Kensington Ophthalmology UBT Develop Innovative New Protocols for Rare Cataract Complication


By Ben Thrutchley

It’s wonderful when an idea, a plan and a team come together to accomplish something amazing. A team in the Kensington Medical Center did just that when they established a new protocol for a rare cataract surgery complication called a dropped nucleus.

Defined as loss of a part or the whole lens nucleus to the interior of the eye, a dropped nucleus is an unusual but well known complication. A site like Kensington may see two or three episodes per year.

“Patients affected by a dropped nucleus face a period of poor vision, floaters and possibly painful post-op treatment. They also face delays in resuming normal life until the complication is resolved and a second surgery is completed,” explained Dr. Tim Hopkins, M.D. Ophthalmology at the Kensington Medical Center. “It’s uncomfortable for any patient, and that’s why we were dedicated to finding a faster way to resolve it.”

We have long had the medical expertise to deliver the complicated intervention and correction to a dropped nucleus. General ophthalmic surgeons would hand the case over to MAPMG’s subspecialized retinal surgeons. But, as clinically strong as each individual was, ultimate resolution required a complete second surgery and could take multiple days for the patient.

Seeing an opportunity to improve patient care, Dr. Tim Hopkins reached out to the Kensington ASC Unit Based Team (UBT) requesting help to build out new protocols for resolving a dropped nucleus. In short order, Dr. Hopkins, and the UBT Co-Leads Mary Ann Rajnauth (Operating Room Nurse representing Labor), and Lorna Vitangcol-Tanasan (Manager, Health Plan Clinical Operations Perioperative Services representing Management) and others on the talented team at Kensington transformed the complication from a lengthy, multiday experience to a 15-minute fix. Leveraging our integration, the retinal surgeon is called right into the operating room and resolution is achieved while the patient is still sedated for their initial surgery.

“The Kensington team whole heartedly wanted to find a solution that quickly resolved a dropped nucleus. Each of the team members used their previous experiences and creative thinking to develop a truly remarkable workflow addressing the complication. It required the kind of teamwork, expertise and collaboration across disciplines that is unique to Kaiser Permanente,” explained Lead UBT Consultant Jennifer Walker.

The new dropped nucleus protocols show the power of teamwork and our UBTs. Because of both, Kensington now has one of the best dropped nucleus solutions across the industry.

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