Delphi consensus statement: Quality indicators for Inflammatory Bowel Disease Comprehensive Care Units

Calvet, Xavier; Panés, Julián; Alfaro, Nelly López; Hinojosa, Joaquín; Sicilia, Beatriz; Gállego, Marta; Pérez, Perez Ildefonso; Mercado, Lazaro y de Mercado Pablo Lázaro y de; Gomollón, Gomollon Fernando; Aldeguer, Xavier; Alós, Rafael; Andreu, Montserrat; Barreiro, Manu; Bermejo, Fernando; Casís, Begoña; Domènech, Eugeni; Espín, Eloy; Esteve, María; García–Sánchez, Valle; López-Sanromán, Antonio; Martínez-Montiel, Pilar; Mendoza, Juan L.; Gisbert, Javier P.; Vera, Maribel; Dosal, Nurses: Angelina; Sánchez, E.; Marín, Laura; Sanromán, Luciano; Pinilla, Pilar; Murciano, Francisca; Torrejón, Antonio; García, Javier José Vales; Ortega, M. Muros; Roldán, J E Viñuela

doi:10.1016/j.crohns.2013.10.010

Cited by 93 publications

(94 citation statements)

References 32 publications

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“…While it is commonly accepted that ICCUs facilitate the provision of quality care to patients with IBD, a structure of ICCU is still not well defined [33] . The cost of implementing some of these quality measures is modest suggesting that substantial improvement is possible.…”

Section: Resultsmentioning

confidence: 99%

“…Similarly, the Crohn's and Colitis Foundation of America have also proposed a questionnaire for the assessment of quality of care of patients with IBD [31,32] (Table 2). In order to identify a set of quality indices, Calvet et al [33] conducted a two-round web-based survey including an expert panel of patient representatives (n = 4), nurses (n = 7), surgeons (n = 2) and physicians (n = 18) using Delphi consensus-based approach. The expert panel selected a core set of 56 QIs (including 12 structure, 20 process and 24 outcome related).…”

Section: Quality Indicators For Ibdmentioning

confidence: 99%

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Quality of care in Crohn's disease

Makharia

2014

WJGP

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Crohn's disease (CD) is a chronic and progressive inflammatory disease of the intestine. Overall, healthcare delivery for patients with CD is not optimal at the present time and therefore needs improvement. There are evidences which suggest that there is a variation in the care provided to patients with CD by the inflammatory bowel disease (IBD) experts and community care providers. The delivery of healthcare for patients with CD is often complex and requires coordination between gastroenterologists/IBD specialist, gastrointestinal surgeon, radiologists and IBD nurses. In order to improve the quality of health care for patients with CD, there is need that we focus on large-scale, system-wide changes including creation of IBD comprehensive care units, provision to provide continuous care, efforts to standardize care, and education of the community practitioners.

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Section: Resultsmentioning

confidence: 99%

Section: Quality Indicators For Ibdmentioning

confidence: 99%

Quality of care in Crohn's disease

Makharia

2014

WJGP

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“…This is likely because such IBD units are managed by IBD specialists to whom cost management functions have been delegated (1 …”

mentioning

confidence: 99%

Pharmaceutical costs for inflammatory bowel disease units An issue for department heads? The GESTIONAEII survey

Argüelles-Arias¹,

Acosta²,

Hinojosa³

2016

Rev Esp Enferm Dig

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Inflammatory bowel disease (IBD) units have a relevant weight within gastroenterology departments. In order to gain insight into the managerial aspects of IBD diagnosis and treatment, SEPD submitted a survey (GESTIONAEII) to department heads, IBD specialists, and other gastroenterologists. In this letter, we discuss the results obtained from gastroenterology department heads.The above-mentioned survey included 28 questions and was responded by 30 department heads, most of them older than 50 years and working for a tertiary university hospital. Only 13 respondents are aware of biologic drug prices (mean expense, € 950,000 per year); 63% of them consider that costs will rise in the upcoming years, but 84% consider that biosimilars will lower their prices. As regards the method for prescription regulation, 47% responded it is per protocol, and in 26% of hospitals, a biologics committee has been set up with pharmacists, medical directors, and specialists. However, the fact that 37% of them do not know who is in the committee is to be highlighted. In most (63%) sites it is the pharmacist who negotiates prices. Among respondents, 63% acknowledges pharmaceutical costs as an issue for their departments because of its rising during the past 2 years.According to these results, many department heads obviously ignore the financial managerial aspects of their IBD units. This is likely because such IBD units are managed by IBD specialists to whom cost management functions have been delegated (1).

