Quality of Care Standards in Inflammatory Bowel Diseases: a European Crohn’s and Colitis Organisation [ECCO] Position Paper

Abstract

The management of inflammatory bowel disease (IBD) is complex, and requires tight control of disease activity, close monitoring to avoid treatment side effects, healthcare professionals with expertise in IBD and an interdisciplinary, holistic approach. Despite various efforts to standardise structures, processes and outcomes1-8, and due to the high variability at the local, national and international levels, there are still no clear definitions or outcome measures available to establish quality of care standards for IBD patients that are applicable in all contexts and all countries. For this reason, the European Crohn’s and Colitis Organisation (ECCO) supported the construction of a list of criteria summarising current standards of care in IBD. The list comprises 111 quality standard points grouped into three main domains (structure n=31, process n=42, outcomes n=38) and is based on scientific evidence, interdisciplinary expert consensus and patient-oriented perspectives. The list of proposed criteria is intended to represent the position of ECCO regarding the optimum quality of care that should be available to patients. Since healthcare systems and regulations vary considerably between countries, this list may require adaptation at local and national levels. It is recognised that not all these criteria that have been identified as optimal will be available in every unit. However, ECCO will continue its efforts to develop and coordinate projects and initiatives that will help to guarantee optimal quality of care for all IBD patients.

Impact of COVID‐19 pandemic on the daily management of biotechnological therapy in inflammatory bowel disease patients: Reorganisational response in a high‐volume Italian inflammatory bowel disease centre

“…Physician and IBD nurse schedules and tasks were organised similarly to that stated by Fiorino et al. 5…”

“…‘Smart working’, ‘telemedicine’, changes in shifts or work attributed to a COVID or non‐COVID path were registered. Physician and IBD nurse schedules and tasks were organised similarly to that stated by Fiorino et al 5 …”

“…Moreover, to reduce the risk of spreading SARS‐CoV‐2 infection, access to hospitals has been strictly limited to urgent cases. In this context, the management of chronic diseases, including inflammatory bowel disease (IBD), has been critically impacted, with a significant reduction in visits, endoscopic and radiological procedures and multidisciplinary evaluations, modifying the current standard of care for IBD 4 , 5 . There are currently only a few reports on IBD patients, 6–10 but no specific recommendations can be given to IBD patients based on direct evidence.…”

Inflammatory Bowel Disease Care in the COVID-19 Pandemic Era: The Humanitas, Milan, Experience

“…IBD patients are severely worried about the impact of their disease and medications on the risk and the prognosis of COVID-19, and many of them are forced to come to hospital because of active disease, complications and drug administration. In order to maintain the quality standard of care, 16 our unit has adopted several strategies [ Figure 1].…”

The impact of COVID-19 pandemic on IBD endoscopic procedures in a high-volume IBD Center

“…Prior to the pandemic, several standards existed for high-quality endoscopy for IBD endoscopy [16]. In our center, access to high-definition endoscopy, particularly for colon cancer surveillance, was routinely provided to patients with UC or colonic CD, as well as deep sedation during endoscopy for selected patients.…”