Abstract
Improved diagnosis of coeliac disease has increased incidence and therefore burden on the health care system. There are no quality outcome measures (QOM) in use nationally to assess hospital management of this condition. This study applied QOM devised by the East of England paediatric gastroenterology network to 99 patients reviewed at two tertiary hospitals in the Network, to assess the quality of care provided by nurse led and doctor led care models. The average performance across all QOM was 96.2% at Addenbrooke’s Hospital (AH), and 98.7% at Norfolk and Norwich Hospital (NNUH), whilst 95% (n = 18) of QOM were met. Patient satisfaction was high at both sites (uptake of questionnaire 53 of 99 patients in the study). The study showed a comparably high level of care delivered by both a nurse and doctor led service. Our quality assessment tools could be applied in the future by other centres to measure standards of care.
Highlights
Coeliac disease affects up to 0.5%–1% of all children in Europe and North America, with a large number of cases being undiagnosed [1,2,3]
The initial focus of our investigation was to compare the quality outcome measures at each site to assess the quality of care delivered by each system, i.e., nurse and dietician (AH) versus doctor and dietician (NNUH) led care
Target set in each subsection, whilst Norfolk and Norwich University Hospital (NNUH) achieved compliance in five of the six targets (Figure 1)
Summary
Coeliac disease affects up to 0.5%–1% of all children in Europe and North America, with a large number of cases being undiagnosed [1,2,3]. With the implementation of simple widespread diagnostic screening tools, the incidence has increased rapidly in recent years, leading to an increasing burden on the healthcare system [3]. It is very well established that a lifelong gluten free diet results in symptom resolution and normalisation of tissue transglutaminase (tTG) in the majority of patients [4,5], and remains the mainstay of treatment. Patient care includes the involvement of primary, secondary and tertiary healthcare institutions as well as several health care professionals such as dieticians, nurses, and doctors. The ultimate aim is to optimise resources and expertise in order to provide the highest quality patient care. In the East of England, patients are managed within the East of England Paediatric
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