Quality of care in adult patients with inflammatory bowel disease transferring between healthcare providers: multicentre audit

Omer F Ahmad; Homira Ayubi; Jennie Clough; Robin Dart; Radha Gadhok; Samuel Pannick; Gareth Parkes; Polychronis Pavlidis; Jonathan Segal; Penelope Sellers

doi:10.1136/flgastro-2019-101347

Quality of care in adult patients with inflammatory bowel disease transferring between healthcare providers: multicentre audit

Omer F Ahmad, Homira Ayubi, Jennie Clough, Robin Dart, Radha Gadhok, Samuel Pannick, Gareth Parkes, Polychronis Pavlidis, Jonathan Segal, Penelope Sellers

Research output: Contribution to journal › Article › peer-review

4 Citations (Scopus)

196 Downloads (Pure)

Abstract

Background: Inflammatory bowel disease (IBD) predominantly affects young adults at critical socioeconomic periods of their lives. There are no studies examining the process of transfer of care for adult patients with IBD changing healthcare providers. Our aims were to assess the quality of referral information provided when patients with an established IBD diagnosis transfer care between heathcare providers and to assess the impact of referral quality on patient outcome. Methods: Retrospective data pertaining to IBD transfer of care referrals were collected from 16 hospitals across London over a 2-month period. Data were collected on patient demographics, source and content of referral and cross-referenced with an established transfer of care checklist. Patient outcome within the 6 months following transfer was also documented. Results: 154 cases were identified, over half of which transferred due to patient relocation. Details included in transfer letters were in many cases incomplete. In over 70% of cases, the letter came from primary care, including when a tertiary opinion was sought. Although referrals from primary care contained fewer patient data points, there was no association with poor patient outcomes at 6 months. Conclusion: This is the first study examining the quality of transfer of care in adult patients with IBD. We highlighted a significant and underreported issue and found that the majority of referrals were led by primary care. Though the inclusion in the referral of fewer data points was not associated with poor outcomes, we highlighted an area where gastroenterologists might take more responsibility to provide smooth and robust transfer of care.

Original language	English
Pages (from-to)	5-10
Number of pages	6
Journal	Frontline Gastroenterology
Volume	12
Issue number	1
Early online date	13 Jan 2020
DOIs	https://doi.org/10.1136/flgastro-2019-101347
Publication status	Published - 1 Jan 2021

Keywords

audit
epidemiology
inflammatory bowel disease

Access to Document

10.1136/flgastro-2019-101347Licence: CC BY-NC

Quality of care in_AHMAD_Acc27Nov2019Epub13Jan2020_GOLD VoR(CC BY NC)Final published version, 544 KBLicence: CC BY-NC

http://fg.bmj.com/lookup/doi/10.1136/flgastro-2019-101347

Cite this

@article{0c77e5c487ca4ee59544a63f8fbffcb7,

title = "Quality of care in adult patients with inflammatory bowel disease transferring between healthcare providers: multicentre audit",

abstract = "Background: Inflammatory bowel disease (IBD) predominantly affects young adults at critical socioeconomic periods of their lives. There are no studies examining the process of transfer of care for adult patients with IBD changing healthcare providers. Our aims were to assess the quality of referral information provided when patients with an established IBD diagnosis transfer care between heathcare providers and to assess the impact of referral quality on patient outcome. Methods: Retrospective data pertaining to IBD transfer of care referrals were collected from 16 hospitals across London over a 2-month period. Data were collected on patient demographics, source and content of referral and cross-referenced with an established transfer of care checklist. Patient outcome within the 6 months following transfer was also documented. Results: 154 cases were identified, over half of which transferred due to patient relocation. Details included in transfer letters were in many cases incomplete. In over 70% of cases, the letter came from primary care, including when a tertiary opinion was sought. Although referrals from primary care contained fewer patient data points, there was no association with poor patient outcomes at 6 months. Conclusion: This is the first study examining the quality of transfer of care in adult patients with IBD. We highlighted a significant and underreported issue and found that the majority of referrals were led by primary care. Though the inclusion in the referral of fewer data points was not associated with poor outcomes, we highlighted an area where gastroenterologists might take more responsibility to provide smooth and robust transfer of care.",

