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Implementation of a pre-dialysis clinical pathway for patients with chronic kidney disease
- Source :
- International journal for quality in health care : journal of the International Society for Quality in Health Care. 18(2)
- Publication Year :
- 2006
-
Abstract
- Objective. The objective of this study was to design and implement an efficient pathway to ensure a smooth transition of patients with advanced chronic kidney disease to dialysis. Setting. In our dialysis service, as elsewhere, we recognized that there was an unacceptably high rate of inadequately prepared patients commencing dialysis. Knowledge of clinical practice and research-based guidelines has not in itself changed clinical practice and patient management. Main measures. To address these problems, multidisciplinary process redesign teams reviewed pre-existing arrangements by assessing current practice. The review identified critical points where problems could occur: failure to notify patients to dialysis service, late referral for vascular surgery, and inadequate pre-dialysis education. As a result of this process, we have formulated a modified and coordinated pre-dialysis programme. Results. In association with process redesign, the proportion of patients registered ‘late’ decreased from 29% in July–September 2000 (pre-implementation) to 6% in January–March 2004 ( P < 0.01) with the corresponding median time from registration to commencement of dialysis increasing from
- Subjects :
- Male
medicine.medical_specialty
Catheterization, Central Venous
Victoria
medicine.medical_treatment
Vascular access
Ambulatory Care Facilities
Clinical pathway
Catchment Area, Health
Patient Education as Topic
Renal Dialysis
Medicine
Humans
Intensive care medicine
Referral and Consultation
Dialysis
Evidence-Based Medicine
Geography
business.industry
Delivery of Health Care, Integrated
Health Policy
Process Assessment, Health Care
Public Health, Environmental and Occupational Health
Pre-dialysis
General Medicine
Guideline
Vascular surgery
medicine.disease
Patient Care Management
Benchmarking
Creatinine
Critical Pathways
Kidney Failure, Chronic
Female
Hemodialysis
business
Kidney disease
Subjects
Details
- ISSN :
- 13534505
- Volume :
- 18
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- International journal for quality in health care : journal of the International Society for Quality in Health Care
- Accession number :
- edsair.doi.dedup.....bb4977252af33847d6834f8fd221c146