Audit of Impact of a Clinician & Patient Support Tool in a Nurse-led Clinic for Inflammatory Bowel Disease Service at Milton Keynes University Hospital
Authors: Lewis L , Michie C , Sheppard A , Stone M.A , MacFaul G , Harrison J 
Published: December 2024

ABSTRACTObjectiveThis audit examines the impact of a recently-commissioned clinician and patient support tool, on care pathways for Inflammatory Bowel Disease patients at Milton Keynes University Hospital, on follow up appointments (including PIFUs), associated cost savings and patient and clinician engagement and experience.DesignThe audit was conducted using a retrospective, consecutive case review of appointment records of patients enrolled onto the iOWNA platform during a 9-month audit period. Patient-clinician interactions were categorised depending on whether an appointment was saved and an appropriate nursing time saving logged. Data on both cost savings and PIFU numbers were also collected from the trust. Quantitative and qualitative feedback of clinician and patient experience were captured.ResultsThe deployment of iOWNA resulted in a total time saving of 14,735 minutes across the audit period, of which 9,280 minutes comprised savings on in-person appointments, representing 232 appointments saved. The cost savings for these 232 replaced appointments totalled 16,704 GBP. The audit period also saw a statistically significant (p<0.01) increase in the number of Patient-Initiated Follow Ups (PIFUs). Patient and clinician surveys reflected positive experiences of the new care pathway among all service users.ConclusionThe results of the audit demonstrate the important role digital tools can play in transforming existing care pathways to deal with the widespread challenges facing the NHS following the COVID-19 pandemic, with annual savings of over 345 million GBP for the NHS if the appointment cost savings demonstrated in this audit were replicated alongside a 5% reduction nationally in outpatient attendances.KEY MESSAGESWhat is already known on the topicThe deployment of evidenced-based digitally-enabled care pathways for Inflammatory Bowel Disease (IBD) is scarce. Traditional pathways are maintained, with patient education during appointments being time-consuming for clinicians and ineffective for patients, resulting in patients forgetting large amounts of what has been communicated to them and not being able to self-manage their condition optimally.Leveraging technology has been acknowledged as an important tool for patient empowerment thus aiding patient self-management, which will play an important role in the recovery of elective care services in the wake of the disruption caused by the COVID-19 pandemic.What this study addsWe report the results of a clinical audit on the impact of a commissioned clinician and patient support tool, iOWNA, on existing IBD care pathways at Milton Keynes University Hospital 2023.How this may affect research, practice or policyThe clinical evidence from the audit demonstrates that digital transformation of chronic disease care pathways is an effective means of improving the delivery of outpatient care, offering advantages in terms of cost, clinician experience, and patient experience.