Inflammatory bowel disease integral care units: Evaluation of a nationwide quality certification programme. The GETECCU experience

Abstract

Background One of the most valued targets in inflammatory bowel disease (IBD) is for physicians to provide and patients to receive a high‐level quality of care. This study aimed to evaluate the implementation of a nationwide quality certification programme for IBD units. Methods Identification of quality indicators (QI) for IBD Unit certification was based on Delphi methodology that selected 53 QI, which were subjected to a normalisation process. Selected QI were then used in the certification process. Coordinated by GETECCU, this process began with a consulting round and an audit drill followed by a formal audit carried out by an independent certifying agency. This audit involved the scrutiny of the selected QI in medical records. If 80%–90% compliance was achieved, the IBD unit audited received the qualification of “advanced”, and if it exceeded 90% the rating was “excellence”. Afterwards, an anonymous survey was conducted among certified units to assess satisfaction with the programme for IBD units. Results As of January 2021, 66 IBD units adhere to the nationwide certification programme. Among the 53 units already audited by January 2021, 31 achieved the certification of excellence, 20 the advanced certification, and two did not obtain the certification. The main survey results indicated high satisfaction with an average score of 8.5 out of 10. Conclusion Certification of inflammatory bowel disease units by GETECCU is the largest nationwide certification programme for IBD units reported. More than 90% of IBD units adhered to the programme achieved the certification.

Immigrant IBD Patients in Spain Are Younger, Have More Extraintestinal Manifestations and Use More Biologics Than Native Patients

“…However, our results show that both native and immigrant populations have full access to biologic therapies under the universal healthcare coverage provided by Spain's public health service, and low socioeconomic status is therefore unlikely to have contributed to differences in prescription patterns in this study. On the other hand, clinical practice among ENEIDA researchers is fairly uniform due to Spanish program of certification of quality of care at inflammatory bowel disease units (53), which sets the standards of care in IBD all over the country. An alternative explanation is that immigrant patients may have a distinctive disease course.…”

Exploring the Potential Mechanism of Xiaokui Jiedu Decoction for Ulcerative Colitis Based on Network Pharmacology and Molecular Docking

“…Many factors contribute to the development of UC, including genetic factors, environmental factors, bacterial infections, and hormonal drugs [ 30 , 31 ]. Several studies have shown that intestinal barrier dysfunction and disruption of immune homeostasis within the intestinal mucosa are important causes of UC under pathological conditions [ 32 , 33 ].…”

Nationwide COVID-19-EII Study: Incidence, Environmental Risk Factors and Long-Term Follow-Up of Patients with Inflammatory Bowel Disease and COVID-19 of the ENEIDA Registry

“…These data are in the upper limit of the wide range of incidence previously described [10,14,28], ranging from 0.95 [29] to 100 per 1000 [15]. The universal access to health care within the National Health System in Spain (less than 3% of IBD patients with private insurance never use public services [30]) and the adherence of most centres to the nationwide certification programme in IBD [26] provide homogeneity to the cohort, minimizing potential bias in the clinical characteristics. We did not calculate the comparative incidence of COVID-19 between the IBD cohort and data obtained from the general population because the identification of cases did not use the same methodology.…”

“…However, data on hospitalisation, severe COVID-19, ICU admission and death from the general population are similar to our cohort and we did not find differences in specific outcomes between these two searching strategies; therefore, this bias is probably small. On the other hand, the majority of participant centres were certified IBD units that had open access to their outpatient clinics, nurse-led advice lines and/or emails for emergencies as mandatory quality criteria [26]. Second, this study, including only the first wave of an ongoing pandemic, is observational and cannot establish causation or account for unmeasured confounders.…”

“…The geographical distribution of cases is shown in Figure 1a, allowing a comparative approach with the incidence of COVID-19 in the Spanish general population (Figure 1B). The majority of cases were reported in ENEIDA centres of the communities of Madrid and in those of the metropolitan area of Barcelona (red colour), where there is also the highest proportion of certified IBD units [26]. These two regions have the highest population density in Spain (844 and 743 inhabitants per km 2 , respectively, as of January 2021 [27]) and register the highest incidence of COVID-19 in the general population.…”