Pathways Project: Kidney Supportive Care

Summary

The Pathways Collaborative is the first attempt to implement supportive (palliative) kidney care at multiple sites in the United States. While supportive kidney care is growing in other countries, notably Canada, Australia, and Great Britain, it is not yet known how to integrate it into the unique nephrology environment in the United States. In Phase 1 of Pathways (completed), we developed an evidence-based change packet of 14 best practices for integrating supportive care practices into the continuum of care for patients with end stage kidney disease (ESKD). In Phase 2 (described in this application), we will conduct a learning collaborative to help up to 15 dialysis and CKD centers implement these best practices. The learning collaborative is based on the IHI Collaborative Model for Achieving Breakthrough Improvement. This model is a tested systematic approach to quality improvement designed to help organizations close the gap between current and future practice based on evidence-based best practices.

The Pathways Project faculty will work with up to 15 change teams at dialysis centers to create a system to identify seriously ill patients with kidney disease; conduct conversations with them so that their values, preferences, and goals for current and future medical treatment are known and respected; assess and address patients' physical, psychological and spiritual needs; and coordinate care throughout the healthcare system so patients receive only the care they want in settings in which they wish to be.

Conditions

• Kidney Diseases
• Chronic Kidney Diseases
• End Stage Renal Disease
• End Stage Renal Disease on Dialysis
• Chronic Kidney Disease Requiring Chronic Dialysis

Interventions

BEHAVIORAL

IHI Breakthrough Collaborative Model

Staff teams at participating dialysis centers take part in a quality improvement/collaborative learning model that was initially planned to include three in-person learning sessions, and three activity sessions during which staff teams at each site use quality improvement processes to implement kidney supportive care best practices from the change package. Technical assistance, education, and quality improvement coaching are provided to the site staff teams throughout the project. Patients at the sites then receive care that has been improved via this staff education and quality improvement activities.

Sponsors & Collaborators

• West Virginia University Research Corporation

  collaborator UNKNOWN

• Gordon and Betty Moore Foundation

  collaborator OTHER

• Coalition for Supportive Care of Kidney Patients

  collaborator UNKNOWN

• Stanford University

  collaborator OTHER

• George Washington University

  lead OTHER

Principal Investigators

• Dale E Lupu, PhD, MPH · The George Washington University

• Alvin Moss, MD · West Virginia University

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2018-11-01

Primary Completion

2020-08-31

Completion

2020-10-31

Countries

• United States

Study Locations