Management of IBD: improving standards of care

Aim: In 2018 ACPGBI published comprehensive guidelines about the management of IBD. We identified 5 key areas of the guideline and assessed current practice at two busy DGHs against this gold standard. Our aim was to identify and reduce variation in practice to improve the management of these complicated patients. Method: We chose 5 areas of the guideline relating to VTE prophylaxis, smoking cessation, endoscopic dilatation, post-operative surveillance and multi-disciplinary team working. A questionnaire was completed by Consultants and Senior Registrars from both Colorectal Surgery and Gastroenterology about their current practice. The results and the ACPGBI guidelines were presented locally at surgical and medical meetings. Results: Thirty-eight clinicians completed the survey. Although all use prophylactic LMWH, only 26% use extended VTE prophylaxis post-operatively. 32% arrange follow up colonoscopy at the recommended 6 months post op. Smoking cessation advice is routinely offered by 84% and 66% are satisfied with the degree of multidisciplinary input. 55% stated they had experience with endoscopic dilatation for Crohn's strictures although outcomes were not always positive. After the data were presented, 100% of participants agreed to: start extended VTE post-operative prophylaxis, request a 6 month follow up colonoscopy and give all in-and-outpatients smoking cessation advice. There were productive discussions about formalising the medical/surgical pathway for the IBD patients. Conclusion: Knowledge of best practice is essential in ensuring optimum patient care and this project enhanced dissemination of the ACPGBI guidelines. More importantly, it encouraged reflection on our current practice and identified areas to improve standards of care.

Citation

Simson, R., Blane, C., & Orchard, M. (2021). Management of IBD: Improving standards of care. Colorectal Disease, 23(Suppl 1), 6–13. https://doi.org/10.1111/codi.15169

DOI

10.1111/codi.15169

URI

https://hdl.handle.net/20.500.14709/1046