N29 Audit of Inflammatory Bowel Disease Telephone Advice Line

Walsh, C.(1)*;

(1)Letterkenny General Hospital, Gastroenterology, Letterkenny, Ireland;

Background

Inflammatory Bowel Disease (IBD) is a chronic unpredictable condition of the gastrointestinal tract and advice lines for chronic disease are well established. Advice lines are a fundamental part of the Inflammatory Bowel Disease services. They offer advice and support for patients and have been shown that early intervention via an advice line can have a major impact in avoiding hospitalisation due to a flare up. Inflammatory Bowel Disease advice lines provide for multiple queries in relation to IBD and increasing demands were observed. The introduction and increased use of biologic medication (subcutaneous and oral) requires a repeat Hi Tech prescription and this has increased the workload through the IBD advice line.

The aim was establish if aspects of the IBD advice line was in accordance with IBD Standards UK and to highlight any deficiencies that would require corrective action

Methods

Data was collected on all telephone calls received by the ANP IBD advice line during the data period 17/01/2022 to 11/02/2022 (n=80). The average number of monthly calls to the service is 146. Prospective data was collected by ANP IBD and analysed by the Clinical Audit Facilitator using IBM SPSS Statistics v 24.

Criteria used to measure against:
Rapid access to specialist advice should be available to patients to guide early flare intervention, including access to a telephone/email advice line with response by the end of the next working day ( IBD Standards UK)

Results

The highest number of calls to the advice line was 23/80 (29%) for a Hi Tech prescription. Flare up calls consisted of 21.2% of the calls and results investigations was equal to this. Administration queries and medication queries consisted of 7.5% of the calls. Clinical related queries were almost 9% of the calls.

59% of calls were returned within 36 hours. Mean interval of time call was returned was 34.7 hours and a median interval of 28 hours.

Conclusion


The audit indicates the highest number of calls are for repeat Hi tech prescriptions for medications. A Quality Improvement Plan includes the establishment of a dedicated Hi Tech Prescription Telephone/Virtual Clinic. This will also ensure an improved quality and a safer standard of care for patients. .

The audit further identifies the number of calls and the effectiveness of the Inflammatory Bowel Disease advice line e.g. the number of calls (17/80) that dealt with a flare up that would have possibly attended the Emergency Department.  It also highlights the time intervals for return of calls (33/80) calls were returned > 36 hours. A new Clinical Nurse Specialist Inflammatory Bowel Disease would improve service outcomes.