Optimising the Inflammatory Bowel Disease Unit to Improve Quality of Care: Expert Recommendations

Louis E1, Dotan I2, Ghosh S3, Mlynarsky L2, Reenaers C4, Schreiber S5. J Crohns Colitis. 2015 May 18. pii: jjv085. [Epub ahead of print]
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1Department of Gastroenterology, University Hospital CHU of Liège, Liège, Belgium edouard.louis@ulg.ac.be. 2IBD Center, Department of Gastroenterology and Liver Diseases, Tel Aviv Sourasky Medical Center and the Sackler School of Medicine, Tel Aviv, Israel. 3Department of Medicine, Division of Gastroenterology, University of Calgary, Calgary, AB, Canada. 4Department of Gastroenterology, University Hospital CHU of Liège, Liège, Belgium. 5Department of Medicine, University Hospital Schleswig-Holstein, Kiel, Germany.


INTRODUCTION: The best care setting for patients with inflammatory bowel disease [IBD] may be in a dedicated unit. Whereas not all gastroenterology units have the same resources to develop dedicated IBD facilities and services, there are steps that can be taken by any unit to optimise patients' access to interdisciplinary expert care. A series of pragmatic recommendations relating to IBD unit optimisation have been developed through discussion among a large panel of international experts.

METHODS: Suggested recommendations were extracted through systematic search of published evidence and structured requests for expert opinion. Physicians [n = 238] identified as IBD specialists by publications or clinical focus on IBD were invited for discussion and recommendation modification [Barcelona, Spain; 2014]. Final recommendations were voted on by the group. Participants also completed an online survey to evaluate their own experience related to IBD units.

RESULTS: A total of 60% of attendees completed the survey, with 15% self-classifying their centre as a dedicated IBD unit. Only half of respondents indicated that they had a defined IBD treatment algorithm in place. Key recommendations included the need to develop a multidisciplinary team covering specifically-defined specialist expertise in IBD, to instil processes that facilitate cross-functional communication and to invest in shared care models of IBD management.

CONCLUSIONS: Optimising the setup of IBD units will require progressive leadership and willingness to challenge the status quo in order to provide better quality of care for our patients. IBD units are an important step towards harmonising care for IBD across Europe and for establishing standards for disease management programmes.

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