keywords = "audit, epidemiology, inflammatory bowel disease",

author = "Ahmad, {Omer F} and Homira Ayubi and Jennie Clough and Robin Dart and Radha Gadhok and Samuel Pannick and Gareth Parkes and Polychronis Pavlidis and Jonathan Segal and Penelope Sellers",

note = "Funding Information: Contributors OFA, HA, JC, RD, RG, SP, PP, JS and PS have all reviewed the literature and prepared the manuscript. All have written and contributed to critical revisions of the manuscript and are listed in alphabetical order according to surname. GP provided senior review and supervision. All Gastroenterology London Investigative Network for Trainees contributors collected the data. Funding Ths study was funded by Guts UK (grant number RE15696). Competing interests None declared. Patient consent for publication Not required. Provenance and peer review Not commissioned; externally peer reviewed. Data availability statement Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Open access This is an open access article distributed in accordance with the Creative Commons Attribution Non Funding Information: Twitter GLINT Research Network @GLINT_Research Acknowledgements The authors thank Guts UK for the award of a grant to support the set-up and running costs of the Gastroenterology London Investigative Network for Trainees research network. We also thank Professor Anton Emmanuel for his support and supervision. Collaborators This work was undertaken by the Gastroenterology London Investigative Network for Trainees Research Network, which comprises Faisal Abbasi, Jane Abbot, Omer Ahmad, Ali Akram, Maria Aslam, Homira Ayubi, Jennifer Clough, Robin Dart, Angad Dhillon, Jonathan Digby-Bell, Robert Eckersley, Tareq El Menabawey, Jemima Finkel, Rishi Fofaria, Radha Gadhok, Shraddha Gulati, Richard Hackett, Joy Harris-Folb, George Hiner, Hein Htet, Sunjae Hwang, Nishani Jayasoorina, Misha Kabir, Rawen Kader, Jonathan King, Teo Lopez Bernal, James Maurice, Susanna Meade, Sam Pannick, Mihir Patel, Raj Patel, Polychronis Pavlidis, Sam Powles, Rebecca Preedy, Rohit Rao, Srivasthan Ravindran, Mark Samaan, Gregory Sebepos-Rogers, Jonathan Segal, Mentaj Sehmbhi, Chehkuan Tai, Holly Theaker, Zohib Tariq, Hannah Walton and Allan Xu. Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2021. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

year = "2021",

month = jan,

day = "1",

doi = "10.1136/flgastro-2019-101347",

language = "English",

volume = "12",

pages = "5--10",

journal = "Frontline Gastroenterology",

issn = "2041-4137",

publisher = "BMJ Publishing Group",

number = "1",

}

TY - JOUR

T1 - Quality of care in adult patients with inflammatory bowel disease transferring between healthcare providers: multicentre audit

