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Implementing a multisite shared haemodialysis care programme.

David Green1,2, Angela Pietrafesa1, Marianne Reyes1

  • 1Churchill Hospital Oxford Kidney Unit, Oxford, UK.

BMJ Open Quality
|October 30, 2024
PubMed
Summary
This summary is machine-generated.

Implementing shared haemodialysis care (SHC) significantly increased patient participation in treatment across seven centres. This initiative improved patient activation and self-care, demonstrating the success of a multisite SHC program.

Keywords:
Healthcare quality improvementPatient educationPatient-centred careQuality improvement

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Area of Science:

  • Nephrology
  • Patient Care
  • Health Services Research

Background:

  • Adults on centre-based haemodialysis (HD) exhibit low patient activation, correlating with adverse health outcomes.
  • Shared haemodialysis care (SHC) is an intervention designed to enhance patient activation and self-care in HD patients.

Purpose of the Study:

  • To increase the proportion of patients actively participating in shared haemodialysis care (SHC) across seven HD centers.
  • To implement and scale a multisite SHC program, improving patient self-care and treatment engagement.

Main Methods:

  • Utilized sequential Plan-Do-Study-Act (PDSA) cycles across central and satellite HD centers.
  • Implemented interventions including staff training, patient-staff partnerships for educational materials, virtual courses, SHC champions, and electronic health record modifications.
  • Monitored patient SHC engagement and competency levels monthly.

Main Results:

  • Patient participation in SHC rose from 4% (19/483) in April 2022 to 43% (220/511) by December 2023.
  • Demonstrated significant and sustained growth in both the number of patients performing SHC and their competency stages.
  • Successfully implemented, scaled, and maintained a multisite SHC program with limited prior staff and patient experience.

Conclusions:

  • A multisite shared haemodialysis care program can be effectively implemented and sustained.
  • The SHC intervention successfully enhanced patient activation and self-care in haemodialysis patients.
  • This approach offers a scalable model for improving patient engagement in chronic disease management.