QUALITY OF CARE I IBD

Transcription

1 INVITATION TIL EFTERUDDANNELSE: QUALITY OF CARE I IBD KAN VI IDENTIFICERE DANSKE KVALITETSINDIKATORER?

2 INVITATION TIL EFTERUDDANNELSE quality of care i ibd kan vi identificere danske kvalitetsindikatorer? PROGRAM quality of care i ibd kan vi identificere danske kvalitetsindikatorer? Tid: Torsdag den 27. november 2014 kl Sted: Bella Sky Comwell Hotel, Center Boulevard 5, 2300 København S Ankomst og morgenmad SESSION 1: Essentielle elementer af Quality of Care & Internationale erfaringer (foregår på engelsk) Chairman s welcome Chairman Jens Dahlerup Back to Basics: essential elements of Quality of Care Subrata Ghosh, CAN Formål: Quality of Care er et emne der i stigende grad bliver diskuteret både nationalt og internationalt. Dette symposium vil adressere aspekter af den nuværende Quality of Care i behandlingen af danske IBD patienter, og give bud på hvordan den kan optimeres og måles. Førende internationale eksperter, deriblandt Subrata Ghosh (CAN), Stefan Schreiber (DE), Ian Arnott (UK) og Karen Kemp (UK) vil fortælle om egne erfaringer med en målrettet indsats på Quality of Care, og bl.a diskutere anvendelse af nationale kvalitetsmålinger, målrettede Quality of Care initiativer, og IBD-sygeplejerskens rolle i at levere Quality of Care. Fra danske gastroenterologiske afdelinger vil der blive sat fokus på lokale løsningsorienterede projekter som har til formål at forbedre behandling og håndtering af IBD patienter. Deltagere: 50 gastroenterologer Chairman: Jens Dahlerup Program: Se bagsiden Tilmelding: Tilmelding senest mandag den 3. november Se kontaktinfo nederst på siden. AbbVie kan refundere transportudgifter for deltagere fra Fyn og Jylland. (Du kan få udleveret en formular til mødet, som du udfylder og returnerer sammen med dine originalbilag. Kilometertakst efter gældende regler, tog og fly på økonomiklasse) PAUSE IBD Standards: UK experiences with addressing Quality of Care Ian Arnott, UK Impact of Quality of Care initiatives in an IBD center in Kiel Stefan Schreiber, DE The role of the IBD nurse in improving Quality of Care Karen Kemp, UK FROKOST Panel debate: how to set ambitions for Danish Quality of Care SESSION 2: Status på Quality of Care i Danmark Quality of Care fra patientens synsvinkel Jeanne Meerson Screening og vaccination af IBD patienter: brug af surrogatmarkør som kvalitetsindikator Brug af patientpaneler for optimeret Quality of Care All Jørn Brynskov og Katrine Christensen, Herlev Hospital Henning Glerup, Silkeborg Hospital Jeg håber, at du har lyst til at deltage. Har du spørgsmål, er du velkommen til at kontakte mig. Med venlig hilsen IBD-sygeplejerskens rolle i at levere Quality of Care Palle Bager og Rikke Edelbo Rasmussen, Aarhus Universitetshospital Ulla Sofie Grønager Medical Manager, MD. AbbVie [email protected] Hvilke kvalitetsindikatorer kan måles med nuværende registre og it-systemer? Workshops introduceres PAUSE Rune Erichsen, Klinisk Epidemiologisk Afdeling, Aarhus Universitetshospital Deltagere Sjælland: Lene Vitus, Produktspecialist [email protected] Tlf.: Deltagere Jylland og Fyn: Stig Grangaard, Produktspecialist [email protected] Tlf.: SESSION 3: Workshop: Implementering af Quality of Care i Danmark Workshop: diskutere og definere kvalitetsindikatorer Workshop feedback. Hvilke kvalitetsindikatorer kan benyttes i Danmark? Plenum diskussion. Jens Dahlerup Afrunding Jens Dahlerup Middag Arrangementet vil blive anmeldt til ENLI inden dets afholdelse, og det er efter arrangørens opfattelse i overensstemmelse med reglerne på området, selvom det ikke på forhånd er godkendt af ENLI.

