The Transition Care Index: Standardizing comprehensive transition and transfer for young adults with inflammatory bowel disease

Objectives In young adults with inflammatory bowel disease (IBD), the time following transfer to adult care is high‐risk for adverse outcomes. We used quality improvement (QI) methods to standardize care, decrease variation, and improve preparation of young adults during the transition/transfer process. Methods We created the IBD Transition Care Index (TCI), a list of 10 variables whose completion was felt to represent a more comprehensive transition/transfer process. Variables were organized into three domains: Disease Control/Physical Health, Psychosocial Well‐being, and Transition/Transfer Preparation. We educated patients, caregivers, and providers on the value of completing the TCI to deliver complete, multidisciplinary preparation. We recorded variable completion in a database, reviewed results regularly with providers, and compared rates of variable completion between IBD‐focused and general gastroenterology (GI) physicians. Results Three hundred twenty‐two patients transferred to adult care during the project period (211 pre‐intervention and 121 post‐intervention). In the overall cohort, the mean percentage of TCI variables completed increased from a baseline of 62%–71% in the post‐intervention period, with a significant increase in the rate of multidisciplinary IBD annual visit (IBD AV) attendance (51% vs. 62%, p = 0.03). Patients cared for by general GI physicians had significantly increased rates of both overall TCI variable completion (54% vs. 72%, p = 0.02) and IBD AV attendance (34% vs. 57%, p = 0.02) in the pre‐ versus post‐intervention period. Conclusions Care Indexes such as the TCI can be used to reduce variability and standardize complex clinical processes like transition/transfer for young adults with IBD, with the goal of improving patient outcomes.