IBD audit provides evidence to step up funding

Hospitals are failing patients with IBD because of a lack of resources, according to the final report of an organisational and clinical audit of IBD services.

The report, published by Crohn’s & Colitis Australia under their Quality of Care Program, called for adequate funding within hospitals to deliver services according to the new Australian IBD Standards 2016.

Gastroenterologist Professor Paul Pavli, a director of Crohn’s & Colitis Australia, said the audit process had clearly demonstrated a lack of resources – not intention – regarding best practice.

“For example, 57% of sites said they do regular DEXA scans for osteoporosis – a complication of both the disease and its treatment. However the clinical audit showed only 9% of patients had a scan documented in the last five years,” he told the limbic in an interview.

He said each of the 71 sites that participated in the audit would receive feedback on their results, which could be used for internal advocacy.

“Those sites need to be able to say to their medical administration that ‘by these criteria and standards we are falling behind’. They need to ask for the IBD nurse, the time to have meetings, access to psychology, access to dietetic services, and so on.”

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The report demonstrated that sites with even a partial IBD service – defined as at least a 0.4 full-time equivalent IBD nurse, a named clinical lead and an IBD helpline – had a significant improvement in outcomes compared to other sites.

“We’ve demonstrated a 15% reduction in hospitalisations via the emergency department. This has important implications in terms of health dollars and the patient experience,” Professor Pavli said.

Partial IBD services were also more likely to provide patients with access to clinical trials.

“Clinical trials provide an important extra modality of therapy and patients can be spared surgery because of this access,” he said.

He said IBD nurses contributed enormously in terms of patient education and better safety monitoring of biologics or immunosuppressants.

The fact that patients were being admitted with anaemia and psychological comorbidities reinforced the need for access to multidisciplinary resources, he added.

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