title: Optimising the Inflammatory Bowel Disease Unit to Improve Quality of Care: Expert Recommendations.
abstract: BACKGROUND
  The best care setting for patients with inflammatory bowel disease [IBD] may be in a dedicated unit. Whereas not all gastroenterology units have the same resources to develop dedicated IBD facilities and services, there are steps that can be taken by any unit to optimise patients' access to interdisciplinary expert care. A series of pragmatic recommendations relating to IBD unit optimisation have been developed through discussion among a large panel of international experts.
  
  
  METHODS
  Suggested recommendations were extracted through systematic search of published evidence and structured requests for expert opinion. Physicians [n = 238] identified as IBD specialists by publications or clinical focus on IBD were invited for discussion and recommendation modification [Barcelona, Spain; 2014]. Final recommendations were voted on by the group. Participants also completed an online survey to evaluate their own experience related to IBD units.
  
  
  RESULTS
  A total of 60% of attendees completed the survey, with 15% self-classifying their centre as a dedicated IBD unit. Only half of respondents indicated that they had a defined IBD treatment algorithm in place. Key recommendations included the need to develop a multidisciplinary team covering specifically-defined specialist expertise in IBD, to instil processes that facilitate cross-functional communication and to invest in shared care models of IBD management.
  
  
  CONCLUSIONS
  Optimising the setup of IBD units will require progressive leadership and willingness to challenge the status quo in order to provide better quality of care for our patients. IBD units are an important step towards harmonising care for IBD across Europe and for establishing standards for disease management programmes.
authors.affiliation: Department of Gastroenterology, University Hospital CHU of Liège, Liège, Belgium edouard.louis@ulg.ac.be.
authors.forename: Edouard
authors.initials: E
authors.lastname: Louis
authors.affiliation: IBD Center, Department of Gastroenterology and Liver Diseases, Tel Aviv Sourasky Medical Center and the Sackler School of Medicine, Tel Aviv, Israel.
authors.forename: Iris
authors.initials: I
authors.lastname: Dotan
authors.affiliation: Department of Medicine, Division of Gastroenterology, University of Calgary, Calgary, AB, Canada.
authors.forename: Subrata
authors.initials: S
authors.lastname: Ghosh
authors.affiliation: IBD Center, Department of Gastroenterology and Liver Diseases, Tel Aviv Sourasky Medical Center and the Sackler School of Medicine, Tel Aviv, Israel.
authors.forename: Liat
authors.initials: L
authors.lastname: Mlynarsky
authors.affiliation: Department of Gastroenterology, University Hospital CHU of Liège, Liège, Belgium.
authors.forename: Catherine
authors.initials: C
authors.lastname: Reenaers
authors.affiliation: Department of Medicine, University Hospital Schleswig-Holstein, Kiel, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Schreiber
mesh_terms: D019468:Disease Management; D005060:Europe; D005762:Gastroenterology / Q000458:organization & administration / Q000592:standards*; D006757:Hospital Units / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000628:therapy; D058996:Quality Improvement
keywords: Crohn’s disease; decision making; delivery of healthcare; interdisciplinary communication; tertiary care centres; ulcerative colitis