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P130. The quality of inflammatory bowel disease inpatient experience: data from the UK IBD Audit

K. Bodger1, R. Driscoll2, A. Protheroe3, M. Roughton3, I. Arnott4, 1University of Liverpool, Liverpool, United Kingdom, 2Crohn's and Colitis UK, United Kingdom, 3Royal College of Physicians, CEEu, London, United Kingdom, 4Western General Hospital, Gastrointestinal Unit, Edinburgh, United Kingdom

Background

The UK IBD Audit seeks to improve the quality and safety of care for IBD patients throughout the UK by auditing individual patient care and the provision and organisation of IBD service resources. The inclusion of an inpatient experience questionnaire in the latest round of audit provided the opportunity to obtain direct patient feedback regarding hospital care.

Methods

Consecutive inpatients with UC and CD were audited. Following completion of data entry for each case a patient experience survey was generated. This comprised a self-completed questionnaire containing items taken from the National Inpatient Survey question bank (Picker Institute) with supplementary questions specific to IBD. Aggregated results are presented for all respondents.

Results

2,028 adults and 166 children returned the questionnaire (response rate: 33%). Results presented as adults [children] where appropriate. Overall care rated as only fair by 7% [6.7% children] and poor by 2.9% [0%]. Overall satisfaction correlated most strongly with rating of how well doctors and nurses worked together (p < 0.01) and individual questions relating to staff knowledge and communication were strong predictors of overall satisfaction. Scores for consistency & coordination of care and nursing were relatively low compared with data for general inpatients (National Inpatient Survey, 2009). Only 60% of adults [76% children] indicated having a visit from a specialist nurse. Scores for CD significantly lower than UC in several domains (p < 0.01). Hospital food: Rated as poor by 20% [11%]; “Too little” food provided was reported by 15% [16%]; “Never” suited to dietary needs by 15% [8%]. No dietician visit in 59% [26%]. Pain: “Ever in pain?” 85% [83%]; Usually severe 52% [52%]; Analgesic medication “not enough” reported in 16% [12%]. One in ten patients reported sub-optimal aspects of discharge information such as lack of information about drug side effects, the danger signs to watch for or how to manage their condition after going home.

Conclusion

There are many positive findings from the United Kingdom survey of IBD inpatient care – over ¾ of adults and children rated their care as ‘very good’ or ‘excellent’. Patients clearly value co-ordinated care. There are a number of areas for potential improvement and greater involvement of IBD nurses at ward level could play a key role. All admitted IBD patients should receive input from specialist multidisciplinary teams with experience of managing these complex disorders.