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Implementation of an intervention bundle leads to quality improvement in ulcerative colitis endoscopy reporting

Kader, R; Dart, RJ; Sebepos‐Rogers, G; Shakweh, E; Middleton, P; McGuire, J; Pavlidis, P; ... Harlow, C; + view all (2020) Implementation of an intervention bundle leads to quality improvement in ulcerative colitis endoscopy reporting. GastroHep 10.1002/ygh2.427. (In press). Green open access

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Abstract

BACKGROUND: Accurate and detailed endoscopy reporting in ulcerative colitis (UC) is critical for clinical decision‐making. High‐quality reporting involves inclusion of several criteria, previously identified by an independent group of experts (Building Research in IBD Globally (BRIDGe) group). Few studies have evaluated UC reporting quality. Our aim was to evaluate the impact of an intervention bundle designed to standardise and improve UC endoscopy reporting. METHODS: This intervention bundle included: integration of a template into reporting software; endoscopist training; instructional posters in endoscopy rooms; cohorting patients onto specific lists. Reporting quality was judged against 10 criteria recommended by BRIDGe. In phase one, UC endoscopy reports were retrospectively evaluated at a centre with prior implementation of the intervention bundle and compared to six centres without. In phase two, the intervention bundle was prospectively implemented and evaluated at a single centre. RESULTS: In phase one, the intervention was associated with greater inclusion of BRIDGe reporting criteria from median 5 (IQR 5‐7) to 7 (5‐8), P < 0.0001. This was replicated in phase two, with improved reporting after the intervention from 5 (4‐6) to 6 (5‐8), P < 0.0001. Reporting of endoscopic indices was more frequent in the centre with prior intervention (77.7% (202/260) vs 44.4% (400/900), OR 4.35 95%CI 3.16‐6.00, P < 0.0001). In phase two, implementation of the bundle increased the use of endoscopic indices pre‐intervention vs post‐intervention (57.7% (131/190) vs 69.6% (117/168), OR 1.68 95%CI 1.1‐2.56, P = 0.02). CONCLUSION: This is the first study to demonstrate that an intervention bundle can achieve greater standardisation and improve UC endoscopy reporting.

Type: Article
Title: Implementation of an intervention bundle leads to quality improvement in ulcerative colitis endoscopy reporting
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/ygh2.427
Publisher version: https://doi.org/10.1002/ygh2.427
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
Keywords: colonoscopy, Endoscopy, ulcerative colitis
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Targeted Intervention
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute > Microbial Diseases
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Med Phys and Biomedical Eng
URI: https://discovery.ucl.ac.uk/id/eprint/10113219
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