Changing the IBD conversation

The conversation around the treatment of IBD often centres around drugs but this is about to change with the launch of new Australian IBD standards of care.

Launching the interim standards at Gastro2015 Dr Greg Moore Head of IBD at Monash Health and a board member of Crohn’s and Colitis Australia and incoming chair of the Australian IBD Association told delegates that we often talk about standards of care but we don’t talk much about the quality of care.

“A standard of care could be clinical guidelines, a position statement, it can be clinical trials, meta-analyses… but it’s not about quality.

What we’re really talking about is evidence based practice and actually delivering that…I think there’s currently a huge disconnect in IBD care in Australia,” he told delgates.

The Interim Australian IBD Standards were developed by a steering committee made up of representatives across the IBD sector.

They put forward six minimum standards of care: the provision of high-quality clinical care; local delivery of care; maintaining a patient-centred service; patient education and support; data, information technology and audit; and the continuation of evidence based practice and research.

The standards form part of the IBD Quality of Care Program, which will also see a full audit of IBD services conducted across more than 60 sites in the next year.

The standards are the goals of care, where as the audit looks more at the practical way in which care is delivered, Dr Moore told the limbic.

“The standards are by necessity an overarching philosophical approach to what quality of care should look like.

But it’s very hard to measure a lot of those qualitative things. In the audit process we need to look at very objective markers of service delivery that are associated with good quality,” he explained.

For example the audit will look at potential red flags that may identify problems with a service such as unplanned emergency admission, surgery, or length of time on steroids.

The audit has “unashamedly” been based on UK standards (see here), which have had a profound impact on the delivery and quality of care in the UK, Dr Moore said.

Taking part in the audit will enable hospitals to compare themselves against national standards and improve the quality of care for their patients with IBD.

“If you don’t have data to know what you’re doing wrong you don’t know how to make it right. You want to identify what are the causes of variations in care – are they structural, are they training, funding, lack of space.

For instance another goal of the standards is to obtain funding and recognition of the role of IBD nurses. In Australia they are largely on unsecure funding or incredibly overworked, or in some cases they do not exist at all.

Importantly, the audit will also provide services with an evidence-based case for improving their local IBD resources.

“We’re collecting the data in such a way that we can make the health economic case – that this will actually save money,” he said.

“I implore you to get on board this is going to be the most impressive tool we ever have in terms of lobbying to get the infrastructure, funding and service delivery that we need,” Dr Moore urged delegates.

 For more information on the Standards or how to get involved in the audit visit Crohn’s & Colitiis Australia or give IBD Quality of Care Program Manager Wayne Massuger a call on 0457 028 900.

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