Utility of the advanced chronic kidney disease patient management tools: Case studies

Meenal B. Patwardhan, David B. Matchar, Gregory P. Samsa, William E. Haley

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

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).

Original languageEnglish (US)
Pages (from-to)105-114
Number of pages10
JournalAmerican Journal of Medical Quality
Volume23
Issue number2
DOIs
StatePublished - Mar 1 2008

Keywords

  • Chronic kidney disease
  • Guideline implementation
  • Implementation tools
  • Quality improvement

ASJC Scopus subject areas

  • Health Policy

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