Abstract: TH-OR18
The Effects of Implementing a Home Dialysis Project ECHO
Session Information
- Dialysis: Patient-Centered Interventions and Outcomes
November 03, 2022 | Location: W414, Orange County Convention Center‚ West Building
Abstract Time: 05:33 PM - 05:42 PM
Category: Dialysis
- 702 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Chan, Christopher T., University of Toronto, Toronto, Ontario, Canada
- Mehrotra, Rajnish, University of Washington, Seattle, Washington, United States
- Rivara, Matthew B., University of Washington, Seattle, Washington, United States
- Concepcion, Danilo, Providence St Joseph Health, Renton, Washington, United States
- Crampton, Karen, University of Michigan, Ann Arbor, Michigan, United States
- Cassidy, Renin, Northwest Kidney Centers, Seattle, Washington, United States
- Pierce, Nancy, ESRD Network 16, Seattle, Washington, United States
- Wilkens, Katy G., Northwest Kidney Centers, Seattle, Washington, United States
- Hutchinson, Stephanie, Comagine Health, Seattle, Washington, United States
- Dommert-Breckler, Barbara, Comagine Health, Seattle, Washington, United States
- Joseph, Jessica, National Kidney Foundation, New York, New York, United States
- Montgomery, Elizabeth, National Kidney Foundation, New York, New York, United States
Group or Team Name
- Home Dialysis Echo HUB group
Background
Insufficient home dialysis education and mentorship are suggested barriers contributing to the under utilization of home therapies in the U.S. The National Kidney Foundation KDOQI Home Dialysis task force hypothesized that the use of a Project ECHO (Extension for Community Healthcare Outcome) program may enhance home dialysis uptake.
Methods
In partnership with Comagine Health, the NKF home dialysis ECHO project delivered 20 interprofessional education sessions virtually to 108 registrants from 19 dialysis centers derived from 2 ESRD network regions over 1 year. Our home dialysis curriculum has previously been published. Sessions were divided into case discussion and didactic teaching moderated by the home dialysis hub team. Using a mixed method before and after approach, we described the differences in home dialysis rate and knowledge utilization.
Results
108 healthcare workers registered for our home dialysis ECHO project. The median number of participated sessions was 1.5 (range = 16). The registrants represented a diverse background (including: dietitian [n = 15], facility administrator [n = 20], nurse [n=36] and social worker [n=18]). Using exit questionnaires, the registrants consistently recommended ECHO sessions to their peers with the top sessions saturating amongst the themes of “establishing home dialysis culture”, “modality education” and “psychosocial adjustment”. At baseline, the participating centers’ median home dialysis rate was 9.28% (0.00 – 18.52%) [25-75%] which increased to 12.8% (0.00 – 24.6%) [Wilcoxon Signed Rank Test, p = 0.004] after the program.
Conclusion
We demonstrated that home dialysis ECHO project was a feasible strategy that was associated with a modest increase in home dialysis rates. A prospective examination of national adoption of such a strategy to physicians and dialysis clinic staff is warranted.