Outcomes of a Comprehensive Specialist Inflammatory Bowel Disease Nursing Service.

models of care multidisciplinary care specialist inflammatory bowel disease nurse

Journal

Inflammatory bowel diseases
ISSN: 1536-4844
Titre abrégé: Inflamm Bowel Dis
Pays: England
ID NLM: 9508162

Informations de publication

Date de publication:
29 Aug 2023
Historique:
received: 09 10 2022
medline: 30 8 2023
pubmed: 30 8 2023
entrez: 29 8 2023
Statut: aheadofprint

Résumé

Inflammatory bowel disease (IBD) is best managed by a multidisciplinary team within a dedicated IBD service. IBD nurses play an important role within this team. We aimed to evaluate the contribution of our comprehensive outpatient IBD nursing service on patient outcomes, quality of care, and healthcare costs. We performed a retrospective review of all IBD nurse encounters with patients over a 12-month period from October 2020 to September 2021 at a tertiary IBD referral center. Each nurse encounter was classified with respect to its clinical context, activities, and outcomes. Descriptive statistics were used to characterize these encounters and an economic analysis was performed to estimate the cost savings to the hospital. A total of 2537 nurse encounters occurred with 682 patients; 41% of encounters were nurse-initiated contacts with patients and 34% were patient-initiated contacts with the nurse helpline (26% via email, 8% via telephone). Most encounters involved clinical assessments (66%), providing education, counseling or updates (47%), and reviewing investigation results (38%). A gastroenterologist was consulted for advice in 35% of contacts. An estimated 29 emergency department visits, 1925 outpatient clinic visits, and 137 general practitioner visits were avoided. After deducting costs incurred, a net estimated annual saving of up to AUD $570 838 was achieved. Nurses commonly facilitated faster access to investigations (29%), education provision (28%), delivery of biologic services (25%), and medication changes (19%). A comprehensive IBD nursing service is associated with improved patient outcomes and quality of care, and reduced healthcare costs. This study supports the expanding role of IBD nurses in a modern multidisciplinary IBD service and the need for greater funding and integration of IBD nurses into IBD services.

Sections du résumé

BACKGROUND BACKGROUND
Inflammatory bowel disease (IBD) is best managed by a multidisciplinary team within a dedicated IBD service. IBD nurses play an important role within this team. We aimed to evaluate the contribution of our comprehensive outpatient IBD nursing service on patient outcomes, quality of care, and healthcare costs.
METHODS METHODS
We performed a retrospective review of all IBD nurse encounters with patients over a 12-month period from October 2020 to September 2021 at a tertiary IBD referral center. Each nurse encounter was classified with respect to its clinical context, activities, and outcomes. Descriptive statistics were used to characterize these encounters and an economic analysis was performed to estimate the cost savings to the hospital.
RESULTS RESULTS
A total of 2537 nurse encounters occurred with 682 patients; 41% of encounters were nurse-initiated contacts with patients and 34% were patient-initiated contacts with the nurse helpline (26% via email, 8% via telephone). Most encounters involved clinical assessments (66%), providing education, counseling or updates (47%), and reviewing investigation results (38%). A gastroenterologist was consulted for advice in 35% of contacts. An estimated 29 emergency department visits, 1925 outpatient clinic visits, and 137 general practitioner visits were avoided. After deducting costs incurred, a net estimated annual saving of up to AUD $570 838 was achieved. Nurses commonly facilitated faster access to investigations (29%), education provision (28%), delivery of biologic services (25%), and medication changes (19%).
CONCLUSIONS CONCLUSIONS
A comprehensive IBD nursing service is associated with improved patient outcomes and quality of care, and reduced healthcare costs. This study supports the expanding role of IBD nurses in a modern multidisciplinary IBD service and the need for greater funding and integration of IBD nurses into IBD services.

Identifiants

pubmed: 37643766
pii: 7254688
doi: 10.1093/ibd/izad145
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© The Author(s) 2023. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Auteurs

Natalie Yu (N)

Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia.

Kyle Wu (K)

Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia.

Tamie Samyue (T)

Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia.

Stephanie Fry (S)

Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia.

Annalise Stanley (A)

Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia.

Alyson Ross (A)

Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia.

Ruth Malcolm (R)

Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia.

William Connell (W)

Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia.
Department of Medicine, University of Melbourne, Melbourne, VIC, Australia.

Emily Wright (E)

Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia.
Department of Medicine, University of Melbourne, Melbourne, VIC, Australia.

Nik S Ding (NS)

Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia.
Department of Medicine, University of Melbourne, Melbourne, VIC, Australia.

Ola Niewiadomski (O)

Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia.

Mark Lust (M)

Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia.

Julien Schulberg (J)

Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia.
Department of Medicine, University of Melbourne, Melbourne, VIC, Australia.

Emma Flanagan (E)

Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia.
Department of Medicine, University of Melbourne, Melbourne, VIC, Australia.

Michael A Kamm (MA)

Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia.
Department of Medicine, University of Melbourne, Melbourne, VIC, Australia.

Chamara Basnayake (C)

Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia.
Department of Medicine, University of Melbourne, Melbourne, VIC, Australia.

Classifications MeSH