title: Delphi consensus statement: Quality Indicators for Inflammatory Bowel Disease Comprehensive Care Units.
abstract: OBJECTIVE
  While it is commonly accepted that Inflammatory bowel disease (IBD) Comprehensive Care Units (ICCUs) facilitate the delivery of quality care to Crohn's disease and ulcerative colitis patients, it remains unclear how an ICCU should be defined or evaluated. The aim of the present study was to develop a comprehensive set of Quality Indicators (QIs) of structure, process, and outcomes for defining and evaluating an ICCU.
  
  
  METHODS
  A Delphi consensus-based approach with a standardized three-step process was used to identify a core set of QIs. The process included an exhaustive search using complementary approaches to identify potential QIs, and two Delphi voting rounds to select the QIs defining the core requirements for an ICCU.
  
  
  RESULTS
  The consensus selected a core set of 56 QIs (12 structure, 20 process and 24 outcome). Structure and process QIs highlighted the need for multidisciplinary management and continuity of care. The minimal IBD team should include an IBD nurse, gastroenterologists, radiologists, surgeons, endoscopists and stoma management specialists. ICCUs should be able to provide both outpatient and inpatient care and admission should not break the continuity of care. Outcome QIs focused on the adequate prophylaxis of disease complication and drug adverse events, the need to monitor appropriateness of treatment and the need to reinforce patient autonomy by providing adequate information and facilitating the patients' participation in their own care.
  
  
  CONCLUSIONS
  The present Delphi consensus identified a set of core QIs that may be useful for evaluating and certifying ICCUs.
authors.affiliation: Servei de Malaties Digestives, Hospital de Sabadell, Institut Universitari Parc Taulí, Departament de Medicina, Universitat Autònoma de Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Calvet
authors.affiliation: Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Spain; Hospital Clínic, Barcelona, Spain. Electronic address: jpanes@clinic.cat.
authors.forename: Julián
authors.initials: J
authors.lastname: Panés
authors.affiliation: Técnicas Avanzadas de Investigación en Servicios de Salud (TAISS), Spain.
authors.forename: Noelia
authors.initials: N
authors.lastname: Alfaro
authors.affiliation: Servicio de Aparato Digestivo, Hospital de Manises, Spain.
authors.forename: Joaquin
authors.initials: J
authors.lastname: Hinojosa
authors.affiliation: Servicio de Gastroenterología, Hospital Universitario de Burgos, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Sicilia
authors.affiliation: Hospital Clínic, Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Gallego
authors.affiliation: Asociación de pacients de Crohn y Colitis Ulcerosa (ACCU), Spain.
authors.forename: Ildefonso
authors.initials: I
authors.lastname: Pérez
authors.affiliation: Técnicas Avanzadas de Investigación en Servicios de Salud (TAISS), Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Lázaro y de Mercado
authors.affiliation: Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Spain; Servicio de Aparato Digestivo, Hospital Clínico "Lozano Blesa" de Zaragoza, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Gomollón
authors.forename: Xavier
authors.initials: X
authors.lastname: Aldeguera
authors.forename: Rafael
authors.initials: R
authors.lastname: Alós
authors.forename: Montserrat
authors.initials: M
authors.lastname: Andreu
authors.forename: Manu
authors.initials: M
authors.lastname: Barreiro
authors.forename: Fernando
authors.initials: F
authors.lastname: Bermejo
authors.forename: Begoña
authors.initials: B
authors.lastname: Casis
authors.forename: Eugeni
authors.initials: E
authors.lastname: Domenech
authors.forename: Eloy
authors.initials: E
authors.lastname: Espín
authors.forename: Maria
authors.initials: M
authors.lastname: Esteve
authors.forename: Valle
authors.initials: V
authors.lastname: García-Sánchez
authors.forename: Antonio
authors.initials: A
authors.lastname: López-Sanromán
authors.forename: Pilar
authors.initials: P
authors.lastname: Martínez-Montiel
authors.forename: Juan
authors.initials: J
authors.lastname: Luis Mendoza
authors.forename: Javier P
authors.initials: JP
authors.lastname: Gisbert
authors.forename: Maribel
authors.initials: M
authors.lastname: Vera
authors.forename: Angelina
authors.initials: A
authors.lastname: Dosal
authors.forename: Elena
authors.initials: E
authors.lastname: Sánchez
authors.forename: Laura
authors.initials: L
authors.lastname: Marín
authors.forename: Luciano
authors.initials: L
authors.lastname: Sanromán
authors.forename: Pilar
authors.initials: P
authors.lastname: Pinilla
authors.forename: Francisca
authors.initials: F
authors.lastname: Murciano
authors.forename: Antonio
authors.initials: A
authors.lastname: Torrejón
authors.forename: José
authors.initials: J
authors.lastname: Ramón García
authors.forename: Mayte
authors.initials: M
authors.lastname: Ortega
authors.forename: Julio
authors.initials: J
authors.lastname: Roldán
mesh_terms: D000553:Ambulatory Care; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000628:therapy*; D003266:Continuity of Patient Care / Q000592:standards; D003424:Crohn Disease / Q000175:diagnosis / Q000628:therapy*; D003697:Delphi Technique; D006757:Hospital Units / Q000458:organization & administration / Q000592:standards*; D006760:Hospitalization; D006801:Humans; D010043:Outcome and Process Assessment, Health Care / Q000379:methods*; D010348:Patient Care Team / Q000458:organization & administration / Q000592:standards*; D019984:Quality Indicators, Health Care
keywords: Crohn's disease; Health care; Inflammatory bowel disease; Quality Indicators; Ulcerative colitis