Stats show improved KCC care

Outcomes for non-dialysis kidney patients across BC are continuing to improve, as shown by the provincial Kidney Care Committee’s latest key indicator report. 

The report, for the six-month period ending September 30, 2015, revealed a number of areas where patient care metrics are at the best level since these data were first compiled, in 2012. 

New HD guidelines

The provincial Hemodialysis Committee is developing new, evidence-based guidelines in an effort to standardize care for HD patients across the province, where appropriate. Two of these guidelines are now available one the BC Renal Agency website.

Polycystic Kidney Disease (PKD)

Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disorder, and is the fourth leading cause of end-stage renal disease in Canada. There is no cure for ADPKD at this time, but research in recent years has led to improved tools for diagnosis and prognosis, as well as new treatments that may slow the progression of ADPKD in some people.  

TB screening program

An enhanced TB screening program is now operational in seven BC dialysis programs. The program will expand in the next few weeks as lab collection sites in Kamloops, Penticton, and Trail begin operation. Lab collection at Abbottsford and Royal Columbian hospitals is set to launch later this year. Through the program, eventually all in-centre hemodialysis and peritoneal dialysis clinics in the province will provide TB screening for new dialysis patients in their first week of starting dialysis.  

Translated patient training materials

In October kidney care staff across the province started using the new Modality Choices patient training materials and the response has been very positive. Available from the BC Renal Agency website, the materials include PowerPoint presentations, a guide for facilitators, and a patient worksheet and feedback form.

GN Committee update

The Glomerulonephritis (GN) Committee has approved two new protocols for the treatment of membranous nephropathy, which is diagnosed in about 30 patients a year in BC and is one of the many glomerular diseases under the GN "umbrella."

Protocols for calcineurin inhibitors and cyclical cyclophosphamide alternating with corticosteroids are now available on the BC Renal Agency website.

The drugs are effective in slowing or stopping the progression of the disease for these patients. The literature on these drugs is summarized in the supporting evidence documents on the website.

Palliative care

The provincial Palliative Care Committee (PCC) is developing a series of quality date indicators for palliative patients. The work is guided by a focus on identifying indicators that are most important for patients and that provide a good overall measure of end-of-life renal care. 

Patient acuity scale revised

The BC Renal Agency’s Patient Acuity Scale has been revised. The original tool was designed to assess the stability of patients on dialysis. The revised tool adds patient fragility as a factor in order to recognize changing patient demographics and the impact on staff workload.  

The new scale will be validated at selected HD clinics over the next few months and will be ready for implementation by all clinics across the province in the spring.

Patient experience survey

The BC Renal Agency is conducting its third provincial survey of kidney patients. The survey, which will soon be 

mailed to all 16,000 kidney patients registered in the PROMIS database, is focused on the core elements of chronic disease management and patients’ evaluation of their experience. The same survey tool was used in 2009 and 2012.

Survey results and analysis of data should be ready for delivery to health authority renal programs by summer. 

PD Assist update

The BC Renal Agency is developing a business case for a provincial PD Assist (PDA) program based on its PDA pilot project.

PROMIS update

Changes are being made at PROMIS to support the development of better applications and improved services to users across BC. A key priority is addressing some of the “pain points” experienced by PROMIS users, such as log-in delays, long response times to queries and reports, and difficulties with different browser versions.

RESEARCH

Renal research in BC

The BC Renal Agency website includes an area dedicated to the research and quality improvement (QI) projects of renal care professionals across the province. These activities are driven by a desire to improve patient care and health outcomes. 

To view a listing of these projects, visit the BC Renal Agency’s website research page.

If you have a research paper or QI initiative that you would like included on the website, contact the BC Renal Agency at 604-875-7340 or by email.

Study of race data in PROMIS

The BC Renal Agency is launching a study, under the leadership of Drs. Sean Barbour and Jag Gill, to assess the accuracy of self-reported race data in the agency’s patient database, PROMIS.

Race is a significant factor in health outcomes for many types of kidney disease. Accurate information on race is critical to understanding a patient’s risk of progressive kidney disease and their barriers to accessing care. However, the accuracy of the race data in PROMIS has never been verified.

BC Kidney Days poster winners

Every year BC Kidney Days features posters from renal teams across the province describing their research, education and patient care initiatives. 

CKD e-learning sessions for primary care

Over the course of 2016, the BC Renal agency will host a series of one-hour continuing education e-learning sessions for primary care clinicians.

Kidney Foundation of Canada

The Kidney Foundation of Canada (KFOC) is undertaking a survey to determine the financial burden that dialysis treatment puts onto dialysis patients and their families.

New on the BCPRA website

For Patients:

• Handouts:  NxStage Emergency Disconnect Procedures for Patients and Paramedics

For Healthcare providers:

• Guidelines and tools: 
  • Polycystic Kidney Disease 
  • Hemodialysis:
    • TB Screening Guideline for Hemodialysis
    • Nocturnal Hemodialysis Program Implementation
    • Unit Checklist for New Hemodialysis Patients
    • Readiness to Leave the Hemo Unit Post-Treatment
  • PD: TB Screening Guideline for Peritoneal Dialysis
  • Vascular Access: 
    • Referrals and Transfers: Guiding Principles, Resource Lists and Algorithms
    • Use of Topical Anaesthetics to Ease Cannulation Pain  
• Visual/ Multimedia Tools:
  • Modality Choices for Kidney Patients- Pediatric version
  • Modality Choices for Kidney Patients: Patients’ “watch at home” version
  • BC Kidney Days 2015 presentations and photo booth pictures