N44 Implementing Electronic Documentation of a Nurse-Led IBD Advice Line

Abstract

Abstract Background Beaumont Hospital is a tertiary referral centre providing care to over 4500 patients with inflammatory bowel disease (IBD). This service offers an IBD nurse telephone advice line per international IBD standards. This was established to allow patients on-demand access to our service, improving the overall quality of care. Aims/Background • Time-to-response is recorded for all calls • Calls and emails are audited every month to ensure • Local KPIs are met • Identify potential weakness in service (i.e. access to emergency clinic spots) • Ensure continued improvement and service evolution • Track appropriate use of service by patients Methods Data was collected by establishing an Excel spreadsheet due to a lack of infrastructure to support a database. The spreadsheet will document the date of the call, date of the return call, patient name, hospital identification number, consultant name, reason for calling, and intervention time spent with each patient. Based on the initial audit of findings, the Patient Satisfaction Survey was distributed (n=110) and recorded. Patient feedback to identify areas for education and service development Results Two thousand six hundred and thirty-three (2,633) calls were received from January 2022 to September 2022. Auditing is performed monthly, identifying areas requiring improvement. Patients are frequently re-educated on how to best engage with our service. Pathways have been established to divert the calls to the appropriate alternative services such as administrators, endoscopy department, infusion services, and GP services, freeing our service for the appropriate calls only—30% of calls related to IBD flares. IBD nurses directly managed 82% of patients with flares. Overall, 75% of calls were managed virtually by an IBD nurse. An online patient satisfaction survey showed that 98% of patients expressed excellent satisfaction with the advice line service. Conclusion The precise documentation guided the established lean pathways for prescription renewal and pathways to redirect patients to endoscopy and non-IBD queries. The study results in aids to establishing protocols to limit prescriptions for patients who are non-compliant with blood/visits. It developed written and verbal information for patients on parameters for appropriate service use—education of patients: Modified written and oral patient education. The results of an online patient satisfaction survey showed 98% of patients report satisfaction with “excellent. The precise documentation and measurement of all the calls received facilitates service improvements and locally appropriate patient care. Patient involvement in improvement projects allows improvements to develop with patients at the centre.