3 INTERNATIONAL SPEAKERS Subrata Ghosh Professor Subrata Ghosh trained in gastroenterology in Bristol, Tokyo, and Edinburgh and became a consultant gastroenterologist in Edinburgh in Between 1995 and 2002, he published over 200 articles and lectured extensively. In 2002, he took up the Chair of gastroenterology at Imperial College London (Hammersmith Hospital) and focused more on laboratory work on mucosal immunology. During this period he served on the British Society of Gastroenterology Council and IBD subcommittee (as secretary) and became an Associate Editor of Gut. In 2009, he moved to Canada to take up his position as Professor of Medicine and Head of the Division of Gastroenterology at the University of Calgary, which has an excellent reputation in inflammatory bowel disease research. Research interests include immunopathogenesis and biological therapies in inflammatory bowel disease, including epithelial immune cell biology and host pathogen interactions. Specific interests are epithelial-dendritic cell interactions, functional genomics of innate immune response defects, lymphocyte trafficking, IL-23/27 and anti-cytokine therapies. He has published over 300 articles, including papers in Nature Medicine, New England Journal of Medicine, Lancet, Gastroenterology and Gut. He is the Editor in Chief of the Canadian Journal of Gastroenterology and a member of the International Organization for Study of IBD (IOIBD). He also sits on the editorial boards of a number of journals, including Gut, Alimentary Pharmacology and Therapeutics, Journal of Crohn s and Colitis, and Therapeutic Advances in Gastroenterology. Ian Arnott Dr. Arnott trained in medicine at St.Andrews and Manchester University. He completed his postgraduate training in Gastroenterology in Edinburgh and UCLA, Los Angeles, USA, and is an accredited Specialist in gastroenterology. He has been a consultant at the Western General Hospital, Edinburgh since 2003 and is an honorary senior lecturer at the University of Edinburgh. He deals with a broad range of gastrointestinal disorders including inflammatory bowel disease, and other diarrhoeal conditions, gastrointestinal bleeding and upper GI cancer. He has an interest in endoscopic techniques including colonoscopy and video capsule endoscopy. He has active interests in teaching and research, particularly in the cause and treatment of gastrointestinal inflammation. In addition to his clinical and academic interests, he has a number of local and national roles in Gastroenterology, including: Scottish representative, National IBD standards group, Secretary, MRCP(UK) speciality question group in Gastroenterology, Scottish Lead, RCP/ BSG national audit of inflammatory bowel disease, BSG clinical trials group member, Physician advisor, National Association for Crohn s and colitis, Editorial board, IBD Monitor Journal, Medical Editor, NACC news, , Professional Lead, Gastroenterology, Western General Hospital. Stefan Schreiber Professor Schreiber received his medical degree in 1988 at University of Hamburg. He is a certificated internist and gastroenterologist. Following a postdoctoral research fellowship in the Departments of Gastroenterology at Washington University (St. Louis, MO) and University of Pennsylvania (Philadelphia, PA) he became junior Faculty in the Department of Gastroenterology at the Charité University Hospital in Berlin, Germany. In 1996 he assumed the position of an associated professor in the Hospital for General Internal Medicine at Christian-Albrechts-University in Kiel, Germany. Stefan Schreiber s present position is a Full Professor of Medicine. He is the director of the Clinic of Internal Medicine I and also head of the Institute for Clinical Molecular Biology, both at the Christian-Albrechts-University in Kiel. Moreover he is the speaker of the German DFG cluster of excellence Inflammation-at-Interfaces. His research interests include the molecular genetics and pathophysiology of chronic intestinal inflammation, the clinical development of new therapies for IBD and the discovery of mechanisms that control ageing. Memberships in professional societies include the American Gastroenterological Association, the European Society of Clinical Investigation, the Scientific Committee of the German Crohn s and Colitis Foundation, the German Society for Internal Medicine and the German Society for Gastrointestinal and Metabolic Disorders. Professor Schreiber has been an invited lecturer and held chairmanships at multiple national and international meetings. He is joint editor of some famous international journals in IBD and genetics and he has to his credit more than 750 original publications in different leading scientific journals. Karen Kemp Karen Kemp is a Clinical Academic IBD Nurse Practitioner, holding a joint appointment between Central Manchester NHS Foundation Trust and the University of Manchester and. She has been working in the field of gastroenterology and IBD since She has a particular interest in follow-up care models for patients with IBD, the focus of her PhD, the role of the IBD nurse and managing patients on biologics. Professionally, Karen Kemp represents IBD at the Gastrointestinal Forum within the Royal College of Nursing, UK, she sits on the National IBD Audit and Biologics Implementation Group, is the Chair of Arena for Immunology and from February 2014 is a member of the Nurses European Crohns and Colitis Organisation committee (N-ECCO).