AU - Ahmad, Omer F

AU - Ayubi, Homira

AU - Clough, Jennie

AU - Dart, Robin

AU - Gadhok, Radha

AU - Pannick, Samuel

AU - Parkes, Gareth

AU - Pavlidis, Polychronis

AU - Segal, Jonathan

AU - Sellers, Penelope

N1 - Funding Information: Contributors OFA, HA, JC, RD, RG, SP, PP, JS and PS have all reviewed the literature and prepared the manuscript. All have written and contributed to critical revisions of the manuscript and are listed in alphabetical order according to surname. GP provided senior review and supervision. All Gastroenterology London Investigative Network for Trainees contributors collected the data. Funding Ths study was funded by Guts UK (grant number RE15696). Competing interests None declared. Patient consent for publication Not required. Provenance and peer review Not commissioned; externally peer reviewed. Data availability statement Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Open access This is an open access article distributed in accordance with the Creative Commons Attribution Non Funding Information: Twitter GLINT Research Network @GLINT_Research Acknowledgements The authors thank Guts UK for the award of a grant to support the set-up and running costs of the Gastroenterology London Investigative Network for Trainees research network. We also thank Professor Anton Emmanuel for his support and supervision. Collaborators This work was undertaken by the Gastroenterology London Investigative Network for Trainees Research Network, which comprises Faisal Abbasi, Jane Abbot, Omer Ahmad, Ali Akram, Maria Aslam, Homira Ayubi, Jennifer Clough, Robin Dart, Angad Dhillon, Jonathan Digby-Bell, Robert Eckersley, Tareq El Menabawey, Jemima Finkel, Rishi Fofaria, Radha Gadhok, Shraddha Gulati, Richard Hackett, Joy Harris-Folb, George Hiner, Hein Htet, Sunjae Hwang, Nishani Jayasoorina, Misha Kabir, Rawen Kader, Jonathan King, Teo Lopez Bernal, James Maurice, Susanna Meade, Sam Pannick, Mihir Patel, Raj Patel, Polychronis Pavlidis, Sam Powles, Rebecca Preedy, Rohit Rao, Srivasthan Ravindran, Mark Samaan, Gregory Sebepos-Rogers, Jonathan Segal, Mentaj Sehmbhi, Chehkuan Tai, Holly Theaker, Zohib Tariq, Hannah Walton and Allan Xu. Publisher Copyright: © Author(s) (or their employer(s)) 2021. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/1/1

Y1 - 2021/1/1

N2 - Background: Inflammatory bowel disease (IBD) predominantly affects young adults at critical socioeconomic periods of their lives. There are no studies examining the process of transfer of care for adult patients with IBD changing healthcare providers. Our aims were to assess the quality of referral information provided when patients with an established IBD diagnosis transfer care between heathcare providers and to assess the impact of referral quality on patient outcome. Methods: Retrospective data pertaining to IBD transfer of care referrals were collected from 16 hospitals across London over a 2-month period. Data were collected on patient demographics, source and content of referral and cross-referenced with an established transfer of care checklist. Patient outcome within the 6 months following transfer was also documented. Results: 154 cases were identified, over half of which transferred due to patient relocation. Details included in transfer letters were in many cases incomplete. In over 70% of cases, the letter came from primary care, including when a tertiary opinion was sought. Although referrals from primary care contained fewer patient data points, there was no association with poor patient outcomes at 6 months. Conclusion: This is the first study examining the quality of transfer of care in adult patients with IBD. We highlighted a significant and underreported issue and found that the majority of referrals were led by primary care. Though the inclusion in the referral of fewer data points was not associated with poor outcomes, we highlighted an area where gastroenterologists might take more responsibility to provide smooth and robust transfer of care.

AB - Background: Inflammatory bowel disease (IBD) predominantly affects young adults at critical socioeconomic periods of their lives. There are no studies examining the process of transfer of care for adult patients with IBD changing healthcare providers. Our aims were to assess the quality of referral information provided when patients with an established IBD diagnosis transfer care between heathcare providers and to assess the impact of referral quality on patient outcome. Methods: Retrospective data pertaining to IBD transfer of care referrals were collected from 16 hospitals across London over a 2-month period. Data were collected on patient demographics, source and content of referral and cross-referenced with an established transfer of care checklist. Patient outcome within the 6 months following transfer was also documented. Results: 154 cases were identified, over half of which transferred due to patient relocation. Details included in transfer letters were in many cases incomplete. In over 70% of cases, the letter came from primary care, including when a tertiary opinion was sought. Although referrals from primary care contained fewer patient data points, there was no association with poor patient outcomes at 6 months. Conclusion: This is the first study examining the quality of transfer of care in adult patients with IBD. We highlighted a significant and underreported issue and found that the majority of referrals were led by primary care. Though the inclusion in the referral of fewer data points was not associated with poor outcomes, we highlighted an area where gastroenterologists might take more responsibility to provide smooth and robust transfer of care.

KW - audit

KW - epidemiology

KW - inflammatory bowel disease

UR - http://www.scopus.com/inward/record.url?scp=85078011401&partnerID=8YFLogxK

U2 - 10.1136/flgastro-2019-101347

DO - 10.1136/flgastro-2019-101347

M3 - Article

SN - 2041-4137

VL - 12

SP - 5

EP - 10

JO - Frontline Gastroenterology

JF - Frontline Gastroenterology

IS - 1

ER -

Quality of care in adult patients with inflammatory bowel disease transferring between healthcare providers: multicentre audit

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this