1082 / Improving patient safety by patient surveys - prevention of Inflammatory Bowel Disease

CROATIA
Classification of the PSP
Type of Patient Safety Practice Not Implemented
 
Clinical Practice (CP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Diagnostics
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Topic of the reported practice
Patient surveys
Aim and the benefit of the Patient Safety Practice
 
In our survey we will collect data of incidence and prevalence of Inflammatory Bowel Diseases (IBD) in the eastern part of Croatia. The aim of survey is to find a better way to early diagnosis of IBD in the whole population in that area. In very simplified sense, this survey will help us to improve prevention of IBD and to improve treatment in early stage of disease.
Description of the Patient Safety Practice
 
Ulcerative colitis (UC) and Crohn`s disease (CD) are chronic intestinal conditions with common pathogenetic background and similar clinical expression, termed inflammatory bowel diseases (IBD). IBD mostly occur in adolescents and young adults and continue in a chronic manner. CD typically involves terminal ileum and the ascending colon, but can affect any part of the gastrointestinal tract, respecting a segmental, discontinuous form of spreading. In CD, inflammation may break throughout the wall, forming the granulomas, which later in the disease can be associated with the intestinal strictures and fistulas and the requirement for a surgical treatment. UC involves the rectum and may spread to the colon, in an uninterrupted manner, sometimes affecting the entire colon. In UC, inflammation is localized in the mucosa and this is the reason why UC is not associated with the late surgical complications. However, in the case of severe bleeding, bloating, or a failure of the patient to respond to the medical treatment, surgery may be considered, by means of colectomy. Patients with UC are also at increased risk of colon cancer. Both diseases are clinically presented with persistent diarrhea, hemorrhage and abdominal pain, and when the disease is severe, or of a long duration, also with weight loss, malnutrition and fever. The symptoms tend to appear in flare-ups, with remissions in between. Due to chronic inflammation and the permanent activation of the immune system, in both diseases, a number of extra intestinal complications can also appear, most of them being immunologically mediated, such as skin lesions, joint pain, eye inflammation and liver disorders. Many potential causing factors, for IBD, have been proposed to date. Increasing evidence suggests IBD as complex, polygenic disorders with incomplete genetic penetrance and poor genotype-phenotype correlation. Rapid changes in the epidemiologic pattern of these diseases, during the past decades, in Europe and wider in the world, provide the evidence that changes in lifestyles and environmental exposures are those dominant factors that drive clinical expression and the natural history of these diseases, while the genetic factors, although nowadays in the focus of research, have only permissive role. There is an initiative, in the scientific community, to conduct long-term studies, in order to compare changes in environmental factors and treatment options with changes in the natural course and prognosis of IBD. Standardization of the severity and the extension of a disease, necessary to making these comparisons, has recently been provided in the form of the Montreal's classification of IBD. Descriptive statistics (expressed with absolute numbers of patients and percentages) were used to analyze the presence/absence of symptoms and complications, depending on the type of diagnosis. Differences among the categories were assessed by using the Fisher exact tests. The duration of the symptoms prior to the first medical check-up (in months) was analyzed by using the nonparametric Mann-Whitney U test. Distributions of phenotypes, particularly for UC and CD, were represented graphically, as columns of percentages. The extent of CD, according to the Montreal's classification three stages per each of three categories: age at time of diagnosis, location and behavior, was represented by using descriptive statistics (absolute numbers of patients and percentages), while differences among categories were analyzed.
Attachment of relevant written information and/or photos, as appropriate
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Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
No
Level of implementation of reported practice
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Specific and measurable outcome for the reported practice were defined
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A baseline measurement before implementation of the reported practice was obtained
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A measurement after full implementation of the reported practice was obtained
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Evaluation of a "positive" effect of the reported practice on Patient Safety
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Type of before-and after evaluation
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Enclosure of a reference or attachment in case of published evaluation's results
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Health care context where the Patient Safety Practices was implemented
 
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Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
No
Specification of implementation in another health care setting(s)
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Successful implementation's level  of this Patient Safety Practice across settings
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Involved health care staff
 
Physicians
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
No
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
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Point of time in which service user or their reprasentatives' involvement takes place
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Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
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Short description of the service users' level of involvement
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Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
Yes
List of sources where public information is accessible
Printed brochures
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
No
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
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List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
Motivated staff
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
No
Description of used incentives, if any.
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Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
No
Total number of person days required to implement this Patient Safety Practice
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External consultants: There is no specified text here
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Managerial staff: There is no specified text here
Others: There is no specified text here
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Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
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Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
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Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
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Contact information
 
Name: Marinko Zulj
Country: CROATIA
Organisation: Medical Faculty Osijek
E-mail: mzulj@mefos.hr
Phone: +385912241479
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