Improving Procedural Documentation of Newly Diagnosed Pediatric Inflammatory Bowel Disease Patients: A Single-center Quality Improvement Study.

Abstract

Introduction: Inflammatory bowel disease (IBD), including ulcerative colitis and Crohn disease (CD), presents significant challenges in management, particularly regarding standardized endoscopic scoring. This study aimed to assess and improve procedural documentation practices among endoscopists managing newly diagnosed pediatric IBD (PIBD).

Methods: This quality improvement project involved a preintervention review of records for newly diagnosed patients with PIBD from January 2022 to December 2022 and a postintervention review of records from March 2023 to March 2024. We evaluated procedural documentation practices pre- and postintervention using control charts. We conducted an educational session on standardized procedural documentation for endoscopists in March 2023. Standardized procedural documentation was defined as the Mayo endoscopic score for ulcerative colitis and the simple endoscopic score for CD. We displayed a reminder flow diagram on the computer used by endoscopists for their procedural documentation.

Results: In the preintervention period (n = 29), endoscopists used standardized documentation in 21% of cases (6/29). Postintervention (n = 43), standardized documentation use increased to 72% (31/43), demonstrating a 51% improvement. Subgroup analysis revealed variable adoption rates, with 100% for IBD-undetermined and 0% for patients with very early onset IBD. Control p-chart revealed a downward trend in the defect rate in the later months, suggesting improved adherence.

Conclusions: Our initiative significantly enhanced the utilization of standardized endoscopic documentation among endoscopists for newly diagnosed patients with PIBD. This improvement underscores the effectiveness of structured educational strategies in promoting adherence to best practices. Future efforts should focus on sustaining these gains and addressing subgroup-specific challenges to optimize patient care in IBD management.