KPI

The Australian Health Practitioner Regulation Agency’s (Ahpra) shared Code of conduct stresses the importance of ensuring that optometrists can make clinical decisions in the interest of patient care freely, and without pressure from employers to meet business targets.

Three clauses every optometrist and their employer must know are:

Health professionals must:

1. “provide treatment options that are based on the best available information and are not influenced by financial gain or incentives”

2. “if you employ other registered health practitioners, do not set performance targets, quotas or engage in business practices that are inconsistent with this code, and/or may compromise patient safety.”

3. “investigate and treat patients based on clinical need and the effectiveness of the proposed investigations or treatment, and not provide unnecessary services or encourage the indiscriminate or unnecessary use of health services.”

The Ahpra Code is specific for practitioners, which includes practitioners who are in management positions. In addition, under the Health Practitioner Regulation National Law, “directing or inciting unprofessional conduct or professional misconduct” is an offence, with penalties for both individuals and organisations.

Kim contacted OA as she was being performance managed for not meeting a same-day Visual Field quota. There were no other concerns about Kim’s workplace performance.

How did Optometry Australia help?

• We provided an optometrist advisor as her HR support person at the workplace meeting.
• We helped Kim understand her rights and Ahpra’s Code of Conduct
• The employer withdrew the concern, as they now understand the regulatory breaches and risk that a same-day visual field quota posed, and the workplace relationship remains positive.

“You never think these things will happen to you, but when they do, I’m very glad I had OA to call upon.” – OA member.

Anna is employed in a busy optometry practice. The practice has recently purchased an expensive optical coherence tomography (OCT) machine. The practitioner owner who employs her, sets a performance target that requires her to provide a certain number of OCT scans each month. This incurs an $80 out-of-pocket cost. Anna reviews her patient records and informs the practice owner that to achieve the target she would need to recommend an OCT to some patients who do not have any signs or symptoms that indicate clinical need for the scan.

Applying the code

Anna and the practice owner read the code and in particular, section 8.10 Conflicts of Interest, which states:

“Good practice includes that:
i. if you employ other registered health practitioners, do not set performance targets, quotas or engage in business practices that are inconsistent with this code, and/or may compromise patient safety.”

Anna and the practice owner agree that good care includes the quality use of imaging based on the best available evidence and the patient’s needs. Anna only scans patients who have a clinical need.

Q. I need ideas on KPIs that elevate performance but does not breach the Code.

A: Our advisors can help you workshop ideas on non-financially incentivised performance goals for your optometrists.

Ideas include:

• Patient satisfaction and net promoter scores
• Clinical audits (record keeping, prescription accuracy, letters to referrers)
• Community engagement events
• Achieving store budget as a team.