4 FORSLAG TIL LITTERATUR Improving quality of care in inflammatory bowel disease: What changes can be made today? Panés J et al. J Crohns Colitis Sep 1;8(9): BACKGROUND AND AIMS: There are a number of gaps in our current quality of care for patients with inflammatory bowel diseases. This review proposes changes that could be made now to improve inflammatory bowel disease care. METHODS: Evidence from the literature and clinical experience are presented that illustrate best practice for improving current quality of care of patients with inflammatory bowel diseases. RESULTS: Best care for inflammatory bowel disease patients will involve services provided by a multidisciplinary team, ideally delivered at a centre of excellence and founded on current guidelines. Dedicated telephone support lines, virtual clinics and networking may also provide models through which to deliver high-quality, expert integrated patient care. Improved physician-patient collaboration may improve treatment adherence, producing tangible improvements in disease outcomes, and may also allow patients to better understand the benefits and risks of a disease management plan. Coaching programmes and tools that improve patient self-management and empowerment are likely to be supported by payers if these can be shown to reduce long-term disability. CONCLUSIONS: Halting disease progression before there is widespread bowel damage and disability are ideal goals of inflammatory bowel disease management. Improving patient-physician communication and supporting patients in their understanding of the evidence base are vital for ensuring patient commitment and involvement in the long-term management of their condition. Furthermore, there is a need to create more centres of excellence and to develop inflammatory bowel disease networks to ensure a consistent level of care across different settings. Quality improvement in inflammatory bowel disease Melmed GY, Siegel CA. Gastroenterol Hepatol (N Y) May;9(5): Chronic illnesses such as inflammatory bowel disease (IBD) present a unique opportunity to define and improve the quality of care. Processes of care can be complex, and outcomes of care may vary across different healthcare delivery settings. Patients with IBD are managed over long periods of time and often by the same physician within a single care delivery system. Both patients with Crohn s disease and ulcerative colitis have variable courses of disease progression that require changes in therapy over time. These factors necessitate multiple areas of potential assessment and improvement of processes and outcomes of care. A current initiative is the development of quality measures. The American Gastroenterological Association has developed accountability measures for the Physician Quality Reporting System, and the Crohn s and Colitis Foundation of America has developed a set of top 10 recommended processes and outcomes of measurement for high-quality care of patients with IBD. In addition, the pediatric ImproveCareNow collaborative network has collected improvement data from dozens of pediatric centers over the past 5 years and has demonstrated improvement in overall disease activity in their cohort through iterative quality improvement processes. Future directions for quality indicators for adults with IBD will involve implementation of quality-measure reporting, both for purposes of reimbursement as well as improvement of care. These strategies will need to be closely monitored to evaluate the effect of improvement programs on outcomes. IBD Standards. Standards for the Healthcare of People who have Inflammatory Bowel Disease (IBD) ( The aim of the IBD Standards is to ensure that IBD patients receive consistent, high quality care and that IBD services throughout the UK are knowledgebased, engaged in local and national networking, based on modern IT and that they meet specific minimum standards. Following the first UK-wide audit of IBD services and care in 2006, which revealed unacceptable variation in services and aspects of clinical care, a working group of the key professional organisations and Crohn s and Colitis UK, the IBD patient organisation, was formed to recommend national standards for IBD care. In the years since the IBD Standards were originally produced, the IBD Audit has demonstrated significant improvements in IBD care and service delivery over this time. However, there is still