Transcript Slide 1

National audit of
paediatric IBD service
provision
Organisational audit
[Enter name of presenter]
[Enter date of presentation]
Introduction to the IBD programme
‘Improving the care of people with IBD’
Five elements, 2012–2014
1. Inpatient care (1 Jan – 31 Dec 2013)
Assesses the treatment that a patient receives when admitted to hospital. Each hospital participating in
the audit collects information on the first 50 patients admitted with ulcerative colitis in 2013.
2. Inpatient experience (1 Jan 2013 – 31 Jan 2014)
Assesses the quality of patient care. Each patient included in the inpatient care audit is given a
questionnaire when they leave hospital. They can comment on the care that they received and how this
made them feel.
3. Biological therapy audit (continuous audit)
Collects information about treatment, delivery, disease activity and quality of life in patients who are
prescribed infliximab or adalimumab for IBD.
Introduction to the IBD programme
‘Improving the care of people with IBD’
Five elements, 2012–2014
4. Organisational audit and quality improvement tool
IBDQIP (1 Feb – 31 March 2014)
A web-based self-assessment that enables hospitals to measure their organisation of care compared with
national service standards. The tool identifies areas for improvement and facilitates change.
5. Quality improvement: peer support visits
A series of visits where hospitals are paired up and meet to compare results and identify methods for
improving the quality of care for patients. The IBD programme team supports the clinical teams to share
best practice and explore new ways of working.
Methodology
• Services were advised to meet as a multidisciplinary
team to collect data into an online web tool
• Data collected was to reflect the IBD service ‘as at’ 31
December 2013
• The dataset was mapped to the IBD Standards
• As soon as all data was entered onto the web tool and
‘submitted’, instant results were available in a results
dashboard
• Online action planning (linked to results) was also
available
Participation in the organisational
audit
• 1 February 2014 – 31
March 2014
• 92% (23/25) specialist
paediatric centres in the UK
• First time audit was
available to a number of
smaller-volume paediatric
services
• Total 31 sites
Key indicators
Your site level data for this table can be found in your local site report (Section 2, Table 1)
Key indicators round 4
National
results
Standard A1 – The IBD team
Median (IQR) number of whole-time
equivalent (WTE) paediatric IBD nurses on site
1
(0.6, 1.8)
Median (IQR) number of WTE paediatric
dietitians allocated to gastroenterology
1
(0.4, 2)
Standard A8 – Inpatient facilities
Sites with an identifiable paediatric
gastroenterology ward
29%
(9/31)
Sites with at least one toilet per three IBD
patients
52%
(16/31)
Your site
results
Key indicators continued
Your site level data for this table can be found in your local site report (Section 2, Table 1)
Key indicators round 4
National
results
Your site
results
Standard A10 – Inpatient care
Sites with guidelines for the management of
acute severe UC
77%
(24/31)
Sites where PUCAI score is used at day 3 and 5
for assessment of acute severe UC
74%
(23/31)
Standard A12 – Arrangements for the care of children and young people
Site with a transitional care service for young
people to support their transfer to adult
services
90%
(28/31)
Key indicators continued
Your site level data for this table can be found in your local site report (Section 2, Table 1)
Key indicators round 4
National
results
Your site
results
Standard C2 – Rapid access to specialist advice
Sites where relapsing patients can be seen for
specialist review within 7 days
94%
(29/31)
Standard E1 – Register of patients under the care of the IBD service
Sites with a searchable database or registry of
paediatric IBD patients
68%
(21/31)
Standard E3 – Participation in audit
Sites where patients undergoing ileal pouch
surgery are entered into the pouch registry
56%
(9/16)
Recommendations
1.
2.
3.
4.
5.
6.
7.
All site should implement guidelines for management of acute severe UC
which include regular use of the PUCAI.
Outcomes of ileal pouch surgery should be entered to the national pouch
registry.
Ongoing monitoring (national or local) should continue against the IBD
standards.
All services should aim to provide an annual review for all patients with IBD.
IBD services should continue to enrol eligible patients to relevant clinical
trials.
All services should capture clinical data about their IBD patients on a
regularly maintained database.
Patients should have a voice and direct involvement in the development of
their IBD service. Services must be able to demonstrate that mechanisms are
in place to obtain and respond to patient feedback.
Your three key areas for local change
Local key area
What action is
needed to facilitate
change?
Who will be
responsible?
1.
Write local algorithm
and circulate to MDT
Consultant
At and MDT
Gastroenterologist meeting in Dec
and IBD nurse
2014
2.
3.
Guidelines for the
management of ASUC
How and when
will you review
this action?
Acknowledgements
Thank you to all the hospital-based staff who
contributed towards case note retrieval and data
collection.
For further information, contact:
[email protected]