Background: Ophthalmology in the Republic of Ireland has one of the longest waiting lists in healthcare, with around 44,000 people awaiting a first outpatient appointment. In the north-east region, 12,500 people are waiting. The North-Eastern Region Integrated Eye Care Service (NERIECS) was established in 2021 to improve patient care and access to services. A key driver for the team was to understand ‘how we work together’ to enable a shared vision of change within regional services.

Aim: To support hospital and community ophthalmology services, which comprise eight organisations in the region, to prepare for the development of system-level integration of eyecare services.

Methods: We integrated a popular process-improvement methodology, Lean Six Sigma, with a person-centred approach to support staff to develop a shared vision of change and to deliver improvements for ophthalmology services.

Findings: The integrated approach enabled staff to work in ways that supported the development of good quality, person-centred care that takes account of the outcomes for and experiences of ophthalmology patients and their families, and of staff.

Conclusions: Our work builds on a recent study that identified coherence in the underlying philosophy, intention, method and outcomes of Lean Six Sigma and person-centred approaches to healthcare improvement, highlighting the added value of an integrated approach in enabling improvement that positively impacts patient outcomes and healthcare culture.

Implications for practice:

• The application of an integrated approach to process improvement in healthcare is shown to be effective beyond a single study site, having a positive impact across geographic and organisational boundaries, and across levels of care (primary, secondary, tertiary and post-acute)
• The integrated approach puts the focus on synergies between both methodological approaches and avoids improvement work being reduced to the use of a decontextualised toolkit

This article by Seán Paul Teeling, Anne-Marie Keown, Úna Cunningham and David Keegan is licensed under a Creative Commons Attribution Non-Commercial 3.0 License.