George Salem, MD, Ijlal Ali, MD, Alyssa Grossen, MD, Hussein Bitar, MD, Donald J. Kastens, MD, FACG
University of Oklahoma Health Sciences Center, Oklahoma City, OK
Introduction: The American Gastroenterology Association (AGA) Bridges to Excellence (BTE) Inflammatory Bowel Disease (IBD) Care Recognition program encourages clinicians to develop a superior quality of care in the management of IBD. The compliance to AGA quality metrics has been historically low in general gastroenterology (GI) clinics. We evaluated adherence to BTE measures in the care of IBD patients seen at a tertiary care hospital gastroenterology fellows’ clinic, and developed a provider-friendly template to further increase compliance.
Methods: Patients with diagnosis of IBD (Crohn’s disease (CD), Ulcerative Colitis (UC), or indeterminate colitis (IC)) were identified in the gastroenterology continuity clinic using ICD-9 and ICD-10 codes at the University of Oklahoma Health Sciences Center, Gastroenterology fellow’s clinic. Baseline patient characteristics and 8 BTE measures were recorded. Based on compliance with quality metrics, a simple, provider-friendly template was added to GI initial and return clinic notes. Overall adherence to BTE measures and average scores as per the AGA 100 point scale were evaluated and compared pre- and post-intervention.
Results: 50 patients were seen in GI fellows’ clinic over 6-month period in the pre-intervention phase, and 35 were seen in the post-intervention phase. Baseline characteristics for both groups were similar. Overall adherence to BTE measures was 54%, and average BTE score was 58.8 (3 star) in the pre-intervention phase. Overall adherence to BTE measures was 42.4%, and average BTE score was 53 (3 star)(p >0.05) in the post-intervention phase. On sub-group analysis, it was found that only half of the patients had had the intervention implemented for their care (18/35). Sub-group analysis of patients where template was implemented, adherence to BTE measures was 98.4% and average BTE score was 98.5 (5 star) (p=0.02). When compared to the group of patients where template was not used, the overall adherence was 42.4%, and average BTE score of 53 (3 star). This was found to be statistically insignificant when compared to pre-intervention group, (p=0.60).
Discussion: The care for IBD patients continues to be a multi-disciplinary, complex approach. Using template increased compliance to vaccination and tobacco screening/counselling in our cohort. Using a provider-friendly template may improve compliance with AGA quality metrics for the care of IBD patients in outpatient settings.
Citation: George Salem, MD, Ijlal Ali, MD, Alyssa Grossen, MD, Hussein Bitar, MD, Donald J. Kastens, MD, FACG. P0459 - BRIDGES TO EXCELLENCE (BTE) QUALITY INDICATORS IN INFLAMMATORY BOWEL DISEASE (IBD) IN GASTROENTEROLOGY FELLOWS’ CLINIC AT THE UNIVERSITY OF OKLAHOMA HEALTH SCIENCES CENTER: A QUALITY IMPROVEMENT PROJECT. Program No. P0459. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.