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An integrated dialysis delivery network in Ontario
Le Journal CANNT = CANNT Journal : the Journal of the Canadian Association of Nephrology Nurses and Technicians
|May 21, 1999
Summary
New community dialysis services in Ontario showed that full-care patients required more support and had more complications than self-care patients. These findings will help optimize dialysis care delivery.
Area of Science:
- Nephrology
- Health Services Management
Background:
- The Ontario Ministry of Health (MOH) sought to expand dialysis services through a request for proposal (RFP).
- London Health Sciences Centre (LHSC) successfully expanded its network to include satellite dialysis units.
Purpose of the Study:
- To establish an operational model for new satellite dialysis services.
- To evaluate the clinical impact of integrated self-care and full-care dialysis models in community settings.
Main Methods:
- Development of an integrated dialysis delivery network with satellite locations.
- Implementation of a balanced scorecard evaluation model (Kaplan & Norton, 1992).
- Analysis of initial outcome data comparing self-care and full-care patients.
Main Results:
- Full-care patients in satellite units required more support from central London units.
- Full-care patients experienced more hypotensive episodes during dialysis.
- Some full-care patients exhibited lower dialysis adequacy and nutritional status compared to self-care patients.
Conclusions:
- Community-based dialysis models require careful consideration of patient type.
- Findings will inform revisions to patient inclusion criteria for optimizing satellite dialysis services.
- Further refinement of processes is needed to enhance the effectiveness of community dialysis care.
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