Providing Our Fellows in Training with Education on Inflammatory Bowel Disease Health Maintenance to Improve the Quality of Care in Our Health Care System

Lee, Ann Joo; Kraemer, Dale F.; Smotherman, Carmen; Eid, Emely

doi:10.1097/mib.0000000000000573

Cited by 11 publications

(13 citation statements)

References 15 publications

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“…Quality improvement projects Twelve quality improvement (QI) projects were retrieved from the search, most of which identified process variation and then utilised educational approaches to change clinician behaviour [23,24,[45][46][47][48][49][50][51][52][53]. Table 3 provides a summary of the projects identified.…”

Section: Facilitated Feedbackmentioning

confidence: 99%

“…They then re-audited after an educational session in which performance against the quality measures was reviewed. Lee at al identified a positive correlation between the intervention and compliance with the quality measures, with compliance increasing by 16% [53]. Two studies progressed this approach by developing algorithms for a range of evidence-based practices as the basis for determining compliance [45,47].…”

Section: Facilitated Feedbackmentioning

confidence: 99%

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Can feedback approaches reduce unwarranted clinical variation? A systematic rapid evidence synthesis

Harrison

Hinchcliff

Manias

et al. 2020

BMC Health Serv Res

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Background Assessment of clinical variation has attracted increasing interest in health systems internationally due to growing awareness about better value and appropriate health care as a mechanism for enhancing efficient, effective and timely care. Feedback using administrative databases to provide benchmarking data has been utilised in several countries to explore clinical care variation and to enhance guideline adherent care. Whilst methods for detecting variation are well-established, methods for determining variation that is unwarranted and addressing this are strongly debated. This study aimed to synthesize published evidence of the use of feedback approaches to address unwarranted clinical variation (UCV). Methods A rapid review and narrative evidence synthesis was undertaken as a policy-focused review to understand how feedback approaches have been applied to address UCV specifically. Key words, synonyms and subject headings were used to search the major electronic databases Medline and PubMed between 2000 and 2018. Titles and abstracts of publications were screened by two reviewers and independently checked by a third reviewer. Full text articles were screened against the eligibility criteria. Key findings were extracted and integrated in a narrative synthesis. Results Feedback approaches that occurred over a duration of 1 month to 9 years to address clinical variation emerged from 27 publications with quantitative (20), theoretical/conceptual/descriptive work (4) and mixed or multi-method studies (3). Approaches ranged from presenting evidence to individuals, teams and organisations, to providing facilitated tailored feedback supported by a process of ongoing dialogue to enable change. Feedback approaches identified primarily focused on changing clinician decision-making and behaviour. Providing feedback to clinicians was identified, in a range of a settings, as associated with changes in variation such as reducing overuse of tests and treatments, reducing variations in optimal patient clinical outcomes and increasing guideline or protocol adherence. Conclusions The review findings suggest value in the use of feedback approaches to respond to clinical variation and understand when action is warranted. Evaluation of the effectiveness of particular feedback approaches is now required to determine if there is an optimal approach to create change where needed.

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Section: Facilitated Feedbackmentioning

confidence: 99%

Section: Facilitated Feedbackmentioning

confidence: 99%

Can feedback approaches reduce unwarranted clinical variation? A systematic rapid evidence synthesis

Harrison

Hinchcliff

Manias

et al. 2020

BMC Health Serv Res

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“…However, the potential risk of comorbidities negatively impacting IBD outcomes has mandated a working knowledge of health maintenance and a holistic approach to healthcare for IBD patients. A recent study showed that incorporating a standard curriculum on IBD health maintenance provided fellows in training with increased awareness and guidance on managing the unique preventive care needs of patients with IBD[172]. Different tools exist to assist practicing gastroenterologists in addressing preventive health issues during clinical encounters with IBD patients, such as, the Crohn’s and Colitis Foundation of America (CCFA) check list for health maintenance or clinical assessment checklist developed by specialized IBD centers[173-175].…”

