Related Experiment Video

Updated: May 24, 2026

Evaluating Therapeutic Interventions in the SHIP-deficient Mouse Model of Crohn Disease-like Ileitis and Fibrosis
09:44

Evaluating Therapeutic Interventions in the SHIP-deficient Mouse Model of Crohn Disease-like Ileitis and Fibrosis

Published on: October 14, 2025

Improved outcomes in a quality improvement collaborative for pediatric inflammatory bowel disease

Wallace V Crandall1, Peter A Margolis, Michael D Kappelman

  • 1Division of Pediatric Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, OH 43205, USA. wallace.crandall@nationwidechildrens.org

Pediatrics
|March 14, 2012
PubMed

Insights

Network-based quality improvement enhanced chronic illness care for pediatric Crohn disease (CD) and ulcerative colitis (UC) patients. This led to better disease classification, appropriate medication dosing, and higher rates of inactive disease, demonstrating improved outcomes.

Area of Science:

  • Pediatric Gastroenterology
  • Quality Improvement Science
  • Chronic Disease Management

Background:

  • Variation in care for pediatric Crohn disease (CD) and ulcerative colitis (UC) can hinder optimal outcomes.
  • Network-based quality improvement methods offer a structured approach to standardize and enhance care delivery.

Purpose of the Study:

  • To improve chronic care delivery and patient outcomes for children with inflammatory bowel disease (IBD) using network-based quality improvement.
  • To assess the impact of collaborative quality improvement efforts on key clinical processes and outcomes in pediatric IBD.

Main Methods:

  • A modified Breakthrough Series collaborative model was employed across 6 ImproveCareNow Network centers.
  • Interrupted time series analysis was used to evaluate the impact of implemented changes on care processes and patient outcomes.
  • Monthly data collection on process and outcome measures was conducted for children with CD and UC.

Main Results:

  • Significant improvements were observed in disease classification, thiopurine methyltransferase (TPMT) testing before thiopurine initiation, and appropriate initial thiopurine dosing for both CD and UC patients.
  • The proportion of CD patients with inactive disease increased from 55% to 68%, and UC patients from 61% to 72%.
  • A notable increase in CD patients not on prednisone (from 86% to 90%) was recorded, though success varied among participating centers.

Conclusions:

  • Improvements in chronic illness care processes were associated with enhanced outcomes for pediatric CD and UC patients.
  • Organizational factors significantly influence the success of implementing quality improvement changes in clinical practice.
  • Network collaboratives are effective in driving measurable improvements in pediatric IBD care.
Abstract

Related Concept Videos

Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Inflammatory Bowel Disease III: Crohn's Disease01:25

Inflammatory Bowel Disease III: Crohn's Disease

Crohn’s disease is a chronic, relapsing form of inflammatory bowel disease characterized by segmental, transmural inflammation that can affect any part of the gastrointestinal tract. Its pathogenesis arises from a combination of genetic susceptibility, environmental exposures, epithelial barrier dysfunction, and immune dysregulation. Together, these factors lead to an exaggerated immune response against components of the gut microbiome.Genetic and Environmental InfluencesMultiple genetic...
Inflammatory Bowel Disease IV: Clinical Manifestations01:20

Inflammatory Bowel Disease IV: Clinical Manifestations

Inflammatory bowel disease (IBD) encompasses two major chronic disorders—ulcerative colitis and Crohn’s disease—each characterized by relapsing episodes of gastrointestinal inflammation. Although they share certain clinical features, their patterns of involvement and manifestations differ in ways that aid diagnosis and guide management.Ulcerative ColitisUlcerative colitis is limited to the colon and rectum and involves continuous inflammation of the mucosal layer. The disease course is marked...
Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Inflammatory Bowel Disease I: Introduction01:26

Inflammatory Bowel Disease I: Introduction

Inflammatory bowel disease is a group of chronic disorders marked by recurrent inflammation of the gastrointestinal tract due to an abnormal immune response against gut microflora. This leads to tissue damage. The two main forms are Crohn’s disease and ulcerative colitis.Crohn’s DiseaseCrohn’s disease is a relapsing inflammatory disorder that can affect any part of the GI tract, from the mouth to the anus. It involves all layers of the bowel wall (transmural) and shows “skip lesions” in which...
Inflammatory Bowel Disease II: Ulcerative Colitis01:20

Inflammatory Bowel Disease II: Ulcerative Colitis

Ulcerative colitis is a chronic inflammatory disorder of the colon characterized by continuous mucosal inflammation that typically begins in the rectum and extends proximally in a uniform pattern. Its pathogenesis involves a complex interplay of genetic predisposition, immune dysregulation, and environmental influences. These factors converge to impair the colon’s epithelial defenses and promote an exaggerated inflammatory response against luminal contents.Breakdown of the Mucosal BarrierA...