Targeted Physician Education and Standardizing Documentation Improves Documented Reporting with Inflammatory Bowel Disease Quality Measures in a Large Academic and Private Practice

• Published in: Digestive diseases and sciences 2018, Vol.63 (1), p.36-45
• Main Authors: Feuerstein, Joseph D., Papamichael, Konstantinos, Popejoy, Sara, Nadelson, Adam, Lewandowski, Jeffrey J., Geissler, Kathy, Martinez-Vazquez, Manuel, Leffler, Daniel A., Ariyabuddhiphongs, Kim, Thukral, Chandrashekhar, Cheifetz, Adam S.
• Format: Article
• Language: English
• Subjects: Biochemistry; Compliance; Documentation; Gastroenterology; Gastrointestinal diseases; Hepatology; Immunization; Inflammatory bowel disease; Intervention; Medicine; Medicine & Public Health; Oncology; Original Article; Quality; Transplant Surgery
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-017-4845-y

Background Prior studies have shown poor compliance with quality measures for IBD at academic and private practices. We sought to provide focused interventions to improve compliance and documentation with the IBD measures. Methods Two centers, academic practice (AP) and private practice (PP), initially reviewed their compliance with eight established IBD quality measures in consecutive charts. A multi-faceted intervention was developed to improve awareness and documentation of these measures. The initial data and the quality measures were reviewed at a group meeting. Following this, a handout summarizing the measures was placed in each exam room. The AP added a new screen to the EHR that summarized the relevant IBD history, while the PP added a new template that was filled out and imported into the charts. Three months after this intervention, charts were reviewed for compliance with the measures. Results The intervention cohort consisted of 768 patients (AP = 569/PP = 199) compared to the initial cohort of 566 patients (AP = 367/PP = 199). Improvement was seen throughout all measures compared to the initial cohort. The AP reported compliance with all relevant measures in 21% and the PP in 60% compared to 7 and 10% in the initial cohort. PP had ≥ 75% compliance with every measure, of which only assessment for bone loss and pneumococcal vaccination was under 80%. In contrast, the AP compliance ranged from 35 to 100% with assessment for bone loss, influenza, and pneumococcal vaccination scoring lowest. Conclusion Our study demonstrates that focused low-cost interventions can significantly improve compliance with IBD quality measures in different practice settings.