Research briefing
The role of Eye Clinic Liaison Officers
April 2011
1. Introduction
The Eye Clinic Liaison Officer (ECLO) was establishedto provide information about eye conditions and services plus emotional support within an eye clinic setting. Although the need for this kind of support at the time of diagnosis has long been recognised, research is required to understand more about the ECLO role in particular. In 2009 RNIB commissioned researchers at CityUniversity, London to conduct an investigation to ascertain the need for the ECLO role, the cost implications of the role and the impact on quality of life and adaptation to vision loss in people who are blind and partially sighted. The fieldwork commenced in May 2009 and was completed in December 2010.
2. Method
The project was divided into several different studies so that an evidence base could be built using information gathered from patients, eye care professionals such as Ophthalmologists and Optometrists and ECLOs themselves. The components of the research comprised: a survey of 84 clinical and 56 rehabilitation staff on services for blind and partially sighted people and their views on ECLOs; in-depth semi structured interviews with 2 Optometrists, 2 Ophthalmologists and 4 ECLO's; a survey of 23 ECLOs; 11 ECLO diary analysis; and questionnaires to ascertain quality of life and adaptation to vision loss in 10 patients with and 17 patients without access to an ECLO.
3. Key findings from the research
3.1 ECLOs are providing essential services that are currently missing from eye clinics in the UK.
More than 80% of eye care professionals agreed that emotional and family support are essential services for blind and partially sighted people despite the fact that this type of support was not always available in their clinic. ECLOsprovide emotional and family support to patients on a regular basis.
ECLOs provide additional services in eye clinics, which the patients may not have access to in the absence of an ECLO, and 56% of clinical staff who had worked with ECLOs felt that this reduced the time that they would spend with patients.
3.2 Cost of an ECLO per patient contact is £17.95
The average annual cost of employing an ECLO is £38,170 pro rata. The cost of an ECLO per patient per contact is £17.95, assuming an average of 9 patients are seen per day, in a 42 week year.
3.3 ECLO's significantly improve the patient experience
A large proportion of eye care professionals (90% of clinical staff and 63% rehabilitation officers) said that ECLOs significantly improve the patient experience. Most clinical staff (77%) reported that they felt more comfortable when patients left their room if they knew that they had the support of an ECLO.
This research was unable to establish a link between ECLO's with quality of life of blind and partially sighted people. This may have been because the questionnaires chosen were not sensitive enough, because the sample size was too small or the effects of the intervention were measured too late.
3.4 A lack of standardisation of the ECLO role leads to confusion over the services that ECLOs provide
Some ECLOs are well known within their departments, conversely, a number of clinicians were unsure whether their hospital employed an ECLO or not. Some ECLOs obtain patients through referrals from clinicians in the hospital, others obtain patients from waiting areas or use a combination of both approaches.
In cases where the ECLO service is not well integrated into the hospital system this has resulted in confusion over which services they do and do not provide and lack of awareness of where they are employed. There was also evidence of under valuing the role, in that some ECLOs do not have access to hospital records or a manager within the hospital. Indeed almost half of those surveyed did not have a computer, one third lacked any storage space and a quarter had neither a telephone nor a private room in which to talk to patients. Given that a large part of the ECLOs job involves making referrals and listening to patients in a confidential manner it is important that they are provided with adequate facilities to perform their role.
In summary
ECLOs provide services, such as information and emotional support to patients and families which are currently missing in eye clinics in the UK.
These services are regarded as essential by eye care professionals.
The lack of standardisation in the current ECLO role is likely to preventit developing to its full potential; this variability needs to be addressed.
For more information visit rnib.org.uk/research
© RNIB, 2011
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RNIB Evidence and Service Impact
Registered charity number 226227