Using American College of Gastroenterology Guidelines to provide effective health maintenance for patients with inflammatory bowel disease

Background:Patients with inflammatory bowel disease (IBD) are at increased risk for infections, malignancies, and osteoporosis, related to both the disease state and medical therapy. Identification and treatment of depression and anxiety is crucial for disease management. Guidelines developed by the American College of Gastroenterology include recommendations for preventive health maintenance in patients with IBD to guide quality care.Local Problem:Chart audits in a private gastroenterology practice revealed that only 20% of patients with IBD were receiving recommended health maintenance. The aim was to increase effective preventive care of patients with inflammatory bowel disease by 50% by the end of 8 weeks.Methods:The quality improvement project consisted of four rapid Plan-Do-Study-Act cycles.Interventions:The interventions implemented for this quality improvement project included a patient questionnaire, an order sheet/order set, a case management log, and team engagement.Results:Providers identified deficiencies and ordered needed health maintenance for 100% of patients with IBD. While effective preventive care orders increased, order completion rates were unchanged during the project.Conclusions:Patient questionnaires, order sheets, a case management log, and teamwork were successfully used by providers in a private gastroenterology practice to increase orders placed for preventive care in patients with IBD. The project tools could easily be modified and implemented in other specialty practices who care for patients with specialized health maintenance needs.