Harmonization of quality of care in an IBD center impacts disease outcomes: Importance of structure, process indicators and rapid access clinic

Jason Reinglas, Sophie Restellini, Lorant Gonczi, Zsuzsanna Kurti, Christine Verdon, Sofia Nene, Rita Kohen, Waqqas Afif, Talat Bessissow, Gary Wild, Ernest Seidman, Alain Bitton, Peter L. Lakatos

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background and aims: We aimed to evaluate the quality of care at a tertiary inflammatory bowel disease (IBD) center using quality of care indicators (QIs) including patient assessment strategy, monitoring, treatment decisions and outcomes. Methods: We retrospectively reviewed the quality of care pre- and post-referral and during follow-up at the at the McGill University Health Center (MUHC) IBD center. Consecutive patients were included presenting with an outpatient visit (‘index visit’) between July and December 2016. Disease characteristics, biochemistry, imaging and endoscopy data, changes in medications, and vaccination profiles were captured. Results: 1357 patients were included. At referral, a large proportion of patients were objectively re-evaluated (ileocolonoscopy: 79%, cross-sectional imaging: 39.3%, biomarkers: 89.9%, 81.9%). Therapeutic strategy was changed in 53.6% with 22.5% of patients starting biologics. Tight objective patient monitoring was applied during follow-up (colonoscopy: 79%, cross-sectional imaging: 61.8% were available at index visit; C-reactive protein: 78%, Faecal calprotectin: 37.6%, therapeutic drug monitoring: 16.3% were performed additionally). Maximum therapeutic step was biologicals in 48.8% of the patients, while only 6.6% of all patients were steroid dependent. Implementation of a rapid access clinic improved healthcare delivery. Conclusions: Our data support that tight monitoring was applied at the MUHC IBD center with a high emphasis on objective patient (re)evaluation, timely access and accelerated treatment strategy at referral and during follow-up.

Original languageEnglish
Pages (from-to)340-345
Number of pages6
JournalDigestive and Liver Disease
Volume51
Issue number3
DOIs
Publication statusPublished - Mar 2019

Keywords

  • Crohn's disease
  • Quality indicators
  • Quality of care
  • Ulcerative colitis

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Fingerprint Dive into the research topics of 'Harmonization of quality of care in an IBD center impacts disease outcomes: Importance of structure, process indicators and rapid access clinic'. Together they form a unique fingerprint.

  • Cite this

    Reinglas, J., Restellini, S., Gonczi, L., Kurti, Z., Verdon, C., Nene, S., Kohen, R., Afif, W., Bessissow, T., Wild, G., Seidman, E., Bitton, A., & Lakatos, P. L. (2019). Harmonization of quality of care in an IBD center impacts disease outcomes: Importance of structure, process indicators and rapid access clinic. Digestive and Liver Disease, 51(3), 340-345. https://doi.org/10.1016/j.dld.2018.11.013