Improving Access to Urgent IBD Care

A collaboration aimed at improving access to immediate urgent care for patients with inflammatory bowel disease helped to reduce emergency department (ED) overutilization, according to a poster presented at the 2016 Advances in IBD Conference. 

“Patients with inflammatory bowel disease may have exacerbations of symptoms necessitating urgent medical attention,” Jason Ken Hou, MD, MS, assistant professor of gastroenterology at the Baylor College of Medicine, and colleagues wrote in a presentation. “Due to barriers in access, patients often seek urgent care from emergency departments (ED) for acute symptoms. Unnecessary ED utilization may result in additional cost, overuse of opiates, steroids, and radiological studies. The aim of this study was to use a Breakthrough Series Collaborative to improve the delivery of urgent care to patients with inflammatory bowel disease.”    

The Breakthrough Series Collaborative was a quality improvement model developed during the Crohn’s and Colitis Foundation of America’s IBD Qorus. The program consists of three in-person training session and multiple web-based meetings. Data on 15 interventions were collected via survey during routine clinical encounters in order to determine patient perception of immediate care availability. 

The researchers studied the efficacy of the Breakthrough Series Collaborative at one site over a 13-month period. The study site identified local deficiencies in urgent care delivery, which included “communicating a specific plan of action during an exacerbation of inflammatory bowel disease symptoms, and timely means for routing urgent messages to clinical staff.” In response, the site developed an “urgent care hotline,” which allowed patients to directly access a nurse. 

The researchers found that development of the hotline was associated with reductions in ED visits and increases in patient satisfaction.

“The creation of a nursing care hotline and patient-education materials were associated with shifts towards improvement in ED utilization... and patient satisfaction for inflammatory bowel disease related urgent care experiences,” Dr Hou and colleagues concluded. “Participation in a quality improvement learning health system facilitates improvement in patient care and outcomes.”  —David Costill