P411 Benefits of implementing a rapid access clinic in a high-volume inflammatory bowel disease centre: Accessibility, resource utilisation and outcomes. (16th January 2018)

• Record Type: Journal Article
• Authors: Restellini, S; Morin, I; Kurti, Z; Bessissow, T; Afif, W; Wild, G; Seidman, E; Bitton, A; Lakatos, P L
• Is Part Of: Journal of Crohn's and colitis. Volume 12:Number 1(2018:Jan.)Supplement 1
• Page Start: S312
• Page End: S312
• Publication Date: 2018-01-16
• Subjects: Inflammatory bowel diseases -- Periodicals; 616.344005
• DOI: 10.1093/ecco-jcc/jjx180.538
• Languages: English
• ISSNs: 1873-9946

Abstract

Abstract: Background: IBD impacts on patient's physical health, social functioning and quality of life, contributing to the health-economic burden associated with the disease, especially in emergency situations. We aimed to prospectively measure indicators of quality-of-care, after implementation of a new rapid access clinic (RAC) at a tertiary care IBD centre. Methods: Consecutive patients from the McGill University Health Centre who accessed the RAC via email were prospectively included, between June and September 2017. Time to medical appointment, utilisation of imaging, endoscopy, laboratory, treatment decisions and need for unplanned emergency room (ER) visits or admissions 30–90 days after consulting the RAC was assessed. Results: Seventy-four patients (35% men, mean age: 35 years, CD: 72%, L3: 59%, B2–3: 39%, UCE3: 48%, biological therapy: 76%, previous surgery: 23%) were included. Seventy-five per cent of requests were considered appropriate for an RAC appointment. Outpatient visits were a median 2 days (mean 3.3) after the email request. Five patients required an ER visit within 30 days after the RAC appointment, out of which 3 were initiated during the rapid appointment. Two of three patients required admission and underwent urgent IBD-related surgery. No patients required an ER visit within 90 days. Treatment was modified in 40 patients (72%). Laboratory assessment including FCAL (65%) and therapeutic drug monitoring (30%) was performed as appropriate. The need for subsequent accelerated assessment was infrequent. Fast-track endoscopy was performed in four patients, and two patients had an abdominal/pelvic CT for assessment. Conclusions: Implementation of an RAC improved healthcare delivery by avoiding unnecessary ER visits and patient care by increasing access to an IBD centre.