Quality care outcomes in Inflammatory Bowel Disease: Doing more with less

Abstract

Introduction: Inflammatory bowel disease (IBD) care is increasingly complex, and substantial unwarranted variation in care delivery persists across services. While clinical quality registries are well positioned to support quality improvement, many rely on retrospective data collection and delayed feedback, limiting their impact on routine clinical practice. There is a need for timely, system-integrated approaches that improve visibility of care processes and outcomes without increasing clinician burden.

Methods: The IBD-PERFECT (Inflammatory Bowel Disease Performance Evaluation Review Framework for Excellence in Clinical Treatment) initiative is a planned 3-year, clinician-led quality improvement initiative. It uses routinely collected data from Crohn’s Colitis Care to populate real-time dashboards with an aim to optimise care. Currently six centre-level key performance indicators (KPIs) and corresponding data completeness metrics are generated across participating centres in Australia and New Zealand. KPIs include smoking status, corticosteroid and opiate use, clinically active disease, anaemia, and colorectal cancer surveillance eligibility. Results are reported as median and interquartile ranges across centres.

Results: IBD-PERFECT was launched in September 2025, and as of November 2025 included 20 centres with 16,988 individuals with IBD; 6,506 individuals comprised the active cohort. Median KPI values and interquartile ranges across centres were low for: current smoking (1.3% [IQR 0–4.8]); systemic corticosteroid use (1.1% [0.2–4.1]); opiate use (0.6% [0–1.6]); clinically active disease (7.9% [0.0–13.4]); and anaemia (0.1% [0–3.8]). The median proportion meeting colorectal cancer surveillance eligibility was 11.2% ([1.8–23.4]). Data completeness varied substantially: smoking status and opiate use status were not recorded in 16.4% (2.5–43.4), and 13.2% (2.3–44.2) respectively. Disease activity indices were not calculable in 41.8% (22.3–71.0), and haemoglobin was not recorded within 14 months in 90.9% (57.1–100.0) of the active cohort. Among those meeting colorectal cancer surveillance eligibility criteria, 95.6% (88.5–100.0) did not have a colonoscopy recorded within three years. Clinician roundtables provided positive feedback for the early implementation and identified healthcare utilisation and health-related quality of life measures as high-priority future functionality.

Conclusion: Early data demonstrate the acceptability and feasibility of real-time quality benchmarking in IBD care. Reporting data completeness alongside KPIs enables meaningful interpretation and supports reflective practice, local quality improvement, and system-level learning.