Development of an Evidence-based Quality Indicator Set for Patients With Inflammatory Bowel Disease in Belgium

This study aimed to develop and validate a set of quality indicators that can be used to improve clinical IBD care in Belgium.

Several quality indicator sets have been developed to standardize, measure, and optimize IBD care. However, currently, no set exists for use in IBD in Belgium.

In a 2 round modified Delphi exercise, 221 quality indicators were scored on a 10-point Likert scale by 32 IBD experts. In a third ranking round, room for improvement benefitting the patient was prioritized to agree on a subset of indicators. In parallel, patient perspectives were collected through 2 patient focus groups. Indicators scoring 7 or higher by ≥80% of the participants during the second scoring round or based on agreement during a closing consensus meeting were included in the final set.

To assess IBD care in Belgium, the following number of quality indicators were agreed upon: 41 structure, 123 process, and 35 outcome indicators (n=199). In the improvement subset, 18 indicators were retained that related to patient characteristics, endoscopy guidelines, infection prevention, steroid use, the IBD care team, services provided in the IBD clinic, the documentation of patient characteristics, the care pathway, and the monitoring of disease activity. Patients considered the latter 5 indicators particularly important.

A set of quality indicators, including an improvement subset, was developed and validated, allowing Belgian IBD centers to assess care, set up quality improvement projects, and potentially a benchmarking exercise.