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Assessing attitudes, access, barriers, and facilitators to multidisciplinary care in pediatric inflammatory bowel
Nicole Davidson1, Jennie G David1, Jennifer L Dotson2
1Nationwide Children's Hospital Columbus Ohio USA.
Insights
Pediatric providers value multidisciplinary care for pediatric inflammatory bowel disease (IBD). However, barriers like leadership support and provider availability hinder access, varying by center size.
Area of Science:
- Pediatric Gastroenterology
- Healthcare Management
- Quality Improvement
Background:
- Multidisciplinary care is crucial for managing pediatric inflammatory bowel disease (IBD).
- Understanding provider perspectives on its implementation is essential for optimizing care delivery.
Purpose of the Study:
- To assess pediatric gastroenterology (GI) provider attitudes towards multidisciplinary care in pediatric IBD.
- To identify barriers and facilitators impacting multidisciplinary care access.
- To explore the relationship between multidisciplinary care and center-level characteristics.
Main Methods:
- A cross-sectional survey was distributed to pediatric GI providers within the ImproveCareNow (ICN) Learning Health System in the US.
- Data collection involved demographic information and questions on multidisciplinary IBD care approaches.
- Statistical analyses included descriptive statistics, chi-squared, and Fisher's exact tests.
Main Results:
- All surveyed providers recognized the benefits of multidisciplinary care, with 80% noting patient/family desire for it.
- Key barriers identified were lack of leadership support (39%), limited provider access (39%), and insufficient provider numbers (35%).
- Nurses (94%) and dietitians (92%) were most common team members; telehealth (94%) and standardized materials (84%) were frequent care modalities. Center size correlated with access to advanced practitioners and support services.
Conclusions:
- Pediatric GI providers hold positive views on multidisciplinary IBD care, deeming it important and desired.
- Significant variability exists in access to and barriers for multidisciplinary care across US ICN centers.
- Further research is needed to address identified barriers and evaluate the impact of multidisciplinary care on pediatric IBD outcomes.
Objective:
Multidisciplinary care is recommended for pediatric inflammatory bowel disease (IBD). This study aims to describe provider attitudes, barriers, and facilitators regarding multidisciplinary care in pediatric IBD, and explore associations between multidisciplinary care access and center-level factors.
Methods:
This is a cross-sectional survey of pediatric gastrointestinal (GI) providers at centers registered with the ImproveCareNow (ICN) Learning Health System in the United States. Participants completed the survey via REDCap. Respondents provided demographic information and answered questions regarding their center's access and approach to multidisciplinary IBD care. Data were analyzed using descriptive statistics, chi-squared, and Fisher's exact tests.
Results:
Sixty-nine providers across 55 ICN centers were included. All participants felt multidisciplinary care was beneficial and 80% felt patients/families desired this care. Participants endorsed barriers including lack of support from institutional leadership (39%), limited access to providers (39%), and inadequate numbers of providers (35%). The most common team members were nurses (94%), dietitians (92%), social workers (67%), and nurse practitioners/physician assistants (67%). Multidisciplinary teams commonly provided care via telehealth (94%), standardized educational materials (84%), multidisciplinary visits (69%), new diagnosis education (65%), and transition programs (61%). Access to nurse practitioners/physician assistants, quality improvement specialists, multidisciplinary visits, and support groups were associated with increasing center size (p < 0.05).
Conclusion:
Pediatric GI providers have positive attitudes regarding IBD multidisciplinary care and perceive this care as important and desired. Access and barriers are variable among US ICN centers. Future work should seek to further understand and address barriers and evaluate the benefits of multidisciplinary care in pediatric IBD.
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