considerable variation in the level and quality of care provided, with many services some way off meeting the IBD Standards and particular deficits in certain aspects of provision across the board. For example, although there is greater access to IBD Specialist Nurses, for most IBD services, this still falls below the minimum level set out in the IBD Standards. Implementation of the updated IBD Standards will ensure that IBD services meet key requirements of the health strategies set out by the four UK countries. UK IBD audit - biological therapy audit ( Aims of the biological therapies audit was to assess nationally: the appropriate use / prescribing of biological therapies in the treatment of IBD the efficacy of biological therapies in the treatment of IBD the safety of biological therapies in the treatment of IBD IBD patients views on their quality of life at defined intervals throughout their use of biological therapies. Overall summary: The data presented in this report suggest that the biological therapies are safe and effective treatments for IBD that are used to good effect throughout the participating adult sites in the UK. We have identified a number of issues, that when addressed will improve the delivery of these medicines and the quality of patient care. Engagement in the biologics audit has been reasonably good but clinicians should be encouraged to enter data on all appropriate patients. Objective assessment of response to therapy is an important part of using expensive medicines and the collection of disease activity scores and quality of life data is central to this. Individual services should assess the delivery of these drugs to ensure that patients are not waiting unduly for these therapies; the use of shortened infusion times for patients established on therapy may help this. It is also vital that patients are appropriately screened for opportunistic infection in keeping with current guidelines prior to initiating therapy. In addition, the correct loading dose of drug and avoiding unnecessary pre-treatment with corticosteroids will ensure that patients receive the most benefit from the prescribed medicine. Continued audit of biological therapy treatment will ensure improvement in these issues and that the quality of care for IBD patients continues to improve. Defining quality indicators for best-practice management of inflammatory bowel disease in Canada Nguyen GC et al. Can J Gastroenterol Hepatol May;28(5): BACKGROUND: There is a paucity of published data regarding the quality of care of inflammatory bowel disease (IBD) in Canada. Clinical quality indicators are quantitative end points used to guide, monitor and improve the quality of patient care. In Canada, where universal health care can vary significantly among provinces, quality indicators can be used to identify potential gaps in the delivery of IBD care and standardize the approach to interprovincial management. METHODS: The Emerging Practice in IBD Collaborative (EPIC) group generated a shortlist of IBD quality indicators based on a comprehensive literature review. An iterative voting process was used to select quality indicators to take forward. In a face-to-face meeting with the EPIC group, available evidence to support each quality indicator was presented by the EPIC member aligned to it, followed by group discussion to agree on the wording of the statements. The selected quality indicators were then ratified in a final vote by all EPIC members. RESULTS: Eleven quality indicators for the management of IBD within the single-payer health care system of Canada were developed. These focus on accurate diagnosis, appropriate and timely management, disease monitoring, and prevention or treatment of complications of IBD or its therapy. CONCLUSIONS: These quality indicators are measurable, reflective of the evidence base and expert opinion, and define a standard of care that is at least a minimum that should be expected for IBD management in Canada. The next steps for the EPIC group involve conducting research to assess current practice across Canada as it pertains to these quality indicators and to measure the impact of each of these indicators on patient outcomes.

5 DKHUG140149a - September Arrangementet vil blive anmeldt til ENLI inden dets afholdelse, og det er efter arrangørens opfattelse i overensstemmelse med reglerne på området, selvom det ikke på forhånd er godkendt af ENLI.