Interventions and targets aimed at improving quality in inflammatory bowel disease ambulatory care

Abstract

Over the past decade, there has been increasing focus on improving the quality of healthcare delivered to patients with chronic diseases, including inflammatory bowel disease. Inflammatory bowel disease is a complex, chronic condition with associated morbidity, health care costs, and reductions in quality of life. The condition is managed primarily in the outpatient setting. The delivery of high quality of care is suboptimal in several ambulatory inflammatory bowel disease domains including objective assessments of disease activity, the use of steroid-sparing agents, screening prior to anti-tumor necrosis factor therapy, and monitoring thiopurine therapy. This review outlines these gaps in performance and provides potential initiatives aimed at improvement including reimbursement programs, quality improvement frameworks, collaborative efforts in quality improvement, and the use of healthcare information technology.

Keywords: Ambulatory care, Crohn’s disease, Inflammatory bowel disease, Quality improvement, Ulcerative colitis

Core tip: Over the past decade, there has been increasing focus on improving quality in healthcare. This has led to the reinvigoration of the quality improvement movement. Inflammatory bowel disease is a complex, chronic condition with associated morbidity, health care costs, and reductions in quality of life. The condition is managed primarily in the outpatient setting. The delivery of high quality care is suboptimal in several ambulatory IBD domains. This review outlines current gaps in performance in IBD outpatient care and provides potential initiatives aimed at improvement.