Quality improvement in pediatric inflammatory bowel disease: Moving forward to improve outcomes

Abstract

In recent years, pediatric health care has embraced the concept of quality improvement to improve patient outcomes. As quality improvement efforts are implemented, network collaboration (where multiple centers and practices implement standardized programs) is a popular option. In a collaborative network, improvement in the conduct of structural, process and outcome quality measures can lead to improvements in overall health, and benchmarks can be used to assess and compare progress. In this review article, we provided an overview of the quality improvement movement and the role of quality indicators in this movement. We reviewed current quality improvement efforts in pediatric inflammatory bowel disease (IBD), as well as other pediatric chronic illnesses. We discussed the need to standardize the development of quality indicators used in quality improvement networks to assess medical care, and the validation techniques which can be used to ensure that process indicators result in improved outcomes of clinical significance. We aimed to assess current quality improvement efforts in pediatric IBD and other diseases, such as childhood asthma, childhood arthritis, and neonatal health. By doing so, we hope to learn from their successes and failures and to move the field forward for future improvements in the care provided to children with IBD.

Keywords: Inflammatory bowel disease, Colitis, Ulcerative, Crohn’s disease, Child, Adolescent, Quality of health care, Review

Core tip: This review article provides an overview of the quality improvement movement and the role of quality indicators. Active quality improvement efforts in pediatric inflammatory bowel disease are discussed, and the need for standardizing the development of quality indicators across all fields of healthcare is emphasized. This article also discusses the importance of incorporating validation techniques when developing and selecting quality indicators. Examples of quality improvement efforts in other areas of pediatric chronic illnesses are presented, with important lessons highlighted to guide future quality improvement initiatives.