In today’s fast-paced healthcare landscape, optometry practices cannot afford to run on autopilot. Clear clinical goals that are aligned with evidence-based guidelines demonstrate that your team delivers up-to-date, high-quality care.
Whether you are a solo provider or leading a large team, defined goals and clinical guidelines anchor your care model and promote consistent, high-impact outcomes across all providers.
This article will show you how to make it happen with minimal grumbles from your team.
Practice goals vs. clinical practice guidelines
What’s the difference between a practice goal and a clinical practice guideline?
- Practice goals: Internal key performance indicators based on your priorities, such as improving recall rates, boosting insurance collections, increasing revenue per patient, or reducing chair time.1
- Clinical Practice Guidelines (CPGs): Externally developed, evidence-based recommendations, created by entities such as the American Optometric Association (AOA), that review and coalesce published research to guide diagnosis, treatment, and management for specific conditions.2
AOA clinical practice guidelines
Clinical practice guidelines by the AOA date back to the 1990s and have been refined over several decades. Today’s CPGs reflect rigorous analysis of peer-reviewed research, expert consensus, and public health priorities.3 They have been aligned to meet the standards of the National Academies of Sciences, Engineering, and Medicine.
Evidence-based standards integrate the best available research, clinical expertise, and patient values and circumstances to augment your clinical judgment. That being said, these standards are meant to provide strong evidence to fit your patient population, workflow, and practice style, rather than serving as a rigid, black-and-white checklist.2,3
4 actionable steps for success
So, what are the best ways to define and set goals for your practice?
Step 1: Define your practice goals
Ask yourself: What matters to our practice, and how can we clearly measure success?
Examples of practice goals could include:
- Improve patient recall rate to 80% in 1 year
- Achieve 90% adherence to AOA recommendations for diabetic eye exams within 6 months
- Launch an evidence-based dry eye specialty clinic and evaluate outcomes in 6 months
Next, choose three to five practice goals at a time and utilize the “SMART” format to ensure each goal is clearly defined, realistically attainable, and measurable within a specific timeframe.
The “SMART” format means your goals are:4
- Specific
- Measurable
- Achievable
- Relevant
- Time-bound
Setting SMART goals for your optometry practice
For instance, the first example from above can be reframed into the SMART format as follows:
- Specific: Improve the percentage of patients returning for their annual routine eye exams
- Measurable: Raise recall compliance from 65% to 80%
- Achievable: Implement automated recall software, staff training, and monthly tracking reports
- Relevant: Enhances continuity of care and stabilizes revenue flow
- Time-bound: Achieve this within 12 months of setting this goal
It may seem nitpicky, but having a well-thought-out problem statement and goal measurements is critical to success. I encourage you to engage all your staff for input to build buy-in and ownership. Otherwise, it may just seem like an additional task burden to your staff, and you may alienate yourself from them.
Step 2: Choose and implement clinical practice guidelines
Next, choose the CPGs most relevant to your population and clinical interests. Download clinical guidelines for free from the AOA website and review the content at your next provider meeting. Once you’ve decided what’s realistic to implement, ensure all staff are informed and aligned on the goal. You may need to mention it regularly at team huddles and meetings to keep everyone fresh.
For example, a practice serving an area with many young families and school-aged children may choose to prioritize the Comprehensive Pediatric Eye and Vision Examination CPG, especially if expanding pediatric and binocular vision services is a strategic goal. The providers may decide to modify their binocular vision testing protocol in routine eye exams to more accurately detect any binocular vision issues.
In contrast, an eye clinic in the VA may want to focus more on implementing recommendations from the Eye Care of the Patient with Diabetes Mellitus publication by establishing routine fundus photograph reminders to document retinal changes.
Side note: No two practices are alike. Your population, location, and clinical interests make your practice unique. That’s why it’s important to have a conversation with your team and tailor goals to your specific setting.
Step 3: Build it into your documentation
Document your customized standards and goals in a clinical handbook to reduce ambiguity.5 Major goals can be displayed in a common area for your team, such as on a bulletin/white board in the meeting room.
This should include adjustments to:
- Practice goals
- Exam flow to align with CPGs
- Documentation requirements
- Referral criteria
- Follow-up intervals
- Screening protocols
For example, if your practice would like to focus on improving the diagnosis and management of dry eye disease, you might revise your exam flow so that any patient who reports symptoms of dry eyes also completes a dry eye-specific questionnaire, such as the OSDI or SPEED, during check-in.
The technician could also perform dry eye-specific testing, such as tear breakup time measurements, tear osmolarity testing, or meibography imaging, as a part of a standardized pretesting workup.
Tip: Some EHR programs may allow for customizable templates or alerts to reinforce adherence. Keep the documentation clear, concise, and accessible and make sure to review/update the goals regularly.
Step 4: Educate and empower your staff
Your front office, techs, and opticians are the bloodline of the practice. If they’re not on board, goals will fall flat.
Hold quarterly training sessions and frequent touchpoints:
- Review updates and changes
- Reinforce workflows and rationale
- Role-play patient education scenarios (e.g., Why do I need to recommend a certain lens type?)
Create reference tools to keep staff aligned and confident so they can review and reference the resources, rather than forget and have to ask you every time. I recommend simple flowcharts and guides in convenient areas for them.
Figure 1: Expanding on the dry eye example from the previous section, a basic flowchart may look like the example below.
Figure 1: Courtesy of Richard Wan, OD, MS, FAAO.
At first, it might seem like money lost due to opportunity cost when blocking a part of your day to train your staff instead of seeing patients. However, it is worth the time and money to invest in your staff and conduct proper trainings so that they gain skills and knowledge and are motivated to contribute to the practice’s goals.6
Key takeaways
- Clearly define your problem statements and SMART goals that reflect your practice’s mission.
- Use AOA guidelines as a foundation, not a law.
- Tailor protocols to your specific clinical situation and document clearly.
- Invest in staff training to help with buy-in.
- Reassess regularly and reward your team when goals are met.
Final thoughts
Practice goals and CPGs are not set-it-and-forget-it situations. Ideally, your goals should evolve as they are met, and your team strives for more.
Don’t let them fall off your radar and become outdated; revisit them regularly during staff meetings. A strong team will stay motivated and excited as they see progress over time.
