P0510 Evaluation of organizational and healthcare provider level readiness in European Inflammatory Bowel Disease centres for outcome-based quality improvement
Authors: Ali M , West R L , Fiorino G , Duijvestein M , Woude C J V D , Deen W K V ,   the Initiative on Crohn’s and Colitis (ICC) European Crohn’s and Colitis Organization (ECCO)
Published: January 2025

Background

Inflammatory bowel disease (IBD) affects quality of life and increases healthcare costs. Measuring patient outcomes for continuous quality improvement (QI) can optimize care, but resource limitations, infrastructure challenges, and strategic misalignments hinder progress. We assessed the readiness for outcome-based QI in European IBD centres at both the organizational and professional levels.

Methods

We employed a mixed-methods design, starting with a survey with follow-up interviews of IBD-specialized gastroenterologists. Dutch centres were approached through the Initiative of Crohn’s and Colitis (ICC) organization and other European centres were recruited through the European Crohn’s and Colitis Organization (ECCO). Eligible centres had a multidisciplinary care model with at least one dedicated gastroenterologist, nurse, and surgeon. Participants completed a web-based survey covering team characteristics, outcome-based monitoring for QI, resources, and attitudes toward outcome-based QI. Quantitative data were analysed using descriptive statistics, and follow-up interviews are ongoing.

Results

Of the 42 IBD centres surveyed, 69% were in the Netherlands (Figure 1). After exclusions, 36 centres were analysed (Table 1), mostly non-academic hospitals (58%) with 500-800 beds. Monitoring practices varied, with 25% monitoring outcomes annually, 25% monitoring outcomes biannually, or 28% more frequently, while 22% did not monitor outcomes. Manual or hybrid EHR data extraction was common, with few using fully automated methods. Doctors (100%) and specialized nurses (96%) consistently engaged in data discussions. Non-academic centres involved more data managers (53%) and patients (65%) than academic hospitals. Doctors led discussions in most cases (82%), particularly in academic centres (91%), with significant nurse involvement (64%). Non-academic centres had diverse leadership, including data managers (47%) and occasional patient involvement (12%). Frequently monitored outcomes included medication use (71%), clinician-reported measures (61%), healthcare utilization data (57%) and patient-reported outcomes (50%). Most centres (68%) had implemented 2-3 QI initiatives in the past year, with 48% regularly assessing their effectiveness, and most respondents recognized the value of outcome monitoring for providers and patients.

Conclusion

Outcomes monitoring is seen as an approach for QI in IBD care, yet practices varied across centres. Academic centres monitor outcomes more frequently and rely on care professionals to lead discussions, whereas non-academic centres often rely on data managers. These differences highlight the need for standardization in monitoring practices and team roles to support consistent, outcome-based QI across Europe.

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