Innovations in Hemodialysis Care: An Evaluation of Quality and the Patient Experience

Overview

Journal J Patient Exp

Specialty Health Services

Date 2021 Jan 18

PMID 33457576

Citations 2

Authors

Lori Harwood

Darrin Pye

Elizabeth Clinton

Kyle Goettl

April Mullen

Janice Qubty

Affiliations

Soon will be listed here.

Abstract

Hemodialysis (HD) performed in a tertiary care facility is the most prevalent and costly treatment for end-stage renal disease in Canada. This life-sustaining treatment is usually performed thrice weekly in an in-center facility. When people on HD also require a rehabilitation/complex care inpatient program, the burden of transportation for dialysis is immense to both the patient and health-care system. To improve the patient experience, create efficiency, and reduce travel costs, the renal team and a team from a rehabilitation/complex care center collaborated to provide HD services in the rehab/complex care setting. A patient/family representative was involved in all aspects of the design through to evaluation of this project. This study used realistic evaluation to examine the efficacy of this program from the perspective of the patient experience, HD staff, rehab/complex care staff and costs. The decreased travel with having dialysis on-site and adequate resources in the HD unit were the mechanisms for success in improved patient experience, quality of life and rehabilitation patient outcomes, decreased costs as well as increased communication and satisfaction.

Citing Articles

Identifying Patient Satisfaction Determinants in Hemodialysis Settings: A Systematic Review.

Al Nuairi A, Bermamet H, Abdulla H, Simsekler M, Anwar S, Lentine K Risk Manag Healthc Policy. 2022; 15:1843-1857.

PMID: 36203651 PMC: 9531609. DOI: 10.2147/RMHP.S372094.

Construction of haemodialysis nursing-sensitive quality indicators based on Donabedian theory: A Delphi method study.

Chen L, Zhang Y, Li C, Li Q, He L Nurs Open. 2022; 10(2):807-816.

PMID: 36040112 PMC: 9834505. DOI: 10.1002/nop2.1349.

References

Shlipak M, Stehman-Breen C, Fried L, Song X, Siscovick D, Fried L . The presence of frailty in elderly persons with chronic renal insufficiency. Am J Kidney Dis. 2004; 43(5):861-7. DOI: 10.1053/j.ajkd.2003.12.049. View

Ebenso B, Huque R, Azdi Z, Elsey H, Nasreen S, Mirzoev T . Protocol for a mixed-methods realist evaluation of a health service user feedback system in Bangladesh. BMJ Open. 2017; 7(6):e017743. PMC: 5734574. DOI: 10.1136/bmjopen-2017-017743. View

Hsieh H, Shannon S . Three approaches to qualitative content analysis. Qual Health Res. 2005; 15(9):1277-88. DOI: 10.1177/1049732305276687. View

Jassal S, Brissenden J, Roscoe J . Specialized chronic care for dialysis patients--a five-year study. Clin Nephrol. 1998; 50(2):84-9. View

Delgado C, Johansen K . Barriers to exercise participation among dialysis patients. Nephrol Dial Transplant. 2011; 27(3):1152-7. PMC: 3289894. DOI: 10.1093/ndt/gfr404. View

Horigan A, Schneider S, Docherty S, Barroso J . The experience and self-management of fatigue in patients on hemodialysis. Nephrol Nurs J. 2013; 40(2):113-22. PMC: 3703392. View

McIntyre C, Selby N, Sigrist M, Pearce L, Mercer T, Naish P . Patients receiving maintenance dialysis have more severe functionally significant skeletal muscle wasting than patients with dialysis-independent chronic kidney disease. Nephrol Dial Transplant. 2006; 21(8):2210-6. DOI: 10.1093/ndt/gfl064. View

Roshanravan B, Khatri M, Robinson-Cohen C, Levin G, Patel K, de Boer I . A prospective study of frailty in nephrology-referred patients with CKD. Am J Kidney Dis. 2012; 60(6):912-21. PMC: 3491110. DOI: 10.1053/j.ajkd.2012.05.017. View

Painter P, Marcus R . Assessing physical function and physical activity in patients with CKD. Clin J Am Soc Nephrol. 2012; 8(5):861-72. DOI: 10.2215/CJN.06590712. View

10.

Jassal S, Karaboyas A, Comment L, Bieber B, Morgenstern H, Sen A . Functional Dependence and Mortality in the International Dialysis Outcomes and Practice Patterns Study (DOPPS). Am J Kidney Dis. 2015; 67(2):283-92. PMC: 5530761. DOI: 10.1053/j.ajkd.2015.09.024. View

11.

Jassal S, Brissenden J, Raisbeck A, Roscoe J . Comparative cost-analysis of two different chronic care facilities for end-stage renal disease patients. Geriatr Nephrol Urol. 1999; 8(2):69-76. DOI: 10.1023/a:1008378422292. View

12.

Loon I, Hamaker M, Boereboom F, Grooteman M, Blankestijn P, van den Dorpel R . A closer look at the trajectory of physical functioning in chronic hemodialysis. Age Ageing. 2017; 46(4):594-599. DOI: 10.1093/ageing/afx006. View

13.

Ma S, Lui J, Brooks D, Parsons T . The availability of exercise rehabilitation programs in hemodialysis centres in Ontario. CANNT J. 2013; 22(4):26-32. View

14.

Wilhelm-Leen E, Hall Y, Tamura M, Chertow G . Frailty and chronic kidney disease: the Third National Health and Nutrition Evaluation Survey. Am J Med. 2009; 122(7):664-71.e2. PMC: 4117255. DOI: 10.1016/j.amjmed.2009.01.026. View

15.

Murtagh F, Addington-Hall J, Edmonds P, Donohoe P, Carey I, Jenkins K . Symptoms in advanced renal disease: a cross-sectional survey of symptom prevalence in stage 5 chronic kidney disease managed without dialysis. J Palliat Med. 2007; 10(6):1266-76. DOI: 10.1089/jpm.2007.0017. View

16.

Manns B, Hemmelgarn B, Lillie E, Dip S, Cyr A, Gladish M . Setting research priorities for patients on or nearing dialysis. Clin J Am Soc Nephrol. 2014; 9(10):1813-21. PMC: 4186509. DOI: 10.2215/CJN.01610214. View

17.

McEvoy P, Richards D . Critical realism: a way forward for evaluation research in nursing?. J Adv Nurs. 2003; 43(4):411-20. DOI: 10.1046/j.1365-2648.2003.02730.x. View

18.

Jassal S, Chiu E, Li M . Geriatric hemodialysis rehabilitation care. Adv Chronic Kidney Dis. 2008; 15(2):115-22. DOI: 10.1053/j.ackd.2008.01.008. View