Every month, an average of seven patients from the Chromalloy Kidney Center are admitted to the hospital for non-adherence type admissions, such as uncontrolled hypertension, fluid overload and hyperkalemia. Improving adherence will reduce the number of hospital admissions and in the process decrease the standardized re-admission ratio, which was 1.2 in 2015 (with a benchmark ratio of 0.648) and approximately 1.46 in 2016.
A team consisting of Patty Anderson RN, Nurse Administrator, Lori Gawat-Abuelo RN, Staff Nurse II, and George Jarad, MD, has been awarded a Renal Staff Microgrant to purchase a laptop, medication organizers and measuring bottles to be used as tools to improve adherence to medications, diet and fluid restriction.
The laptop will be used to review education topics with the patients via web-based tools and videos. The laptop will also be used “at chairside” to help visualize the patient’s dialysis treatment, including review of the amount of fluid gained between treatments, blood pressure and trending of lab results.
In addition, patients will receive organizers that hold seven days of medications. When assistance is needed, patients can bring in their medicine and the staff will help fill the organizers. Patients filling their own organizers will bring in their organizers monthly for a medication adherence check. One-liter measuring containers will be used to demonstrate to patients how much fluid they are allowed in a 24 hour time period.
Monthly prizes will be given to patients who show improvement in fluid gains, blood pressure control or hospital admissions.
Click here for more information on the Quality Incentive Program (QIP), which promotes high-quality services in outpatient dialysis facilities treating patients with end-stage renal disease.