Quality of care indicators in inflammatory bowel disease in a tertiary referral center with open access and objective assessment policies

Gönczi, Lóránt; Kürti, Zsuzsanna; Golovics, Petra A.; Lovász, Barbara D.; Menyhárt, Orsolya; Serés, Anna Astals; Sümegi, Liza; Gal, Alexander; Iliás, Ákos; Janos, Papp; Gecse, Krisztina; Bessisow, Talat; Afif, Waqqas; Bitton, Alain; Végh, Zsuzsanna; Lakatos, László

doi:10.1016/j.dld.2017.09.137

Cited by 11 publications

(12 citation statements)

References 22 publications

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“…In active disease patients are mainly concerned about their therapy, efficacy, safety, convenience and access [ 37 , 47 , 63 ]. In terms of patient perspectives and expectations during treatment, patients viewed efficacy of therapy to be most important.…”

Section: Discussionmentioning

confidence: 99%

“…An equally important point is access. In a recent study by our group on assessing patients reflection on the quality of care this was highlighted as one of the problem areas [ 37 , 47 , 63 ]. Of note, the availability of rapid access option by email, phone to contact the IBD center with a rapid response has also shown to significantly decrease the burden for the patients with lesser utilization of the emergency units and decreasing costs [ 37 , 47 , 63 , 64 ].…”

Section: Discussionmentioning

confidence: 99%

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Patient Perspectives and Expectations in Inflammatory Bowel Disease: A Systematic Review

et al. 2021

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Background In this systematic review, our objective was to assess inflammatory bowel disease (IBD) patient preferences and perspectives relating to their disease diagnosis, treatment, knowledge needs and telemedicine. Methods This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Four databases and conference proceedings were searched between January 1, 1980, and May 1, 2020. The methodological quality of the included studies was assessed using the Standards for reporting qualitative research checklist. Results Our search identified 240 citations and 52 studies met the inclusion criteria. The major expectations of the patients are symptomatic and pain control, quality of life and normal endoscopy. Patients' main concerns are access to information and healthcare, and shared decision making. At the time of diagnosis, patients expressed a greater need for knowledge about their IBD, preferentially by their treating gastroenterologist. The main treatment expectations in active disease are efficacy, safety and convenience. Patients are willing to accept relatively high risks of complications from medical therapy to avoid a permanent ostomy and to achieve durable remission. Patients are more interested in disease monitoring, research and development during the time of remission. Telemedicine and self-management with supervised e-health tools are feasible and acceptable amongst patients with IBD. Conclusion This systematic review demonstrates that patients with IBD expect more information about their disease process, shared decision making and symptom control. Further research is needed to help align patient and physician expectations in order to improve the quality of care provided to patients with IBD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Patient Perspectives and Expectations in Inflammatory Bowel Disease: A Systematic Review

et al. 2021

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“…Thus, variable health care access and delivery for IBD patients create significant gaps and barriers to improving quality of care. Current practice patterns vary among IBD health care providers, in North America and Europe, for key therapeutic decisions in the management of Crohn’s disease and ulcerative colitis ( 25–28 ). Strategies to mitigate these barriers require the development and implementation of innovative models to enhance care delivery nationally in a standardized and monitored setting ( 23–25 , 29 ).…”

Section: Inflammatory Bowel Diseasementioning

confidence: 99%

Development of a Global Rating Scale for Inflammatory Bowel Disease

Bitton

Devitt

Bressler

et al. 2019

Journal of the Canadian Association of Gastroenterology

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Background The Global Rating Scale (GRS) is a web-based self-assessment quality improvement tool used to identify gaps in health care, change the focus to patient-centred care and standardize care. There are four levels of achievement ranging from basic-(D) to excellent-(A) service delivery. The goal was to develop a GRS for inflammatory bowel disease (IBD) to improve the quality of care for patients on a system level. Methods The IBD GRS was developed through an iterative process and modeled upon the successful endoscopy GRS programs in the United Kingdom and Canada. Dimensions, items and statements were drafted based on expert opinions, patient-informed quality indicators and best available evidence, then reviewed and modified by a core committee. A working group of IBD and GRS experts voted in-person to establish consensus on the inclusion and quality of statements. Results Two dimensions (Clinical Quality and Quality of Patient Experience), 10 items and 89 statements made up the IBD GRS. There was a 100% response rate for each of the 40 votes for statements in the IBD GRS. All statements within each level received a mean rating score between four (agree) and five (strongly agree). Revisions agreed upon during the voting process were incorporated into the IBD GRS. Group consensus was achieved on the inclusion of statements, and 10 items were selected as standards within the two dimensions. Conclusions We have developed the first IBD GRS with the aim of improving quality of care through ongoing evaluations and improvements by health care teams, focusing on patient-centred care.

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“…Recently, a study from Hungary was one of the first of its kind to report on its center’s performance with respect to well accepted structure, process and outcome QIs. Gonczi et al[ 36 ] vigorously evaluated whether or not their center was meeting the targeted QIs. In addition, they demonstrated effective implementation of a fast track open clinic concept centered on IBD care.…”

Section: Evidence Surrounding Qi Applicationmentioning

confidence: 99%

Quality of care in inflammatory bowel diseases: What is the best way to better outcomes?

Strohl

Gönczi

Kurt

et al. 2018

WJG

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Inflammatory bowel disease (IBD) is a lifelong, progressive disease that has disabling impacts on patient’s lives. Given the complex nature of the diagnosis of IBD and its management there is consequently a large economic burden seen across all health care systems. Quality indicators (QI) have been created to assess the different façades of disease management including structure, process and outcome components. Their development serves to provide a means to target and measure quality of care (QoC). Multiple different QI sets have been published in IBD, but all serve the same purpose of trying to achieve a standard of care that can be attained on a national and international level, since there is still a major variation in clinical practice. There have been many recent innovative developments that aim to improve QoC in IBD including telemedicine, home biomarker assessment and rapid access clinics. These are some of the novel advancements that have been shown to have great potential at improving QoC, while offloading some of the burden that IBD can have vis-a-vis emergency room visits and hospital admissions. The aim of the current review is to summarize and discuss available QI sets and recent developments in IBD care including telemedicine, and to give insight into how the utilization of these tools could benefit the QoC of IBD patients. Additionally, a treating-to-target structure as well as evidence surrounding aggressive management directed at tighter disease control will be presented.

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Quality of care indicators in inflammatory bowel disease in a tertiary referral center with open access and objective assessment policies

Abstract: Our results highlight that structural components and processes applied in our center are in line with international recommendations, including an open clinic concept and fast track access to specialist consultation, endoscopy and imaging.

Cited by 11 publications

References 22 publications

Patient Perspectives and Expectations in Inflammatory Bowel Disease: A Systematic Review

Patient Perspectives and Expectations in Inflammatory Bowel Disease: A Systematic Review

Development of a Global Rating Scale for Inflammatory Bowel Disease

Quality of care in inflammatory bowel diseases: What is the best way to better outcomes?

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