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“…The British guidelines and European societies recommend the development of ''high quality, safe and integrated teams'' for the clinical care of patients with inflammatory bowel disease [7,10]. In a discussion of quality indicators, the Europeans describe the establishment of functional IBD comprehensive care units (ICCUs) [10].…”

mentioning

confidence: 99%

“…In a discussion of quality indicators, the Europeans describe the establishment of functional IBD comprehensive care units (ICCUs) [10]. Although this goal may be more difficult to achieve in the US due to geographic and other concerns, initiatives such as this will likely be of benefit to practitioners caring for IBD patients of reproductive age and desire who have undergone J-pouch surgery, in particular to inform less experienced physicians about these issues and to provide appropriate referrals to a comprehensive center that can provide surgical, obstetric and gastrointestinal expertise.…”

mentioning

confidence: 99%

Pregnancy Concerns in Patients with Ileal Pouch Anal Anastomosis for Ulcerative Colitis: Time for Increased Education Across Specialties

Isaacs

2014

Dig Dis Sci

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Pregnancy is an emotionally charged and physically demanding time in a woman's life. Patients who have had surgery for ulcerative colitis during their reproductive years provide a unique set of challenges for physicians before and during pregnancy. Pregnant women who have undergone surgery for medically refractory ulcerative colitis, usually total abdominal colectomy with ileal pouch anal anastomosis (IPAA), often have a close relationship with their surgeon and gastroenterologist. The patient's surgeon, gastroenterologist or obstetrician may provide counseling regarding pre-pregnancy issues and pregnancy management, with the advantage that these specialists may have diverse understanding of and approaches to the issues based on their differing training environments, respective literatures, and practice settings.In this issue of Digestive Diseases and Sciences, Bradford et al.[1] assess differences in reproductive and pregnancy-related recommendations in this population using a survey design encompassing multiple clinical vignettes detailing multiple management options. They examined the impact of fertility on IPAA, the timing of IPAA in relationship to pregnancy, delivery recommendations, and who should be providing advice, reporting major differences in advice given among the specialties studied. The data in the literature that support counseling decisions range in focus from the effects of IPAA on fertility and the choice of practitioner providing advice to these patients, which are unsupported by data, to controversial surgical timing issues supported by few data.The authors highlight some of the most difficult areas of decision-making in terms of reproduction in women with a J-pouch. The survey data they obtained were derived from responses to an invitation distributed to two national gastroenterology and surgical professional society email lists. The obstetricians surveyed were from two large obstetric groups in Southern California. Very few of the respondents saw more than five pregnant IBD patients per year and likely far fewer of these patients had J-pouches. Since education informs excellent care, in this very specialized area of inflammatory bowel disease, the presence of key data is essential. A limited Pubmed search shows that the bulk of the information published on pregnancy and ulcerative colitis is in the gastrointestinal and surgical literature (Table 1). Obstetricians-who provide J-pouch patients with pre-pregnancy counseling, discuss pregnancy management issues, and make delivery decisions, may have the least readily available patient resource information. Most of the quality measures for IBD care currently in development in the USA are focused on treatment-related issues rather than physician and patient education [2].Decreased fertility in patients after IPAA should be the least controversial topic addressed in this manuscript since a large body of literature supports this issue. Patients undergoing traditional IPAA procedures have extensive manipulation of the pelvis that likely leads to a...

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Delphi consensus statement: Quality indicators for Inflammatory Bowel Disease Comprehensive Care Units

Abstract: The present Delphi consensus identified a set of core QIs that may be useful for evaluating and certifying ICCUs.

Cited by 93 publications

References 32 publications

Quality of care in Crohn's disease

Quality of care in Crohn's disease

Pharmaceutical costs for inflammatory bowel disease units An issue for department heads? The GESTIONAEII survey

Pregnancy Concerns in Patients with Ileal Pouch Anal Anastomosis for Ulcerative Colitis: Time for Increased Education Across Specialties

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Delphi consensus statement: Quality indicators for Inflammatory Bowel Disease Comprehensive Care Units

Abstract: The present Delphi consensus identified a set of core QIs that may be useful for evaluating and certifying ICCUs.

Cited by 93 publications

References 32 publications

Quality of care in Crohn's disease

Quality of care in Crohn's disease

Pharmaceutical costs for inflammatory bowel disease units  An issue for department heads? The GESTIONAEII survey

Pregnancy Concerns in Patients with Ileal Pouch Anal Anastomosis for Ulcerative Colitis: Time for Increased Education Across Specialties

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Pharmaceutical costs for inflammatory bowel disease units An issue for department heads? The GESTIONAEII survey