Section: Resultsmentioning

confidence: 99%

Preventive health measures in inflammatory bowel disease

Abegunde

Muhammad

Ali

2016

WJG

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We aim to review the literature and provide guidance on preventive health measures in inflammatory bowel disease (IBD). Structured searches were performed in PubMed, MEDLINE, EMBASE, Web of Science and Cochrane Library from January 1976 to June 2016 using the following keywords: (inflammatory bowel disease OR Crohn’s disease OR ulcerative colitis) AND (health maintenance OR preventive health OR health promotion). Abstracts of the articles selected from each of these multiple searches were reviewed, and those meeting the inclusion criteria (that is, providing data regarding preventive health or health maintenance in IBD patients) were recorded. Reference lists from the selected articles were manually reviewed to identify further relevant studies. Patients with IBD are at increased risk of developing adverse events related to the disease course, therapeutic interventions, or non-adherence to medication. Recent studies have suggested that IBD patients do not receive preventive services with the same thoroughness as patients with other chronic diseases. Preventive health measures can avert morbidity and improve the quality of life of patients with IBD. Gastroenterologists and primary care physicians (PCPs) should have an up to date working knowledge of preventive health measures for IBD patients. A holistic approach and better communication between gastroenterologists and PCPs with explicit clarification of roles will prevent duplication of services and streamline care.

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“…Recent studies have reported poor compliance with IBD QI measures amongst gastroenterologists [ 12 , 14 , 15 ]. Within gastroenterology, there are additional areas of interest and specialization.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown that, despite large initiatives for quality improvement in IBD patients, compliance with QI continues to be low [ 12 , 14 - 16 ]. It is, however, encouraging that in our study both groups of physicians exceeded the AGA recommended score of 60.…”

Section: Discussionmentioning

confidence: 99%

Bridges to excellence quality indicators in inflammatory bowel disease (IBD): differences between IBD and non-IBD gastroenterologists

Bilal¹,

Singh

Lee

et al. 2016

aog

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BackgroundThe American Gastroenterology Association (AGA) Bridges to Excellence (BTE) Inflammatory Bowel Disease (IBD) Care Recognition program encourages clinicians to develop a superior quality of care in the treatment of IBD. We evaluated adherence to BTE measures in the care of IBD patients among IBD and non-IBD gastrointestinal physicians at a tertiary care hospital.MethodsWe performed a retrospective chart analysis of IBD patients who had received care at our center between January 2013 and March 2015. The patients were divided into two groups: a. care provided by an IBD-trained physician with more than 50% of their practice dedicated to IBD; and b. care provided by a non-IBD gastrointestinal physician. Data collected included baseline patient characteristics and eight BTE measures. Overall adherence to BTE measures and average scores as per the AGA 100 point scale were evaluated and compared between the two groups.ResultsA total of 325 IBD patients met the inclusion criteria and were included in the analysis. Of these, 216 patients received care from an IBD physician. Patients managed by IBD physicians were younger and had more severe disease. Both physician groups scored above the recommended score of 60. IBD physicians had a higher average score on the AGA 100 point scale (73.9 vs 66.3, P=0.001). Overall adherence to BTE quality measures was higher for IBD physicians compared to non-IBD physicians (71.8% vs. 58.8%, P value: 0.001).ConclusionBoth IBD and non-IBD physicians exceeded the AGA recommended score of 60 on the BTE measures at our center. IBD physicians perform better overall on BTE quality measures compared to non-IBD physicians.

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Providing Our Fellows in Training with Education on Inflammatory Bowel Disease Health Maintenance to Improve the Quality of Care in Our Health Care System

Abstract: Incorporating a standard curriculum on IBD health maintenance provides fellows in training with increased awareness and guidance on managing the unique preventive care needs of patients with IBD.

Cited by 11 publications

References 15 publications

Can feedback approaches reduce unwarranted clinical variation? A systematic rapid evidence synthesis

Can feedback approaches reduce unwarranted clinical variation? A systematic rapid evidence synthesis

Preventive health measures in inflammatory bowel disease

Bridges to excellence quality indicators in inflammatory bowel disease (IBD): differences between IBD and non-IBD gastroenterologists

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