N48 Exploring & evaluating the benefits of initiating an IBD Transition clinic

Abstract

Abstract Background Establishing an Inflammatory Bowel Disease (IBD) Transition Clinic can bring about several significant benefits. This includes providing continuity of care, specialised care, education in new treatment, emotional support, collaboration and coordination of care, empowering patients and assisting in adherence to medication and follow up appointments. In the author's history within the Trust there has never been an established IBD Transition clinic. This has led to young adults delayed in transitioning to adult services without any formal handover. Methods The IBD Consultant Nurse felt that the young adults were given a second class service and that they were not receiving the care and advice that they needed in the difficult time of being a young adult with a long term condition. They enlisted the help of a paediatric gastroenterologist and worked with the paediatric operations team and a cohort of patients were booked into a three monthly clinic held on a Saturday as this was felt the best day for engaging both patients and family. The paediatric gastroenterologist and IBD Consultant Nurse undertook the clinic jointly. Results A number of clinics were undertaken and the IBD Consultant Nurse asked for all patients to be assigned to an adult gastroenterologist after the first appointment. At the joint clinic all medication was discussed and a personalised plan of care was adopted for all patients to allow a smooth transition into adult services. The feedback from patients and family members was extremely favourable and all patients felt that they had been given all of the required information, a personalised care plan and were prepared to be transitioned to adult care. All patients were given a post clinic questionnaire on their satisfaction of the Transition clinic. The clinic was recently stopped as a adult gastroenterologist felt that this should not have been undertaken by a nurse and that they can only be undertaken by doctors. The current waiting time to be reviewed by a gastroenterologist is currently around 65weeks which could lead to a delay in treatment. Conclusion Ideally establishing a nurse-led transition clinic requires collaboration among healthcare providers, administrative support, and resources dedicated to its development. Additionally, an emphasis on patient and family involvement in the planning and execution stages can lead to a more patient-centric and successful transition program. This clinic was extremely successful but has had to stop as the gastroenterologists feel that only gastroenterologists can undertake transition clinics and should not be nurse led. Unfortunately this will lead to transition patients having an extended delay into adult services.