DEPARTMENT OF COUNSELLING
Importance of counselling in community
outreach programme
ARAVIND EYE CARE SYSTEM
Aravind Eye Hospital
& Postgraduate Institute of Ophthalmology
 Outreach plays a vital role in reaching out the unreached poor
blind people in rural areas
 The main objective of the camp is to create awareness among
the people which pares the way for intervention to clear the
backlog of avoidable blindness
 Every patient has hundreds of questions to ask while they
undergo screening for eye problems and later treatment
 Counselling helps the patients tremendously to take decision
on accepting surgical or medical treatment
Cont…
 A doctor or paramedical staff cannot spend more
time, with the patient to explain the nature of the eye
problems, clear their doubts and educate them to
follow up the required medication
 It is a phychological, process that patient wants the
doctor to spend more time whether it is a base
hospital or a rural eye screening camp to attend their
problems. Clarify the doubts and fulfill their needs
 Hence it is the responsibility of counsellors to
communicate to the patient the need and importance
of eye care etc
The concept of introducing patient – counselling has the
following major aspects
 Health education in eye care
 Increase the level of patient satisfaction
 Optimum utilization of resources
Role of counsellor in outreach
programs
 In a screening eye camp, the patient undergo
various clinical examinations and finally the
ophthalmologist advise for
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Cataract Surgery
A pair of Spectacles
Medicines
Speciality treatment in base hospital
 The medical team attending the screening eye camp
should have a place for counselling and a a counsellor
is a part of the medical team
 Reducing the work load of the doctors and Mid Level
Ophthalmic Personnel (MLOP), to enable them to
spend their time more efficientlly in clinical activities
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Not willing handling
Patients satisfaction
Surgery acceptance rate
Spectacles acceptance rate
Specially referral acceptance rate
Surgery follow up acceptance rate
The productivity of the camp in terms of number
of admissions, acceptance of spectacles and
speciality referrals highly depends upon the
counsellor’s communication skills.
Responsibilities of a counsellor in base
hospital
 Counsellor is to continue the counselling in the base
hospital also in different stages of in patients services
 More importantly, they should talk to the group of
admitted patients just prior to surgery regarding the
duration and type of surgery in order to reduce their
fear and anxiety
 Counselling should be continued even after surgery
in the ward regarding the post operative medication
during their stay in the hospital
Cont…
 They should also talk to them how to maintain the
hygiene to prevent any kind of infections after they
go back to their villages
 The counsellors have to be aware of discharge
details and follow up details
 Usually follow up is done after 4 weeks of surgery
 The counsellors should make a point on the date and
venue of follow up to the discharge summary for all
the patients
Cont…
 During the post operative stay, they should explain
the importance of follow up which will help to
attain a high level follow up acceptance rate
 If any one is not co - operated upon the counsellor
has to collect the valid reason and record the
information
 Surgery drop out is one of the important factors
which influence the cost of surgery
Cont….
 The counsellor should be able to collect and
submit the particular to outreach payment
after each camp
 The medical records or cash sheets are the
main source of information
 On the arrival at the base hospital, the
counsellor should refer all the case sheets
and categorise the information of report
generation
The following information should be collected for each
camp to evaluate the quality and productivity of the
camp
This also helps to match with pre-set performance
indicators
 The number of patients screened on the camp day
(includes defective and normal patients who attend
the camp as out-patients)
 Age and Gender break up of out patients
 Diagnosis details (disease wise category of out
patient)
Cont….
 The number of patients advised for cataract surgery.
(The cataract condition may be early immature or
mature stage. It is good to have immature and mature
cataract patient noted separately)
 Cataract surgery acceptance rate (number of patients
advised for cataract Vs number of patients admitted
for surgery)
 The reasons of patients for not accepting surgery
 The number of patients advised for spectacles and
spectacles acceptance rate
Cont…
 Patients diagnosed with speciality problems like
glaucoma, retina, childhood blindness etc
 The number of patients attended the camp with eye
defects (cataract, refractive errors and speciality
problem together)
 The number of patients required and advised for
further medical intervention in the base hospital
 The number of patients who agreed to come to the
base hospital for speciality treatment
Cont…
 Details of patients operated on and discharged
 The number of operated patient who attend the
follow up camp and follow up acceptance rate ( if
should be furnished after the follow up camp is
conducted)
All the above information is interpreted to
monitor the performance of outreach activity in a
very scientific manner. This significant role of
counsellor helps to improve the total quality
management of outreach eye care services