QUALITY INDICATORS AND KIDNEY SUPPORTIVE CARE
Dr Hannah Sawkins1,2, Jenny Beavis3, Dr Adam G Steinberg2,3,4,5
1Department of Palliative Care, The Royal Melbourne Hospital, Parkville, Australia, 2Department of General Medicine, The Royal Melbourne Hospital, Parkville, Australia, 3Department of Nephrology, The Royal Melbourne Hospital, Parkville, Australia, 4Department of Medicine (RMH), The University of Melbourne, Parkville, Australia, 5Safer Care Victoria, Australia
Aim: To review and summarise the current literature relevant to quality indicators (QIs) in kidney supportive care (KSC) in order to inform future research in identifying and implementing QIs to improve the quality of care for patients receiving KSC.
Background: QIs can be implemented in healthcare to maximise patient outcomes, increase transparency and equity of healthcare delivery, and reduce healthcare expenditure. KSC is an interdisciplinary approach in the care for people with advanced chronic kidney disease (CKD) with a focus on quality of life, symptom management, and empowering patient decisions with or without the use of kidney replacement therapy. QIs have been utilised in other areas of nephrology but have not been routinely applied to KSC.
Methods: Searches of the medline and EMBASE databases were conducted. The results were then screened using inclusion and exclusion criteria, and further screened based on the relevance of the abstracts. The selected literature was then reviewed and summarised.
Results: Several domains for QIs have been identified including integration of KSC into CKD care; symptom assessment and management; shared decision making and advance care planning; holistic psychosocial support; and dying including withdrawal from dialysis. There are existing QIs for KSC however their utility has yet to be demonstrated. Ongoing challenges remain including uniform definitions for KSC, different models of care and measuring, collecting, and storing data.
Conclusions: QIs could be integrated into the KSC with the view of improving care and outcomes of patients with advanced CKD. Existing QIs have been established and their use, other potential QIs, barriers and facilitators to their implementation require further research and consideration.
Biography:
Hannah is a first year General Medicine Advanced Trainee from Royal Melbourne Hospital. She hopes to dual train in Nephrology and General Medicine and has an interest in renal supportive care. Hannah spent the first 6 months of this year working in palliative care, which has given her further insight into the role of palliative care as it applies to Nephrology.