Integrated Renal Care

Jones, Edward R.; Hostetter, Thomas H.

doi:10.2215/cjn.04440514

Cited by 7 publications

(6 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, Valentijn et al [67] and Jones et al [66] conducted an analysis to explore the applicability of the integrated care model and future strategies for implementation in the renal care setting. Their main conclusion was that some pilots were initiated, but the process changes in standard of care have so far been on a rather small scale, instead of on a meaningful level [66,67]. A similar conclusion can be drawn for the Chassin and Loeb [12] assessment on improving quality of care in particular in hospitals.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Chronic Kidney Disease: Exploring Value-Based Healthcare as a Potential Viable Solution

et al. 2019

View full text Add to dashboard Cite

Background: Increasing healthcare expenditures have triggered a trend from volume to value by linking patient outcome to costs. This concept first described as value-based healthcare (VBHC) by Michael Porter is especially applicable for chronic conditions. This article aims to explore the applicability of the VBHC framework to the chronic kidney disease (CKD) care area. Methods: The 4 dimensions of VBHC (measure value; set and communicate value benchmarking; coordinate care; payment to reward value-add) were explored for the CKD care area. Available data was reviewed focusing on CKD initiatives in Europe to assess to what extent each of the 4 dimensions of VBHC have been applied in practice. Results: Translating VBHC into value-based renal care (VBRC) seems to be initiated to a limited extent in European health systems. In most cases not all dimensions of VBHC have been utilized in the renal care initiatives. Conclusion: The translation of VBHC into VBRC is possible and even desirable if an optimal treatment pathway for CKD patients could be achieved. This would require an organizational change in health system set up and should include a strategy focusing on full care responsibility. The patient outcome perspective and health economic analysis need to be the centre of attention.

show abstract

Section: Discussion/conclusionmentioning

confidence: 99%

Chronic Kidney Disease: Exploring Value-Based Healthcare as a Potential Viable Solution

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The mission to Target Zero Infections requires nephrologists to broaden their accountability and be effective leaders who help align interdependent health care systems (3,29,30). Some nephrologists may resist changes, because they the lack of training and experience in leadership (4).…”

Section: Ntds and The Futurementioning

confidence: 99%

“…Nephrology is being reshaped by larger transformative changes in health care, with a greater focus on value and increased provider accountability (2). Nephrologists need new knowledge and skills to navigate these changes and promote better patient outcomes (2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

“…This larger scope of accountability was intended to empower nephrologists with official authority to make important decisions, improve quality, and ensure patient safety in their facilities. However, this power has been embraced with varying levels of enthusiasm, understanding, and effectiveness (2,3,11). Many leadership functions are unfamiliar to nephrologists with little formal training or experience managing people and organizations (4).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Systems Thinking and Leadership

Wong

2018

CJASN

View full text Add to dashboard Cite

Infections are the second leading cause of death for patients with ESKD. Despite multiple efforts, nephrologists have been unable to prevent infections in dialysis facilities. The American Society of Nephrology and the Centers for Disease Control and Prevention have partnered to create Nephrologists Transforming Dialysis Safety to promote nephrologist leadership and engagement in efforts to "Target Zero" preventable dialysis infections. Because traditional approaches to infection control and prevention in dialysis facilities have had limited success, Nephrologists Transforming Dialysis Safety is reconceptualizing the problem in the context of the complexity of health care systems and organizational behavior. By identifying different parts of a problem and attempting to understand how these parts interact and produce a result, systems thinking has effectively tackled difficult problems in dynamic settings. The dialysis facility is composed of different physical and human elements that are interconnected and affect not only behavior but also, the existence of a culture of safety that promotes infection prevention. Because dialysis infections result from a complex system of interactions between caregivers, patients, dialysis organizations, and the environment, attempts to address infections by focusing on one element in isolation often fail. Creating a sense of urgency and commitment to eradicating dialysis infections requires leadership and motivational skills. These skills are not taught in the standard nephrology or medical director curriculum. Effective leadership by medical directors and engagement in infection prevention by nephrologists are required to create a culture of safety. It is imperative that nephrologists commit to leadership training and embrace their potential as change agents to prevent infections in dialysis facilities. This paper explores the systemic factors contributing to the ongoing dialysis infection crisis in the United States and the role of nephrologists in instilling a culture of safety in which infections can be anticipated and prevented.

show abstract

“…An increasing prevalence of chronic conditions and an ageing population have highlighted the importance of developing innovative methods for patient care. 1 Chronic diseases provide a strong incentive for telehealth services, 2 3 which can facilitate access to specialists, and potentially provide convenience and cost saving for patients. These considerations are particularly relevant when patients’ have impaired mobility, live in remote areas or are in a pandemic like COVID-19.…”

Section: Introductionmentioning

confidence: 99%

Integrated virtual medical consultations versus traditional clinic care in a public and a private outpatient service

Katz

Lane

Pirabhahar

et al. 2022

Integrated Healthcare Journal

View full text Add to dashboard Cite

ObjectivesThe iConnect Care programme provided integrated ‘virtual care’ (VC) for patients with chronic kidney disease (CKD) in the South Eastern Sydney Local Health District. VC is an alternative to outpatient care which expedites time to specialists’ opinions and is safe. Comparing different outpatient care models is important to understand the role of telehealth and integrated care, especially following the COVID-19 pandemic. This study aimed to compare a VC model with existing CKD outpatient care.Design, participants and settingA multisite, comparative, retrospective cohort study with parallel groups. 374 patients with mild CKD were recruited (July 2013 and August 2015) from public and private outpatients and followed for 12 months (n=304) or via VC (n=70). Estimated glomerular filtration rate (eGFR) and urine albumin/creatinine ratio (ACR) were compared at baseline, 6 and 12 months.ResultsAt 12 months, no significant differences existed among groups in eGFR or ACR or haemoglobin, but serum creatinine was lower in the VC cohort. A significant difference existed in time to see a patient from time of referral; 7 days for VC clinic and 35–42 days for outpatient clinic. Patients interviewed felt VC was efficient and they were well managed.ConclusionVC can be a faster mechanism to access a nephrologist and other specialists. It provided similar outcomes to outpatient care. VC represents an additional assessment and follow-up pathway supported in the community. Time to deliver is similar, but specific resources are needed. It has the potential to evolve into a standard component of chronic disease care.

show abstract

Integrated Renal Care

Cited by 7 publications

References 17 publications

Chronic Kidney Disease: Exploring Value-Based Healthcare as a Potential Viable Solution

Chronic Kidney Disease: Exploring Value-Based Healthcare as a Potential Viable Solution

Systems Thinking and Leadership

Integrated virtual medical consultations versus traditional clinic care in a public and a private outpatient service

Contact Info

Product

Resources

About