Access Optimization for Seattle Children’s GI Patients: Constipation and Celiac Triage Updates

Seattle Children’s strives to provide patients and families with timely access to specialized care and is dedicated to continually improving to meet the needs of the community. To support this work, clinical teams have worked with each other, families and referring providers to understand current pain points and develop a multiyear plan to optimize patient access.

The Seattle Children’s GI team is launching process improvements to ensure patients are prioritized appropriately for scheduling constipation and celiac disease referrals. Here’s what primary care providers need to know:

What’s changing about the way Seattle Children’s handles GI referrals?

To optimize the referral process, starting this month the GI team is:

• Prioritizing the most urgent and complex constipation patients over those who are less sick
• Publishing a new Constipation Algorithm to help community providers navigate the referral process and share key information that will help with prioritizing patients
• Instituting requirements for lab work to triage potential celiac patients, ensuring patients needing specialized celiac care will be scheduled with the Celiac Disease Program

Constipation Referrals

Primary care providers should utilize the new Constipation Algorithm that provides guidance on appropriate actions based on the patient’s current clinical status. Please note it’s important to establish basic constipation education and treatment initially before making a referral, so Seattle Children’s will not accept referrals for patients unless they’ve first received constipation care from their primary care provider.

Celiac Referrals

To request an appointment with GI’s Celiac Disease Program, providers must submit the following labs with the referral:

• TTG IgA
• Total IgA (if TTG is elevated >2x upper limit, no Total IgA is required)
• DGP IgG if Total IgA <20

If Seattle Children's does not receive the lab results, a FaxBack will be sent to the referring provider requesting the information. If the required labs are not received or if the results are within normal limits, the patient will be scheduled with a general GI provider.

Why are these changes being made?

In the past, Seattle Children’s didn’t have an official triaging process for patients with constipation or suspected celiac disease so there was no consistent way to ensure the sickest patients were prioritized. By using triaging tools internally and providing additional guidance to the community, Seattle Children’s is optimizing the process to better meet the needs of patients and primary care providers.

Additionally, these are important first steps as Seattle Children’s expands its care capabilities toward developing a Constipation Clinic within the GI team, to better meet the needs of the community.

For more information: Visit GI’s Refer a Patient page.

There’s also a wide assortment of online educational materials available for patients and families to learn more about constipation and celiac disease.