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P081 10 years of the UK Inflammatory Bowel Disease (IBD) Audit and the journey is just beginning

Protheroe A., Murray S.

Royal College of Physicians, Clinical Effectiveness and Evaluation Unit, London, United Kingdom

Background

The UK IBD Audit aims to improve the quality of care of people with IBD by auditing aspects of patient care and experience. IBD affects more than 300,000 people in the UK. Before 2006 little was known about the quality of care provided to people with IBD. The UK IBD audit was the first truly national audit performed within the field of gastroenterology

Methods

Since 2006 the audit has collected data, analysed and reported at least biannually on one or more aspects of patient care. Publication of results in 2006 showed marked variation in aspects of care delivery and an intervention strategy was developed to improve care. IBD teams contributed keenly, with the benefit of being able to benchmark against their peers. The work was driven by a multidisciplinary steering group and delivered by the Royal College of Physicians of London. Information for each element of the programme can be found: www.rcplondon.ac.uk/ibd.

Table 1. Activity over 10 years

2006–08*2008–102010–122012–142014–16
Inpatient careYYYY
Organisation of servicesYYYY
Inpatient experienceYY
Primary care surveyY
Biological therapiesYYY
Transition to IBD RegistryY

*Adult IBD services only.

Results

Participation increased from 75% in 2006 to 96% in 2015. Advances in technology have allowed for more frequent reporting of progress with real-time graphical displays built into web-based data collection tools.

Table 2. Improvements in key measures

2008–102012–14
At least some IBD nurse provision62% (127/206)86% (148/173)
Gastroenterology ward on site75% (155/207)95% (146/173)
Mortality during admission1.54% (46/2981)0.75% (30/3987)
Patient seen by an IBD nurse during unplanned admissions27% (614/2269)48% (1526/3156)
Prophylactic Heparin prescribed73% (1773/2436)90% (3282/3644)

National and team level reports were produced with an adaptable slide set and action plan to facilitate local action. Regional workshops supported networking, sharing of best practice and also empowered teams to undertake focussed quality improvement projects.

Reporting variation enabled the IBD community to focus on how to eradicate it. Following the 2006 audit a collaborative group was formed and the “IBD Standards” were developed, future audit focused on assessing delivery of care against these standards. Results have shown steady improvement in key areas.

Conclusion

Each round of audit used learning from the previous and the process was one of constant refinement and improvement. As a result of 10 years of the UK IBD audit, there is now a greater understanding of the quality of IBD services and the care provided. There is also a higher expectation of excellence and a desire to continue to improve.