Observational Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 21, 2020; 26(7): 759-769
Published online Feb 21, 2020. doi: 10.3748/wjg.v26.i7.759
Benefits of implementing a rapid access clinic in a high-volume inflammatory bowel disease center: Access, resource utilization and outcomes
Sofia Nene, Lorant Gonczi, Zsuzsanna Kurti, Isabelle Morin, Kelly Chavez, Christine Verdon, Jason Reinglas, Rita Kohen, Talat Bessissow, Waqqas Afif, Gary Wild, Ernest Seidman, Alain Bitton, Peter Laszlo Lakatos
Sofia Nene, Isabelle Morin, Kelly Chavez, Christine Verdon, Jason Reinglas, Rita Kohen, Talat Bessissow, Waqqas Afif, Gary Wild, Ernest Seidman, Alain Bitton, Peter Laszlo Lakatos, Division of Gastroenterology, McGill University Health Centre, Quebec, Montreal H3G1A4, Canada
Lorant Gonczi, Zsuzsanna Kurti, Peter Laszlo Lakatos, First Department of Medicine, Semmelweis University, Budapest H-1083, Hungary
Author contributions: Nene S and Gonczi L contributed equally to this work. Nene S and Gonczi L were responsible for data analysis, literature overview and drafting the manuscript. Kurti Z, Morin I, Chavez K, Verdon C, Reinglas J, Kohen R, Bessissow T, Afif W, Wild G, Seidman E and Bitton A contributed to the data collection and final analysis and conducted critical review of the manuscript. Lakatos PL was leader of research planning and result interpretation, also he contributed to the statistical planning and data analysis, supervised the manuscript preparation and is acting as guarantor of submission. All authors read and approved the final manuscript including the authorship list.
Institutional review board statement: We hereby certify that the present study design was approved by The Research Ethics Office (Institutional Review Board) of McGill University. Ethics Committee approval was obtained in accordance to ISO protocol, local legal regulations and McGill University Health Center Research Ethics Board guidelines, prior to initiation of this study.
Informed consent statement: Our investigation only included evaluation of clinical data (as approved by the IRB, granting "access to adult health records") and did not required any additional procedures, or influenced health care delivery. As a result, informed consent forms were not required from the subjects for this study.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Peter L Lakatos, AGAF, DSc, FEBG, FRCP (C), MD, Full Professor, Staff Physician, Division of Gastroenterology, McGill University Health Centre, Montreal General Hospital C7-200, 1650 Cedar Avenue, Montreal H3G1A4, Quebec, Canada. peter.lakatos@muhc.mcgill.ca
Received: November 2, 2019
Peer-review started: November 2, 2019
First decision: December 4, 2019
Revised: December 29, 2019
Accepted: January 19, 2020
Article in press: January 19, 2020
Published online: February 21, 2020
Processing time: 110 Days and 2.9 Hours
ARTICLE HIGHLIGHTS
Research background

Emergency department (ED) attendance in inflammatory bowel disease (IBD) patients put significant burden on the healthcare system.

Research motivation

We theorize that a large proportion of IBD patients presenting with urgent IBD specific complaints could potentially be managed in alternative care settings, thus avoiding unnecessary ED visits.

Research objectives

To report a comprehensive analysis of patient access and resource utilization after the implementation of the new rapid access clinic (RAC) service at a tertiary IBD center, compared to usual ED visits in IBD patients.

Research methods

Patient access, resource utilization and outcome parameters were collected from consecutive patients contacting the RAC in a two year period. Comparative analysis of resource utilization and healthcare costs were carried out evaluating ED visits of IBD patients with no access to RAC services.

Research results

Creating a RAC for IBD patients is associated with quick patient access, optimized and specific use of diagnostic procedures and services, with similar outcome parameters and lower resource utilization and overall costs compared to regular ED visits for IBD patients.

Research conclusions

Implementation of a RAC facilitated easier access to IBD specific medical care, with optimized resource utilization and helped avoiding potential ED visits and subsequent hospitalisations.

Research perspectives

A RAC is ideal for providing IBD specific medical care in urgent situations, reducing burden to both the healthcare system and patients.