AbstractBackgroundIndividuals hospitalized with severe ulcerative colitis represent a complex group of patients. Variation exists in the quality of care of admitted patients with inflammatory bowel disease. We hypothesized that implementation of a standardized admission order set could result in improved adherence to current best practice guidelines (Toronto Consensus Statements) for the management of this patient population.MethodsA retrospective cohort study of patients admitted with severe ulcerative colitis to a Montreal tertiary center was conducted. Two cohorts were defined based on pre- and post-implementation of a standardized order set. Adherence to 11 quality indicators was assessed before and after implementation of the intervention. These included:Clostridioides difficileand stool cultures testing, ordering an abdominal X-ray and CRP, organizing a flexible sigmoidoscopy, documenting latent tuberculosis, initiating thromboprophylaxis, use of intravenous steroids, prescribing infliximab if refractory to steroids, limiting narcotics, and surgical consultation if refractory to medical therapy.ResultsAdherence to 6 of the 11 quality indicators was improved in the post-intervention cohort. Significant increases were noted in adherence toC difficiletesting (75.5% versus 91.9%,P< 0.05), CRP testing (71.4% versus 94.6%,P< 0.01), testing for latent tuberculosis (38.1% versus 84.6%,P< 0.01), thromboprophylaxis (28.6% versus 94.6%,P< 0.01), adequate corticosteroids prescription (72.9% versus 94.6%,P< 0.01), and limitation of narcotics prescribed (68.8% versus 38.9%,P< 0.01).ConclusionsImplementation of a standardized order set, focused on pre-defined quality indicators for hospitalized patients with severe UC, was associated with meaningful improvements to most quality indicators defined by the Toronto Consensus Statements.