scholarly journals Leveraging Institutional Support to Build an Integrated Multidisciplinary Care Model in Pediatric Inflammatory Bowel Disease

Children ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. 286
Author(s):  
Jennifer Verrill Schurman ◽  
Craig A. Friesen
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Institutional Support ◽  
Multidisciplinary Care ◽  
Decision Makers ◽  
Care Experience ◽  
Care Models ◽  
Value Streams ◽  
Inflammatory Bowel ◽  
Integrated Care Models

While the biopsychosocial nature of inflammatory bowel disease (IBD) is now well accepted by clinicians, the need for integrated multidisciplinary care is not always clear to institutional administrators who serve as decision makers regarding resources provided to clinical programs. In this commentary, we draw on our own experience in building successful integrated care models within a division of pediatric gastroenterology (GI) to highlight key considerations in garnering initial approval, as well as methods to maintain institutional support over time. Specifically, we discuss the importance of making a strong case for the inclusion of a psychologist in pediatric IBD care, justifying an integrated model for delivering care, and addressing finances at the program level. Further, we review the benefit of collecting and reporting program data to support the existing literature and/or theoretical projections, demonstrate outcomes, and build alternative value streams recognized by the institution (e.g., academic, reputation) alongside the value to patients. Ultimately, success in garnering and maintaining institutional support necessitates moving from the theoretical to the practical, while continually framing discussion for a nonclinical/administrative audience. While the process can be time-consuming, ultimately it is worth the effort, enhancing the care experience for both patients and clinicians.

scholarly journals Physicians in Supporting Roles: Time to Share the Spotlight

2019 ◽  
Vol 1 (3) ◽  
Author(s):  
Benjamin Click
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Inflammatory Bowel Disease Patient ◽  
Disease Patient ◽  
Multidisciplinary Care ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Care Models ◽  
Medical Home Model ◽  
Inflammatory Bowel

With rising interest in multidisciplinary care models for inflammatory bowel disease, the optimal team arrangements, roles, and dynamics are unknown. This editorial comments on the importance of work addressing this issue in an inflammatory bowel disease patient-centered medical home model.

scholarly journals Can a transition clinic bridge the gap between paediatric and adult inflammatory bowel disease care models?

2020 ◽  
Vol 52 (5) ◽  
pp. 516-527
Author(s):  
Olga Maria Nardone ◽  
Marietta Iacucci ◽  
Subrata Ghosh ◽  
Fabiana Castiglione
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Transition Clinic ◽  
Care Models ◽  
Inflammatory Bowel

scholarly journals N29 Application of the AREA model to a standard care plan for patients with inflammatory bowel disease

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S670-S671
Author(s):  
M I Mateos Hernandez
Keyword(s):  
Inflammatory Bowel Disease ◽  
Nursing Care ◽  
Bowel Disease ◽  
Multidisciplinary Care ◽  
Holistic Approach ◽  
Care Plan ◽  
Average Hospital ◽  
Area Model ◽  
Inflammatory Bowel ◽  
Institutional Model

Abstract Background The clinical characteristics of the inflammatory bowel disease (IBD), its psychosocial/occupational impact and the increase in its incidence and prevalence, justify the proliferation of Multidisciplinary Care Units (with reference nurses for patients). The standardisation of care and the recording of the performance of the professionals that integrate them are necessary to give continuity to the care, to value the role of each of them in these, to reduce the variability in clinical practice and the collection of data that allow decision-making at the management and research assistance level. All of the above plus the existence in our country of legal regulations that define and regulate the records of mandatory existence and completion in the medical records, of our patients has made us set ourselves as a general objective: Develop a standard nursing care plan for the care of patients with IBD. Methods A literature review of the literature published in the last 10 years in the Medline, Cocharane, Cinahl and Cuiden databases is carried out. The search criteria establish the existence of the words ‘Care plan’ ‘nursing care’ and ‘nursing diagnoses’, all of them combined with IBD. Natural words bounded by the limits determined in the inclusion criteria. The needs model of Virginia Henderson (Institutional model) is used for the assessment and for the diagnosis, objectives and planning of nursing interventions the taxonomies NANDA, NOC, and NIC (NNN). Finally, in order to achieve a realistic and applicable plan of care taking into account, criteria of average hospital stay per process, and average time of outpatient care, we apply the AREA model (Analysis of Current State Outcomes) of Pesut1. Results The assessment highlights the altered needs: food, disposal, safety mobility, self-realisation, values and communication beliefs. In relation to the diagnoses, we classify them into clinical, psychosocial and secondary to the treatment, discriminating those written as diagnosed by nurses and therefore resolved or minimised autonomously by the nurses from whom they should be considered as collaborative problems. Normality characteristics are defined by protocol. Conclusion The model favours a broad and comprehensive view of the situation, leading to the selection of the diagnosis (or more than three) that allows the holistic approach to be effective and efficient. It would allow us to know the prevalence and incidence of diagnoses and agree on objectives and activities to establish comparison patterns.

Inflammatory bowel disease in pregnancy: Developing a multidisciplinary care pathway in East London

2021 ◽  
pp. 1753495X2110097
Author(s):  
Mandeep K Kaler ◽  
Madeleine Malina ◽  
Klaartje Kok ◽  
Rehan Khan
Keyword(s):  
Inflammatory Bowel Disease ◽  
Pregnant Women ◽  
Bowel Disease ◽  
Care Pathway ◽  
Multidisciplinary Care ◽  
Obstetric Medicine ◽  
Royal London Hospital ◽  
Inflammatory Bowel ◽  
Medicine Team ◽  
Active Disease

Objectives Evaluate the management of pregnant women with inflammatory bowel disease. Method We collected data from maternity records for women with IBD who gave birth at The Royal London Hospital between January 2018 and February 2019. Results Twenty-three pregnancies were identified where 8/23 (35%) women had a peri-conception flare and 7/23 (30%) had a flare during pregnancy. Two women received pre-conception counselling. The obstetric medicine team reviewed a patient on average three times and the gastroenterologists twice, during pregnancy. Nine women (39%) gave birth pre-term. Mean birthweight was lower in the group with active disease at conception compared with those in remission (2173 g vs. 2807 g, p = 0.03). Conclusions Women with IBD should all receive pre-conception counselling to reduce the risk of pregnancy complications. By developing a multidisciplinary care pathway for pregnant women with IBD (which includes a joint obstetric/gastroenterology clinic), this will ensure care is standardised throughout the pregnancy and puerperium.

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