S1862 Optimizing Healthcare Maintenance in IBD Patients: A Quality Improvement Initiative

Introduction: Patients with inflammatory bowel disease (IBD) require diligent healthcare maintenance (HCM) to mitigate the risks associated with chronic inflammation and immunosuppression. Nevertheless, adherence to preventive care recommendations remains inconsistent in clinical practice. This quality improvement (QI) initiative aimed to evaluate the status of adherence to IBD HCM components, followed by the implementation of multifaceted interventions to enhance HCM in IBD patients. Methods: Baseline data were collected for 200 IBD patients seen in the fellows' clinic from January 2024 to March 2024. The components of HCM were evaluated in these patients. STATA 14.2 was utilized for statistical analysis. Results: Considerable variability was seen in the provision of recommended HCM practices. Covid-19 vaccination had the highest compliance rate, documented in 87.00% of the patients. In contrast, significantly lower rates were noted for other immunizations, including annual influenza (48%), hepatitis B (42%), herpes zoster (39.5%), and HPV (23.81% of age-eligible patients). Although 65.7% of the eligible 111 immunocompromised patients received pneumococcal vaccine, respiratory syncytial virus vaccination showed the lowest adherence (10%), followed closely by hepatitis A vaccine at 16%. While dysplasia surveillance via colonoscopy was performed in 83.5% of the cohort, mental health evaluation lagged significantly behind (42%). Among those meeting criteria for osteoporosis screening, 60.9% had a recorded DEXA scan. Pap smear and cessation counselling for smokers were noted in less than half the eligible population, whereas annual dermatologic evaluation was only performed in 13 of the 111 candidates. Conclusion: Review of metrics uncovered substantial lapses in recommended IBD HCM measures. A structured didactic session was delivered to the gastroenterology department, focusing on evidence-based HCM practices in IBD. In parallel, a SmartPhrase was created and integrated into the electronic medical record (EMR) to facilitate documentation of key HCM elements. Post-intervention improvement in HCM will be assessed in the future phase. The findings will provide valuable insights into the effectiveness of the QI initiative and guide future refinements to optimize IBD patient care.