Volume 86 - 2023 - Fasc.4 - Original articles
Quality outcome measures project in IBD: a proof-of-concept benchmarking study in three Belgian IBD units
Introduction: Current treatment modalities in IBD allow us to
render normal quality of life to most patients. Ideally, structured
digital care pathways can be harmonised in order to measure
(semi-) automatically key outcome quality indicators and compare
between institutions.
Materials and methods: Key quality criteria were selected
through a consensus process and aligned with the ICHOM quality
criteria in IBD, including clinical parameters, PROMs, quality of
life, health care utilisation and productivity.
Results: Measurements of the 11 selected key quality criteria
were integrated in the structured care pathways of three IBD units.
All patients received (at least) twice a year three questionnaires
(PRO2 or SCCAI, ICHOM criteria and IBD Disk) through the
electronic application to collect necessary information ahead of
their planned outpatient clinic. In addition, interpretation of
biomarkers was automated, and more difficult outcome indicators
were manually added by the caregiver during the visit in
anticipation of adaptations to or improvements of the electronic
record. All information was collected centrally electronically in a
structured way allowing benchmarking between the three centres,
and stored for future retrospective research.
Conclusion: A (partially) automated benchmarking for
measuring quality of care is feasible. It provides an objective
assessment of IBD care, enables benchmarking between centres
and facilitates quality improvements projects.
A survey among Flemish gastroenterologists about endoscopic sedation practices in colorectal cancer screening
Background & study aims: The sedation levels and methods used
for colonoscopy in colorectal cancer screening programs vary from
country to country and from continent to continent. Little is known
in the literature about how frequently the different sedation levels
are used in colorectal cancer screening colonoscopies. We made a
survey among all Flemish gastroenterologists (GI) to determine
how frequently they use the different sedation modalities in this
target population and to determine the motives of the GI to opt for
one or another sedation modality.
Patient and methods: An online survey was sent to all 329
Flemish GI by e-mail. A reminder e-mail was sent one month later.
Participants could indicate how frequently (by percentage) they
used the different sedation methods (no sedation, minimal sedation,
conscious sedation, deep sedation) and which sedative medication
they administered. In addition, they were asked to indicate their
main motives for choosing a specific sedation method. Descriptive
statistics were used.
Results: 112 out of 329 GI answered the questionnaire (response
rate 34%). Anesthesia monitored care is the most frequently
used sedation modality, followed by conscious sedation. Patient
preference is the main motive for most GI to use each sedation
modality.
Conclusions: Anesthesia monitored care is currently the most
frequently used sedation regimen to perform a colonoscopy in
the FIT positive population or in the colorectal cancer screening
program in Flanders. The motives given by the GI for choosing
one or another sedation modality are not always congruent with
current scientific evidence or guidelines.
