TY - JOUR
T1 - Utility of the advanced chronic kidney disease patient management tools
T2 - Case studies
AU - Patwardhan, Meenal B.
AU - Matchar, David B.
AU - Samsa, Gregory P.
AU - Haley, William E.
PY - 2008/3
Y1 - 2008/3
N2 - Appropriate management of advanced chronic kidney disease (CKD) delays or limits its progression. The Advanced CKD Patient Management Toolkit was developed using a process-improvement technique to assist patient management and address CKD-specific management issues. We pilot tested the toolkit in 2 community nephrology practices, assessed the utility of individual tools, and evaluated the impact on conformance to an advanced CKD guideline through patient chart abstraction. Tool use was distinct in the 2 sites and depended on the site champion's involvement, the extent of process reconfiguration demanded by a tool, and its perceived value. Baseline conformance varied across guideline recommendations (averaged 54%). Posttrial conformance increased in all clinical areas (averaged 59%). Valuable features of the toolkit in real-world settings were its ability to: facilitate tool selection, direct implementation efforts in response to a baseline performance audit, and allow selection of tool versions and customizing them. Our results suggest that systematically created, multifaceted, and customizable tools can promote guideline conformance. (Am J Med Qual 2008; 23:105-114).
AB - Appropriate management of advanced chronic kidney disease (CKD) delays or limits its progression. The Advanced CKD Patient Management Toolkit was developed using a process-improvement technique to assist patient management and address CKD-specific management issues. We pilot tested the toolkit in 2 community nephrology practices, assessed the utility of individual tools, and evaluated the impact on conformance to an advanced CKD guideline through patient chart abstraction. Tool use was distinct in the 2 sites and depended on the site champion's involvement, the extent of process reconfiguration demanded by a tool, and its perceived value. Baseline conformance varied across guideline recommendations (averaged 54%). Posttrial conformance increased in all clinical areas (averaged 59%). Valuable features of the toolkit in real-world settings were its ability to: facilitate tool selection, direct implementation efforts in response to a baseline performance audit, and allow selection of tool versions and customizing them. Our results suggest that systematically created, multifaceted, and customizable tools can promote guideline conformance. (Am J Med Qual 2008; 23:105-114).
KW - Chronic kidney disease
KW - Guideline implementation
KW - Implementation tools
KW - Quality improvement
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U2 - 10.1177/1062860607313142
DO - 10.1177/1062860607313142
M3 - Article
C2 - 18305098
AN - SCOPUS:41149141984
SN - 1062-8606
VL - 23
SP - 105
EP - 114
JO - American Journal of Medical Quality
JF - American Journal of Medical Quality
IS - 2
ER -