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World J Gastroenterol. Oct 14, 2013; 19(38): 6367-6374
Published online Oct 14, 2013. doi: 10.3748/wjg.v19.i38.6367
Quality improvement in pediatric inflammatory bowel disease: Moving forward to improve outcomes
Pauline Quach, Geoffrey C Nguyen, Eric I Benchimol
Pauline Quach, Eric I Benchimol, CHEO IBD Centre, Division of Gastroenterology, Hepatology and Nutrition, Children’s Hospital of Eastern Ontario, Ottawa K1H 8L1, Canada
Pauline Quach, Geoffrey C Nguyen, Eric I Benchimol, Institute for Clinical Evaluative Sciences, Ottawa K1Y 4E9, Canada
Geoffrey C Nguyen, Zane Cohen Center for Digestive Research, Division of Gastroenterology, Mount Sinai Hospital, Toronto M5T 3L9, Canada
Geoffrey C Nguyen, Department of Medicine, University of Toronto, Toronto M5S 2J7, Canada
Eric I Benchimol, Departments of Pediatrics, Epidemiology and Community Medicine, University of Ottawa, Ottawa K1H 8M5, Canada
Author contributions: Quach P drafted and edited the manuscript; Nguyen GC and Benchimol EI contributed to revising and editing the manuscript.
Correspondence to: Eric I Benchimol, MD, PhD, FRCPC, CHEO IBD Centre, Division of Gastroenterology, Hepatology and Nutrition, Children’s Hospital of Eastern Ontario, 401 Smyth Road, Ottawa K1H 8L1, Canada. ebenchimol@cheo.on.ca
Telephone: +1-613-7377600 Fax: +1-613-7384854
Received: July 23, 2013
Revised: September 12, 2013
Accepted: September 15, 2013
Published online: October 14, 2013
Processing time: 83 Days and 17.5 Hours
Abstract

In recent years, pediatric health care has embraced the concept of quality improvement to improve patient outcomes. As quality improvement efforts are implemented, network collaboration (where multiple centers and practices implement standardized programs) is a popular option. In a collaborative network, improvement in the conduct of structural, process and outcome quality measures can lead to improvements in overall health, and benchmarks can be used to assess and compare progress. In this review article, we provided an overview of the quality improvement movement and the role of quality indicators in this movement. We reviewed current quality improvement efforts in pediatric inflammatory bowel disease (IBD), as well as other pediatric chronic illnesses. We discussed the need to standardize the development of quality indicators used in quality improvement networks to assess medical care, and the validation techniques which can be used to ensure that process indicators result in improved outcomes of clinical significance. We aimed to assess current quality improvement efforts in pediatric IBD and other diseases, such as childhood asthma, childhood arthritis, and neonatal health. By doing so, we hope to learn from their successes and failures and to move the field forward for future improvements in the care provided to children with IBD.

Keywords: Inflammatory bowel disease; Colitis; Ulcerative; Crohn’s disease; Child; Adolescent; Quality of health care; Review

Core tip: This review article provides an overview of the quality improvement movement and the role of quality indicators. Active quality improvement efforts in pediatric inflammatory bowel disease are discussed, and the need for standardizing the development of quality indicators across all fields of healthcare is emphasized. This article also discusses the importance of incorporating validation techniques when developing and selecting quality indicators. Examples of quality improvement efforts in other areas of pediatric chronic illnesses are presented, with important lessons highlighted to guide future quality improvement initiatives.