IBD 13 Referral, review and scoping timelines in IBD in pandemic, compared to national quality standards. (12th September 2022)

• Record Type: Journal Article
• Authors: Copley, Sian; Suresh, Roshan; Rivlin, Gillian Dorit; Hong, Chi Tse; Byrne, Lauren; Skoutelis, Nikolaos; Nair, Manjula
• Is Part Of: Frontline gastroenterology. Volume 13(2022)Supplement 1
• Page Start: A45
• Page End: A45
• Publication Date: 2022-09-12
• Subjects: Gastroenterology -- Periodicals; 616.33005
• DOI: 10.1136/flgastro-2022-bspghan.63
• Languages: English
• ISSNs: 2041-4137

Abstract

Abstract : Alderhey Childrens hospital, Liverpool accepts referrals from 8 Hospitals around the region and we get 2–3 new referrals of IBD every week. During the pandemic, we were limited, like the rest of our country in performing regular endoscopies for a period of 6 months in 2020.During that period, we continued to perform emergency endoscopies for children who presented with acute presentations of IBD. We have in 2021, caught up with those children who needed routine and emergency endoscopies, and we wanted to audit our referral, review and scoping times for our NEW IBD referrals and compare them against the standards set by RCPCH(Quality standards in paediatric Gastroenterology, Hepatology and Nutrition) in 2017 and compare them with our own survey done in 2019. Methods: We looked at 30 records of children who had a new diagnosis of IBD in last three years and looked at their referral date, date of first review and their date of first scopes. We compared this data with our previous data from the IBD standards benchmarking tool done in 2019. Results: Of the 30, 4 children had a referral earlier than the last three years and were excluded. 12 children were newly diagnosed in 2021 and were referred and seen mostly between 0–4 weeks 91%) with one child seen at 8 weeks( 9%); which is much improved from 2019(75%). The median time of review was 2 weeks. The time taken to scope them after the review ranged from 0–12 weeks with a mean of 6 weeks and median of 4 weeks. In 2020, Of the 9 notes reviewed the time for reviews from referral ranged from 1–8 weeks, the median being 4 weeks, and average being 4 weeks, which is still on target.The time to scope varied depending on if the child presented acutely unwell or not. It varied between 0 weeks to 10 months for children who were reasonably well and were not scoped till a routine date was available. The mean time was 6 weeks, barring the outlier of 10 months. In 2019, of the 6 notes reviewed showed a range between 2–8 weeks, median being 2 weeks and average of 4 weeks.Of the 6 notes reviewed, the mean was 6 weeks and median 5 weeks. Again there was an outlier at 11 months. Conclusion and Discussion: In early 2020, the country went in to lockdown and routine endoscopy came to a standstill. We struggled to manage new IBD referrals and also importantly to scope children who were not unwell enough to warrant an emergency endoscopy. In 2020, we found some late diagnosis in such children, but we appeared to have caught up with early reviews of all referrals for IBD in 2021.Our IBD standards for diagnosis are on target in 2021 and much better than 2019. References: Quality standards for Paediatric Gastroenterology, Hepatology and Nutrition Jan 2017 RCPCH Publications.