the patient and allow time for patients to enter return appointments into their phones.

Summary:

Think audible and digital for patients with impaired vision. This webinar provides you with easy, inexpensive protocols to prepare your staff and streamline your practice.

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