Abstract: FR-PO797

Developing an Organized Approach to Symptom Screening, Assessment, and Management for Hemodialysis Patients in Ontario: A Pilot Project

Session Information

Category: Dialysis

  • 601 Standard Hemodialysis for ESRD


  • Glazer, Alysha, Ontario Renal Network, Toronto, Ontario, Canada
  • MacKinnon, Marnie, Ontario Renal Network, Toronto, Ontario, Canada
  • Heale, Esti, Ontario Renal Network, Toronto, Ontario, Canada
  • Moolji, Carey, Ontario Renal Network, Toronto, Ontario, Canada
  • Blake, Peter G., London Health Sciences Centre, London, Ontario, Canada
  • Walsh, Michael, McMaster University, Hamilton, Ontario, Canada

People living with chronic kidney disease (CKD) requiring dialysis experience a high degree of symptom burden. Symptom assessment, particularly the assessment of chronic symptoms, is not typically done systematically as routine care which may result in a care gap. A provincial approach to routine symptom assessment that can be customized by renal programs may provide an opportunity to improve patient-provider communication and patient experience with dialysis care.To improve the experience of people treated with in-facility hemodialysis and their care team by providing an organized approach to routine symptom screening, assessment, and management.


Eight Regional Renal Programs in Ontario were selected to participate in a one year pilot project. Participating Programs will routinely assess patients undergoing in-facility hemodialysis with the Edmonton Symptom Assessment Scale Revised – Renal (ESAS-r:Renal), a self-reported symptom questionnaire. The project is being developed by a Task Group with multi-institutional and multi-sectoral representation utilizing a co-design model that engages patients, healthcare providers, and administrators in project planning and development.


Each pilot site has developed a new clinical workflow that includes symptom screening, assessment, and management every four to six weeks. Healthcare providers will be educated on symptom assessment and management through a train-the-trainer approach and the use of evidence-based clinical symptom management guides. Patients will also be educated about the project and use of the screening tool through various resources, including one-on-one education from the care team. Finally, an extensive evaluation framework was developed to guide the evaluation of the pilot project.


This pilot project will help determine the feasibility of a provincial approach to symptom screening, assessment, and management in Ontario. Furthermore, the project will increase awareness of CKD patient symptom burden.


  • Government Support - Non-U.S.