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Using the knowledge-to-action framework to guide the timing of dialysis initiation
Manish M Sood1, Braden Manns, Gihad Nesrallah
1aOttawa Hospital Research Institute (OHRI), Department of Medicine, The Ottawa Hospital, Ottawa bFoothills Hospital, University of Calgary, Calgary cHumber River Hospital dThe Li Ka Shing Knowledge Institute, Keenan Research Centre, St. Michael's Hospital, Toronto, Canada.
Current Opinion in Nephrology and Hypertension
|April 11, 2014
Summary
Optimal timing for initiating chronic dialysis is unclear. Evidence suggests early dialysis offers no clinical benefits and is costly, highlighting a need for knowledge translation to improve patient care.
Area of Science:
- Nephrology
- Knowledge Translation
- Health Services Research
Background:
- The optimal timing for initiating chronic dialysis remains an unresolved clinical question.
- Significant practice variations exist in current dialysis initiation protocols.
Purpose of the Study:
- To summarize key findings on dialysis initiation timing.
- To describe a knowledge translation strategy for improving practices.
- To address the scope of the problem using the knowledge-to-action framework.
Main Methods:
- Utilized a pan-Canadian collaboration (CANN-NET).
- Employed the knowledge-to-action framework.
- Conducted a knowledge synthesis and guideline development.
Main Results:
- Identified significant variation in dialysis initiation at different estimated glomerular filtration rate levels.
- Survey revealed provider knowledge gaps regarding dialysis timing.
- Evidence indicates early dialysis initiation is costly with no measurable clinical benefits.
Conclusions:
- Practice variations and barriers to optimal dialysis timing were identified.
- Knowledge translation strategies are proposed to improve care quality.
- The knowledge-to-action framework guided the identification of actionable insights.
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