The Crohn's & Colitis Australia Inflammatory Bowel Disease Audit: Measuring the quality of care in Australia.

Abstract

To audit the quality of care received by patients admitted for inflammatory bowel disease (IBD) across Australia against national IBD Standards. Retrospective cross-sectional survey and clinical audit assessing organisational resources, clinical processes and outcome measures. Australian hospitals. Hospitals that care for inpatients with Crohn's disease or ulcerative colitis. Adherence to national IBD Standards and comparison of quality of care between hospitals with and without multidisciplinary IBD services. 71 hospitals completed the organisational survey. Only one hospital had a complete multidisciplinary IBD service and 17 had a Partial IBD Service (IBD nurse, helpline and clinical lead). 1440 inpatient records were reviewed from 52 hospitals (mean age 37 years; 51% female, 53% Crohn's disease), approximately 26% of IBD inpatient episodes over a 12-month period in Australia. These patients were chronically unwell with high rates of anaemia (30%) and frequent readmissions (40% within two years). In general, care was inconsistent, and documentation poor. Hospitals with a Partial IBD Service performed better in many process and outcome measures: for example, 22% reduction in admissions via emergency departments and greater adherence to standards for safety monitoring of biologic (89% vs 59%) and immunosuppressive drugs (79% vs 55%) in those hospitals than those without. Patients admitted to hospital suffering from IBD are young, chronically unwell, and are subject to substantial variations in clinical documentation and quality of care. Only one hospital met accepted Standards for multidisciplinary care; hospitals with even a minimal IBD service provided improved care. This article is protected by copyright. All rights reserved.