TBA (21W108)

Development of a Nurse-Led Virtual Clinic for Patients with Chronic Stable Inflammatory Bowel Disease (IBD)- A Quality Improvement (QI) Project

Author(s)

A Mullen, T Duignan, CL Murphy

Department(s)/Institutions

IBD Department, Mater Misericordiae Hospital

Introduction

The forced introduction of virtual clinics within the department due to the COVID-19 pandemic was favourably received by certain patients who have chronic stable IBD.Virtual clinics allow convenient telephone assessment and triage of patients with stable IBD without the need for hospital attendance.

Aims/Background

A nurse-led virtual IBD clinic was created as QI project to:1)Provide patients with chronic stable IBD access to high-quality care in a convenient format 2)Free up face to face clinic slots for complex sicker patients. 3)Provide a template for monitoring endoscopic surveillance, medication compliance and clinical investigations

Method

Plan: Clinic format, eligibility criteria, pro-forma documentation and, governance were agreed. Do: suitable patients were recruited prospectively from IBD clinic lists and diverted to virtual clinic. Study: The impact on waiting lists was computed and patient satisfaction assessment is ongoing Act: ongoing service improvement

Results

In the first 6weeks of the project, 28 patients have been reviewed in the weekly virtual nurse-led clinic.100% of patients consented to partaking in the clinic as opposed to the standard format.100% of patients expressed satisfaction with the format and consented to yearly follow-up in this clinic with access to the nurse telephone service should their medical status change.As a result of prospectively triaging upcoming clinic lists with diversion of suitable patients to this clinic, a total of 41 clinic slots over the last 6 weeks were reallocated to urgent patients from the waiting list.

Conclusions

A PDSA approach was taken to successfully set up a nurse-led IBD virtual clinic.All patients reviewed expressed satisfaction with the service and wished to remain in the nurse-led clinic.Diversion of suitable patients from general clinic lists has significantly increased capacity for urgent patient reviews at an earlier increment.