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Process based quality improvement using a continuous renal replacement therapy dashboard.

Theresa A Mottes1, Stuart L Goldstein2, Rajit K Basu3

  • 1Renal Section, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Feigin Building ,1102 Bates Ave, Suite 245, Houston, TX, 77030, USA. tamottes@texaschildrens.org.

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Summary
This summary is machine-generated.

Implementing a quality dashboard improved continuous renal replacement therapy (CRRT) delivery in critically ill patients. This quality improvement initiative enhanced adherence to standards and optimized CRRT processes.

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Area of Science:

  • Nephrology
  • Critical Care Medicine
  • Healthcare Quality Improvement

Background:

  • Continuous renal replacement therapy (CRRT) use is rising in critically ill patients with acute kidney injury.
  • Limited research exists on the quality of CRRT delivery, focusing instead on timing, anticoagulation, and modality.
  • Assessing and improving CRRT quality is crucial for better patient outcomes.

Purpose of the Study:

  • To assess if a quality assessment methodology improves CRRT delivery outcomes.
  • To establish objective metrics for evaluating CRRT quality longitudinally.
  • To implement a CRRT Dashboard for process monitoring and improvement.

Main Methods:

  • A single-center process improvement project was conducted.
  • Three objective CRRT metrics categories were developed: filter, prescription, and fluid balance.
  • Quarterly analyses, provider education, and care standard adherence were implemented from 2012 to 2017 for 184 patients.

Main Results:

  • Mean filter life was 56 ± 28.4 hours, with 62% achieving 60-hour filter life and 15% unplanned filter changes.
  • 98% of patients received the minimum prescribed CRRT dose (mean 2300 ml/1.73 m²/hour).
  • 83% of CRRT patient days achieved the desired daily fluid balance goal.

Conclusions:

  • A quality dashboard and improvement strategies provide a platform for measuring CRRT delivery adherence.
  • The study demonstrated successful implementation of quality metrics for CRRT care.
  • This approach facilitates monitoring and enhances the quality of CRRT processes.