Kapasi Rukshana, Glatter Jackie, Lamb Christopher A, Acheson Austin G, Andrews Charles, Arnott Ian D, Barrett Kevin J, Bell Graham, Bhatnagar Guaraang, Bloom Stuart, Brookes Matthew James, Brown Steven R, Burch Nicola, Burman Andy, Crook Kay, Cummings Jr Fraser, Davies Justin, Demick Anne, Epstein Jenny, Faiz Omar, Feakins Roger, Fletcher Melissa, Garrick Vikki, Jaffray Bruce, Johnson Matthew, Keetarut Katie, Limdi Jimmy, Meade Uchu, Muhammed Rafeeq, Murdock Andrew, Posford Nick, Rowse Georgina, Shaw Ian, St Clair Jones Anja, Taylor Stuart, Weaver Sean, Younge Lisa, Hawthorne Antony Barney
Crohn's & Colitis UK, Hatfield, UK.
Newcastle University, Newcastle upon Tyne, UK.
Frontline Gastroenterol. 2019 Jul 24;11(3):178-187. doi: 10.1136/flgastro-2019-101260. eCollection 2020.
Symptoms and clinical course during inflammatory bowel disease (IBD) vary among individuals. Personalised care is therefore essential to effective management, delivered by a strong patient-centred multidisciplinary team, working within a well-designed service. This study aimed to fully rewrite the UK Standards for the healthcare of adults and children with IBD, and to develop an IBD Service Benchmarking Tool to support current and future personalised care models.
Led by IBD UK, a national multidisciplinary alliance of patients and nominated representatives from all major stakeholders in IBD care, Standards requirements were defined by survey data collated from 689 patients and 151 healthcare professionals. Standards were drafted and refined over three rounds of modified electronic-Delphi.
Consensus was achieved for 59 Standards covering seven clinical domains; (1) design and delivery of the multidisciplinary IBD service; (2) prediagnostic referral pathways, protocols and timeframes; (3) holistic care of the newly diagnosed patient; (4) flare management to support patient empowerment, self-management and access to specialists where required; (5) surgery including appropriate expertise, preoperative information, psychological support and postoperative care; (6) inpatient medical care delivery (7) and ongoing long-term care in the outpatient department and primary care setting including shared care. Using these patient-centred Standards and informed by the IBD Quality Improvement Project (IBDQIP), this paper presents a national benchmarking framework.
The Standards and Benchmarking Tool provide a framework for healthcare providers and patients to rate the quality of their service. This will recognise excellent care, and promote quality improvement, audit and service development in IBD.
炎症性肠病(IBD)患者的症状和临床病程因人而异。因此,个性化护理对于有效管理至关重要,应由以患者为中心的强大多学科团队在精心设计的服务体系内提供。本研究旨在全面修订英国成人及儿童IBD医疗保健标准,并开发一种IBD服务基准工具,以支持当前及未来的个性化护理模式。
由英国IBD组织牵头,该组织是一个由患者以及IBD护理领域所有主要利益相关者提名代表组成的全国性多学科联盟。通过对689名患者和151名医疗保健专业人员收集的调查数据来确定标准要求。标准经过三轮改进的电子德尔菲法起草和完善。
就涵盖七个临床领域的59项标准达成了共识;(1)多学科IBD服务的设计与提供;(2)诊断前转诊途径、方案和时间框架;(3)新确诊患者的整体护理;(4)发作管理,以支持患者赋权、自我管理并在需要时获得专家诊治;(5)手术,包括适当的专业知识、术前信息、心理支持和术后护理;(6)住院医疗服务的提供;(7)在门诊部和初级保健机构的持续长期护理,包括共享护理。基于这些以患者为中心的标准并参考IBD质量改进项目(IBDQIP),本文提出了一个全国性的基准框架。
这些标准和基准工具为医疗保健提供者和患者提供了一个评估其服务质量的框架。这将表彰优质护理,并促进IBD领域的质量改进、审核和服务发展。