UK IBD audit 3rd round

1
UK IBD audit 3rd round

• Inpatient experience questionnaire

2
Participation in round 3

• Inpatient experience questionnaire report follows
  the
• national organisational audit reports (May 2011)
• national clinical audit reports (February 2012)
• For each complete audited admission entered to
  the UK IBD audit web tool, a questionnaire was
  generated that was sent to the patient
• The questionnaire was returned to the RCP or
  entered directly on to the audit web tool by the
  patient, to ensure confidentiality

3
Inpatient questionnaire responses

• Inpatient questionnaires were received from one
  third of adults and paediatrics included in the
  inpatient care aspect of the audit
• - The total number of cases entered into the
  audit 6689
• - The response rate for adult patients 33.7
• - The response rate for paediatric patients
  32.2
• The full results are presented for the UK overall
  and divided into adults and paediatrics where
  possible

4
Key findings

• One in ten adults rated their overall inpatient
  care as fair or poor
• No paediatric patients rated their care as poor,
  6.7 rated it as fair
• For both adults and children with IBD, overall
  care satisfaction correlated most strongly with
  their rating of how well doctors and nurses
  worked together

Combined IBD respondents Combined IBD respondents
N
Overall how would you rate the care you received? Overall how would you rate the care you received? Overall how would you rate the care you received?
Excellent 874/2181 40.1
2. Very good 814/2181 37.3
3. Good 289/2181 13.2
4. Fair 146/2181 6.7
5. Poor 58/2181 2.7
5
Key findings continued

• IBD patients appeared to give relatively poorer
  rating for consistency, coordination of care and
  nursing care
• The bars in the graph above show the range of
  Trust-level scores for each sub-domain using the
  National Inpatient Survey results for 2010. The
  red region shows the scores of the lowest 20 of
  trusts, the orange region is for the middle 60
  and the green region represents the top 20 of
  trusts. The mean score, and 95 confidence
  intervals, for IBD patients are shown as the
  black marker.

6
Key findings continued

• Hospital food was rated as poor by one in five
  adults and one in ten children.
• At least one in ten of all IBD patients reported
  that the food provided was not enough
• Over half of adults and a quarter of children
  reported receiving no visit from a dietician
• Eight out of ten IBD patients experienced some
  pain during their inpatient stay
• Around a quarter reported being in pain all or
  most of the time
• More than one in ten IBD patients rated their
  analgesic medication as not enough
• At least one in ten patients reported sub-optimal
  aspects of discharge information such as lack of
  information about drug side effects, the danger
  signs to watch for or how to manage their
  condition after going home

7
Key results

• Adult patient responders versus non responders
  across a range of key data items

Adult patients Responders N2028 Non-responders N4143
Patient age, median (IQR) 43 (31, 59) 37 (26, 51)
Male Female 867 (42.8) 1161 (57.2) 2099 (50.7) 2044 (49.3)
UC CD Elective or Transfer 1056 (57.1) 972 (47.9) 1624 (80.1) 1993 (48.1) 2150 (51.9) 3501 (84.5)
Non-Elective Operated Non-operated 404 (19.9) 673 (33.2) 1352 (66.8) 342 (15.5) 1154 (27.9) 2980 (72.1)
8
Key results

• Paediatric patient responders versus non
  responders across a range of key data items

Paediatric patients Responders N167 Non-responders N351
Patient age, median (IQR) 13 (11, 15) 13 (11, 15)
Male Female 94 (56.3) 73 (43.7) 221 (63.0) 130 (37.0)
UC CD Elective or Transfer 51 (30.5) 116 (69.5) 24 (14.4) 125 (35.6) 226 (64.4) 53 (15.1)
Non-Elective Operated Non-operated 143 (85.6) 35 (21.0) 132 (79.0) 298 (84.9) 79 (22.6) 271 (77.4)
9
Key results

• Hospital food was rated as poor by one in five
  adults and one in ten children

Adult respondents Adult respondents Paediatric respondents Paediatric respondents
n n
How would you rate the hospital food? How would you rate the hospital food? How would you rate the hospital food? How would you rate the hospital food? How would you rate the hospital food?
1. Very good 284/2015 14.1 12/167 7.2
2. Good 624/2015 31 48/167 28.7
3. Fair 665/2015 33 52/167 31.1
4. Poor 400/2015 19.8 18/167 10.8
5. I did not have any hospital food 42/2015 2.1 37/167 22.2
10
Key results

• Eight out of ten IBD patients experienced some
  pain during their inpatient stay

Adult respondents Adult respondents Paediatric respondents Paediatric respondents
n n
Were you ever in any pain? Were you ever in any pain? Were you ever in any pain? Were you ever in any pain? Were you ever in any pain?
1. Yes 1723/2022 85.2 138/166 83.1
2. No 299/2022 14.8 28/166 16.9
During your hospital stay, how much of the time were you in pain? During your hospital stay, how much of the time were you in pain? During your hospital stay, how much of the time were you in pain? During your hospital stay, how much of the time were you in pain? During your hospital stay, how much of the time were you in pain?
1. All or almost all 481/1722 27.9 37/138 26.8
2. Some 925/1722 53.7 73/138 52.9
3. Occasionally 316/1722 18.3 28/138 20.3
11
Key recommendations

• All admitted IBD patients should receive input
  from specialist multidisciplinary teams
• Local IBD teams should consider whether the
  general nursing staff has sufficient awareness
  and knowledge of IBD and initiate appropriate
  educational interventions and care pathways to
  support high quality nursing
• All hospitalised patients with active IBD require
  routine documentation of nutritional intake,
  weight measurement and dietetic review
• Ward medical and nursing teams should review
  their local policies and current practice with
  regard to the frequency and effectiveness of pain
  assessment and provision of analgesia
• Discharge policies for IBD patients require local
  review to ensure that patients receive good
  quality pre-discharge information regarding
  medication, self-care and follow-up plans

12
Acknowledgements

• Most importantly thank you to all of the IBD
  patients, their parents and carers for their time
  and effort taken in responding to the
  questionnaires and also all of the people who
  worked towards collating and entering the data.
• All members of the UK IBD Audit Steering Group
• To access the full report please click here
• For further information contact
  ibd.audit_at_rcplondon.ac.uk