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Am J Med Qual. 2008 Mar-Apr;23(2):105-14. doi: 10.1177/1062860607313142. Epub 2008 Feb 27.

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

Author information

1
Department of Medicine, Duke Center for Clinical Health Policy Research, Duke University Medical Center, Durham NC 27705, USA. mechpatw@gmail.com

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.

PMID:
18305098
DOI:
10.1177/1062860607313142
[Indexed for MEDLINE]

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