February 28, 2023 – 11:10 PM
Fewer tedious examinations in children and better registration in adults. These are the results of the IBD improvement program of the seven Santeon hospitals.
IBD stands for Inflammatory Bowel Disease. These include Crohn’s disease and ulcerative colitis. IBD is one of the conditions in which the Santeon hospitals work together through the improvement program Samen Beter to improve the care for their patients by learning from each other.
We have succeeded in realizing great improvements. For example, far fewer examinations are being carried out in children, registration in adults has improved considerably, efforts have been made to reduce visits to the emergency department and to jointly purchase expensive medicines. The Santeon hospitals collectively treat nearly 12,000 adults with IBD, and a number of hospitals also treat children.
“I am proud that within Santeon we treat almost 12,000 of the 85,000 IBD patients in the Netherlands. Our improvements therefore have a real impact.” Lennard Gilissen, gastroenterologist at the Catharina Hospital
Fewer studies in children with IBD
IBD patients have to deal with many stressful tests, such as calprotectin tests – which look at stool – and MRI scans. By comparing the care results with each other, it turned out that there was a lot of difference between the Santeon hospitals in the number of examinations that were conducted in children.
This is an important focus point of the improvement team to improve care for children with IBD, because the examinations are often experienced as unpleasant and also entail high costs. That is why the team has looked in detail at the need for these studies and shared good practice examples. This has led to Santeon guidelines, as a result of which the number of examinations in hospitals has fallen considerably compared to the previous year, with the same care result. The number of calprotectin tests decreased by 22% and the number of MRI scans by 8%.
Better registration, better care
In order to provide good care to IBD patients, it is important for doctors to map out the disease. This is done via the Montreal score. A patient’s disease activity is measured by the Physician Global Assessment (PGA) score. The registration of these scores proves to be difficult, because many healthcare professionals are involved in the disease IBD and there are sometimes IT challenges. In order to provide patients with the best care, the Santeon hospitals have nevertheless improved these registrations for both syndromes. For example, the registration of the Montreal score in Crohn’s Santeon disease has broadly increased from 25% to 53% and in ulcerative colitis from 15% to 45%. The registration of the PGA score increased from 6% to 46% in Crohn’s disease and from 4% to 40% in ulcerative colitis. This has been achieved by drawing the attention of care providers more often to the lack of registration scores and file research, whereby missing values are supplemented. In the coming years, efforts will be made to improve registration even further.
“Good registration helps doctors to have an overview at once of how the disease is progressing and how active the disease is in the patient. This ensures that we can ask the right questions and arrive at an appropriate treatment together with the patient. In addition, registering helps us to accurately reflect the differences between the hospitals, so that we can learn from each other and improve.” Evelyne Verweij, gastroenterologist at Maasstad Hospital
Transparency for better (IBD) care
The Samen Beter program aims to provide the most appropriate care for the patient. Medical specialists and care providers work together with the patient to continuously improve and personalize the care. This is done by comparing each other’s results, in which learning from each other is central. By sharing the results of the Samen Beter program, Santeon also wants to inspire the broader healthcare field to get started with value-based healthcare. This report describes all improvement initiatives, including reducing the number of visits to the emergency department and the purchase of expensive medicines. The process of improvement will of course continue. In the coming years, the improvement team will focus on the digitization of IBD care, the use of data for a prediction model, science and value-driven financing and a wider range of biologicals.
Read the Samen Beter IBD report here.
Bron: Santeon