NNCC has chosen two facilities as the 2020 recipients of its Award for Quality Improvement Project in Nephrology, which recognizes an individual or organization that promotes optimal patient outcomes in nephrology.
Fresenius Kidney Care Crystal Springs Dialysis, Roanoke, VA, and UVA Health Dialysis Program Kidney Center and Lynchburg Dialysis, Charlottesville, VA, both received QI awards for innovative patient programs launched at their facilities.
The Fresenius Program
The Fresenius team won for their project, “Promoting Appropriate Home Dialysis: A Quality Improvement Report,” which aimed to increase home dialysis use among eligible patients admitted to their facility.
According to clinic managers Rhonda Wilson, RN, and Melissa Buchanan, RN, the project focused on increasing patient education and expanding resources. Assigned technicians and staff taught patients how to self-cannulate and familiarize themselves with home dialysis procedures and wore supportive themed T-shirts and ribbons to show positivity and support. The project resulted in a 180% increase over the previous year (2018), with 28 patients starting home dialysis during a 9-month period.
"The benefits [of the project] to our facility was learning that a systematic approach along with an 'all hands on deck' attitude afforded more success at giving all patients treatment options and quality outcomes," Wilson and Buchanon said. "This project helped to create a culture of awareness of modality choices in our facility."
Wilson and Buchanon said a vital part of their approach was having Certified Clinical Hemodialysis Technician (CCHT) champions to spearhead and guide the process for patients. CCHTs had daily conversations with patient, and the patients developed trust with the CCHT staff. They also said the numerous patient success stories taught the clinical team that we needed a no-limits mindset.
The UVA Program
The UVA team won for their program, “Improving Outcomes for Incident ESRD Patients with Transitional Care Units.” According to Deborah A. Cote, MSN, RN, CNN, NE-BC, administrator of the UVA Dialysis Program, many incident ESRD patients are overwhelmed, fearful, and grieving the loss of their kidneys.
"We wanted to provide a 'soft landing' into dialysis and provide support and education from an interdisciplinary team to provide the patient with the best possible start to dialysis,” Cote said. “Our goal was for the patient to feel empowered about their disease and its treatment."
The program used an interdisciplinary team to develop and deliver 4 weeks of comprehensive dialysis education. As a result, Cote said patients were far more knowledgeable about their disease and felt more empowered about managing their own care. There was also a marked increase in patients choosing home dialysis. She said the concept has been presented to other organizations and a multi-center study on transitional start programs is upcoming.
From NNCC Executive Director Kathy Houle, MSN, APRN, C-FNP, CNN-NP
Several years ago, NNCC developed the Quality Improvement Award to recognize the individual or organization who develops a quality improvement project to promote optimal patient outcomes in nephrology. NNCC believes that applying QI strategies to the care of nephrology patients ultimately leads to safer and better outcomes.
At our summer 2020 commissioners meeting, we reviewed several excellent applications. After much thought and discussion, we agreed to present two organizations with the award.
Both organizations developed a project to promote and to ease the transition to home dialysis. Home dialysis is underutilized in this country and, for appropriate patients, can provide a safer treatment and an improved quality of life. While going about it in different ways, both organizations developed successful projects that can easily be integrated into other facilities’ programs.
NNCC congratulates both 2020 QI Award recipients, Fresenius Kidney Care, Crystal Spring, Roanoke, VA - Rhonda Wilson, RN, and Melissa Buchanan, RN; and UVA Health Dialysis Program Kidney Center and Lynchburg Dialysis, Charlottesville, VA - Deborah A. Cote, MSN, RN, CNN, NE-BC.