Successful development and application of a strategic dialysis planning model (RENPLAN)

Strategic planning for chronic dialysis services to allow cost-effective organization of resources and workforce planning is a difficult but essential task. The planning process within an individual unit involves consideration of both generic issues and issues specific to the unit. We used the Balance of Care approach to planning, which takes into account the affect that the dependency level of patients has on the therapeutic options and on how those options can be delivered. In a workshop format, we developed a spreadsheet computer model (RENPLAN) and applied it to facilitate discussion between clinical and non clinical health care professionals, dialysis unit managers, and renal patient representatives. Within the unit concerned, we used the model to explore a variety of planning options, including reducing the number of patients receiving automated peritoneal dialysis (proposed as a cost-reduction measure by managers). The model precisely calculates future resource requirements (staff numbers, hemodialysis stations, disposables costs), indicates deficits in clinical audit data, and facilitates education of non clinical managers regarding the major issues in dialysis planning. The RENPLAN model is freely available to all units and is adaptable for analysis of local planning issues.