• Inflammatory Bowel Disease (IBD) – Quality Measures

    The Cincinnati Children’s Schubert-Martin IBD Center is part of the Division of Gastroenterology, Hepatology and Nutrition, which has been consistently ranked as one of the top three gastroenterology programs in the nation by U.S. News & World Report.

    In the last five years our inflammatory bowel disease outcomes have dramatically improved.  

    • Remission rates have improved from 60 percent to 80 percent.
    • 80 percent of patients report a good or excellent quality of life.
    • 96 percent of patients are not taking steroids.
  • Our Performance

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    Clinical remission is defined as freedom from IBD-related symptoms. The goal of treatment in the IBD Center is for each patient to achieve and maintain remission for the longest period of time possible. Each month, we measure the percentage of our patients currently in remission (remission rate) and the percentage in remission for the past 13 months (sustained remission rate).

    • Our remission criteria are based on objective clinical data (physician global assessment) as well as our patients’ feedback regarding symptom control.
    • Our remission rate after three months of treatment is 80 percent. 

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    How We Measure

    We measure remission rate on all patients after three months of initial treatment. Patients are considered in remission if they have no IBD-related symptoms at their last clinic visit.

    Continuous Improvement

    We analyzed the reasons patients are not in remission and discovered a primary reason is failure to have a follow-up visit after an increase in symptoms. We have initiated an improvement project to further explore this cause and have begun work to standardize our procedures to ensure each patient receives routine follow-up.
    > Learn more about our ongoing improvement efforts.

    Quality of life refers to the general well-being of our patients and how they view themselves.  Our goal is that each patient feels well and that his or her life and activities are not adversely affected by IBD.  At each clinic visit, patients rate their quality of life on a 10-point scale.  The goal is to have every patient rate his or her quality of life as excellent. This translates to between 8 and 10 on the 10-point scale. 

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    How We Measure

    Quality of life is reported by the patient or the patient’s parent (if the patient is under 9 years old) at each visit. Quality of life is rated on a scale of 1-10, with 10 being the highest score.

    Continuous Improvement

    We review all patients with an upcoming appointment and identify their quality of life documented at the last visit. If the patient’s quality of life is reported as less than 8, recommendations are made to the care team to consider a referral to our IBD psychologist.
    > Learn more about our ongoing improvement efforts.

    Using medications safely and effectively is crucial to managing a patient’s IBD and maintaining remission. One of the medications we monitor is steroids (Prednisone) because of the negative side effects in children. Our approach is to use steroids sparingly and for our patients to not be taking steroids after the first three months of initial treatment.

    • Only 5 percent of our patients are taking prednisone after three months of treatment, an indication of our ability to utilize steroid-sparing medications effectively. Steroid-sparing medications include 6-MP, Imuran, Remicade and methotrexate.
    • Treatment guidelines were developed using evidence to enable the treatment team to best screen, dose and monitor steroid usage.   

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    How We Measure

    We measure steroid usage on all patients three months after diagnosis. Our goal is to have 95 percent of patients no longer taking steroids within three months of diagnosis.

    Continuous Improvement

    • We review and identify patients who are prescribed prednisone before each visit and discuss decreasing the dose as part of their visit.
    • We review patients who have been taking prednisone for longer periods of time and recommend steroid-sparing medications.
    • We review patients’ medications at each visit to ensure accuracy and provide education.

    > Learn more about our ongoing improvement efforts.

    Over the last five years, the IBD Center at Cincinnati Children’s has experienced growth in the number of patients served. This growth represents the excellence in care and dedication of everyone in the GI division, and recognizes our leadership in the care of children with IBD.

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