By increasing the number of external infliximab infusions at the pediatric inflammatory bowel disease clinic, researchers were able to enhance access and remove obstacles to therapy.

Using an iterative Quality Improvement (QI) technique, pediatric patients with inflammatory bowel disease aged over or equal to 12 years were offered the option of receiving infliximab infusions at home or at an external infusion facility. They had to initially complete at least 5 infusions at the hospital without experiencing any serious infusion reactions. P-charts were used to gather and track data each month. The Fisher exact test was used to assess comparisons between control chart centerlines.

 

Fifty-four patients were given external infusions, with 87% having Crohn’s disease, 63% being males aged (17.6 ± 2.9) years, and 89% have private insurance. From September 2016 to January 2018, the percentage of eligible patients receiving external infusions ranged from about 7% to 30%. A statistically significant movement in the centerline occurred between October 2016 and June 2017 (P < 0.001). There have been no serious safety concerns.

They now provide external infusion service choices to all suitable patients as standard practice. Home infusions are a feasible alternative for lowering obstacles to care, and none of our patients had any adverse effects.

Reference:journals.lww.com/jpgn/Fulltext/2019/11000/A_Quality_Improvement_Approach_to_External.8.aspx

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