TBA (22W166)

Development and introduction of a pre-clinic screening, triage system and virtual consultations for patients with Inflammatory Bowel Disease: a nurse led quality improvement project

Author(s)

S.Gleeson, K.Sugrue, C.O'Sullivan, G.O'Sullivan, Dr. M.Buckley, Dr. J.O'Grady, Dr. C.Moran, Dr. J.McCarthy.

Department(s)/Institutions

Mercy University Hospital

Introduction

There are more than 1000 cases of IBD diagnosed each year. IBD is one of the fastest growing chronic diseases worldwide with growing waiting lists for outpatient appointments and disease monitoring. The rising prevalence of IBD calls for more patient friendly, cost and time-efficient management of IBD.

Aims/Background

The primary outcome was to implement and standardise pre-clinic screening and triage of patients into virtual vs face-to-face consultations based on clinical needs and patient preferences as well as evaluate its impact on patient acceptability and service outcomes (waiting list numbers and accessibility for urgent review).

Method

We used a quality improvement framework to develop, implement, refine, and sustain a pre-clinic screening, triage system, and introduce virtual consultations. The logic model and Plan-Do-Study- Act cycles guided the development of the pre-clinic screening, triage system and virtual consultation pathways, algorithms, and pre-clinic screening ‘pack’.

Results

There was a very high patient compliance (95%) who attended for pre-clinic screening and triage and 83% of patients would be happy to continue with the new system. Most patients felt that their symptoms (94%), disease management (81%), and follow up plan (89.3%) were discussed in sufficient detail. Most patients (84%) would opt for continued telephone consultations where possible (34%) or would like a choice of telephone vs face-to face consultation (46%). This service implementation has cleared the IBD waiting list in the Mercy University Hospital and has freed up space in OPD for urgent reviews and new referrals

Conclusions

This quality improvement project led to the successful development and implementation of a pre-clinic screening, triage system and virtual consultations.