TBA (22W112)

Triaging of Magnetic Resonance Enterography: A Quality Improvement Project at an Inflammatory Bowel Disease Centre.

Author(s)

Lynch K, O’Sullivan A, Zulquernain S, Sawbridge D, Kenny E. Byron, C.

Department(s)/Institutions

Dept. of Gastroenterology/Hepatology, Cork University Hospital. School of Medicine, University Collage Cork.

Introduction

Magnetic Resonance Enterography (MRE) is a useful tool in assessment of small bowel involvement of Inflammatory Bowel disease (IBD). Access to MRE at Cork University Hospital (CUH) is limited to two patients per week. MREs in CUH are generally performed in chronological order from the time of booking, with a median waiting time of over 2 years.

Aims/Background

This project aimed to triage requests so that the patients most likely to have a subsequent management change are prioritised.

Method

We conducted a review of all MRE requests in CUH and correlated these with clinical correspondence and laboratory findings. We subsequently triaged each request into one of four categories as follows. Category 1: Known IBD, active flare clinically and biochemically. Category 2: Known IBD, obstructive symptoms present, but biochemically and other symptoms stable or improving. Category 3: Query of IBD with biochemical abnormalities (eg raised faecal calprotectin) or Known IBD, clinically and biochemically stable at present. Category 4: Query of IBD with no biochemical abnormalities. Requests not relating to IBD were excluded.

Results

A total of 125 requests were identified. 18 were triaged as category 1, 13 as category 2, 69 as category 3, and the remaining 25 as category 4. The median reduction in wait time for category 1 MREs was 21 months. 83 of the requests were for patients with known IBD.

Conclusions

MRE wait times for patients with known IBD which is active, and escalation of treatment is being considered can be significantly reduced with our triage system.