S925 Implementation of Standardized Endoscopic Scoring Systems in Patients With Inflammatory Bowel Disease

Introduction: Endoscopic scoring systems are an established mechanism for standardized assessment of disease activity in inflammatory bowel disease (IBD) with disease-specific systems for Crohn’s disease (CD) and ulcerative colitis (UC). Despite expert opinion regarding their use in endoscopy, implementation at our institution is suboptimal. Methods: A query was opened using our institution’s endoscopy software, Provation. Inclusion criteria were patients with documented IBD undergoing colonoscopy. This data was then analyzed for inclusion of either the SES-CD for CD or Mayo Score for UC in the final endoscopy report. Our intervention included departmental education regarding the implementation of standardized IBD endoscopy templates. Pre- and post-intervention data were collected. Results: From August 2020 to February 2022, 90 CD endoscopies were performed. Of these, 61 were pre-intervention and 29 post-intervention. Prior to the intervention, 14.8% (9/61) of the colonoscopy reports included the SES-CD score, and following the intervention, 44.8% (13/29) (p = 0.002). Of the 160 UC endoscopies, 121 were pre-intervention and 39 following the intervention. Prior to the intervention, 46.3% (56/121) of the colonoscopy reports included the Mayo score, and following the intervention, 84.6% (33/39) (p = 0.00003). Conclusion: Implementing a standardized endoscopic scoring system for patients with IBD may help alleviate some of the subjective reporting variance seen between differing endoscopists. We plan to identify providers who may not meet our proposed benchmarks individually and provide further education on the rationale behind adopting this intervention institutionally. We are also considering the implementation of standardized colonoscopy templates for incoming first-year Gastroenterology fellows to use throughout their training to make standardized reporting more routine. We believe that our practical approach to implementing standardized methods of reporting current disease states in inflammatory bowel disease patients undergoing colonoscopy is readily reproducible at other large academic and private medical centers nationwide and will improve the overall consistency and quality of endoscopy reporting for this cohort of patients. This method will lead to more patients eligible for future clinical trials and improve the overall consistency of reporting disease activity in IBD patients, thus fostering a more reliable and consistent handoff between endoscopists and the primary gastroenterologist/team.