Kapasi R, Glatter J, Lamb CA, et al
Consensus standards of healthcare for adults and children with inflammatory bowel disease in the UK
Frontline Gastroenterology Published Online First: 24 July 2019. doi: 10.1136/flgastro-2019-101260
How do you provide quality care for a patient with IBD? What standards define good quality IBD care? Building on previous IBD standards published in 2009 and 2013 this humungous effort from key stakeholders involved in IBD care provided a Delphi-consensus on seven key domains to set standards that should be adhered to in order to provide good quality IBD care. The seven domains were
1.Design and delivery of the multidisciplinary IBD service
2.Prediagnostic referral pathways, protocols and timeframes
3.Holistic care of the newly diagnosed patient
- flare management to support patient empowerment, self-management and access to specialists where required
- Surgery including appropriate expertise, preoperative information, psychological support and postoperative care
- inpatient medical care delivery
- Ongoing long-term care in the outpatient department and primary care setting including shared care. framework.
The standards were created using an E-Delphi voting system. For those not familiar with this, it essentially asks experts in the field to vote on specific statements. Generally speaking, a consensus of > 80% means a statement is accepted.
What is really striking about these standards is the vast number of professionals and patients it involved- some 689 patients and 151 healthcare professionals. This included 65 IBD nurse specialists, 60 gastroenterologists, 5 colorectal surgeons, 6 specialist pharmacists, 7 dietitians, 4 GPs, 2 nurse endoscopists, 1 radiologist and one trainee physiologist) assessed the usage and impact of previous iterations of the IBD Standards. This means you get a vast and diverse opinion from all the different MDT members involved in IBD care.
A blog cannot do this justice on all the details of the document but I thought I would highlight some overriding messages to whet your appetites. Essentially right from pre-diagnosis to follow-up these standards highlight the need to offer timely investigations and treatment for those with IBD. The standards suggest that IBD care should be looked after by specialists with rapid access to healthcare professionals when things go wrong. What I really liked about these standards was the emphasis of involving the patient in decision making the whole way throughout an IBD journey.
The standards are also so easy to read and I would say pretty jargon free. These make this document accessible to all healthcare professionals and patients alike.
Want to know what standards you need to achieve to get the best IBD care. Look no further than this document online now on
https://fg.bmj.com/content/early/2019/07/19/flgastro-2019-101260