[Successful implementation of the EFQM management model at the Department of Ophthalmology in Graz]. / Erfolgreiche Umsetzung des EFQM-Management-Modells an der Universitätsaugenklinik Graz.

BACKGROUND AND OBJECTIVE: In the context of legal requirements and scarcer resources, the implementation of a quality management (QM) model will provide a competitive advantage or a site warranty for a hospital. For 3 years, the Department of Ophthalmology in Graz has been working with the EFQM model and has now accomplished the first level quality award, namely "Committed to Excellence (C2E)". The project work towards achieving this C2E-award is described below. STUDY DESIGN AND METHODS: EFQM stands for European Foundation for Quality Management, an organization that was founded in 1989 by the EU, together with 14 leading enterprises. In the EFQM model, the maturity of an organization in terms of quality is determined through the achievement of a number of quality awards. The C2E award is the first of these awards. At the beginning of our work for the C2E level, the strengths and weaknesses of the Department of Ophthalmology were determined by means of an EFQM questionnaire. Three improvement measures with the highest impact on the performance of the clinic were identified by the questionnaire: 1. The hospitalization of a cataract patient. 2. The lack of information between the various professional parties. 3. The lack of knowledge within the professional groups of the objectives and strategy of the Department of Ophthalmology. RESULTS: These areas requiring improvement were targeted, addressed and improved in a 6-months project work, structured by the EFQM model. The project work as a whole, the results obtained and the corresponding written documentation were evaluated positively in a 1-day assessment by Quality Austria. DISCUSSION: The EFQM model is a challenging quality management model. After the necessary training of project members or under the supervision of experienced quality managers, the EFQM model may be successfully applied to patient care, teaching and research in a department of ophthalmology.

Evaluating an impression cytology grading system (IC score) in patients with dry eye syndrome.

PURPOSE: To evaluate the IC score, a newly developed grading system for the morphological alterations of the ocular surface as a diagnostic tool in relation to type and severity of dry eye disease. METHODS: Impression cytological specimens of 309 patients with simple dry eye (S-DE), 50 patients with Sjögren's syndrome and dry eye (SS-DE), and 39 patients with connective tissue disease and dry eye (CTD-DE) were examined. In all, 10 different morphological parameters were judged with points (IC subscores) and summarized to the IC score. IC score and subscores were correlated to tear function test results and with each other. RESULTS: SS-DE patients had the highest IC scores and IC subscores. IC scores and IC subscores correlated significantly with the fluorescein staining of the cornea in all three patient groups. They were correlated to the rose bengal score in SS-DE and S-DE patients. The analysis of the IC subscores showed that there are significant correlations between most of the morphological alterations investigated. This underlines the importance of each parameter for the summarized IC score. CONCLUSION: The IC score provides detailed information about the morphological alterations of the bulbar conjunctiva. It has proven to be useful for the differentiation of dry eye diseases and might help in the investigation of the pathogenesis of these diseases as well as for follow-up and therapy control.