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Kidney Week

Abstract: SA-PO759

Quality Improvement Empowerment: Dialysis Clinic Staff Lead Projects for Change

Session Information

Category: Dialysis

  • 601 Standard Hemodialysis for ESRD


  • Maursetter, Laura J., University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States

Quality improvement provides an avenue for delivering healthcare that meets the best practices standards across medicine. Dialysis centers strive to provide the optimal care but in the era of dialysis center ratings measures of care delivery become even more impactful. There are many centers that have provided examples where quality improvement projects have improved the delivery of care. There are none that have created a system where all staff are educated about quality improvement and encouraged to lead their own project.


In the fall of each year, a portion of the staff meeting is dedicated to quality improvement (QI). The dialysis director talks about the differences between quality improvement and research, noticing gaps in care, methods of analyzing and measuring a problem and thinking of interventions. Each staff member is encouraged to develop a indea and there is a simple QI curriculum available to assist in facilitating the project. Periodically the dialysis direct and charge nurse discuss the projects with each leader and the results of the projects were brought to the hospital administration at the end of the year.


After this program was started, there have been 12 projects initiated. In the first year of the program 80% of the staff developed a project. All types of staff led projects: these included the dietician, the social worker, 75% of the nurses, and 100% of the dialysis technicians. The project topics included improved patient knowledge of emergencies, improved knowledge of dialysis treatment options, discussions with patients about the importance of dialysis adequacy and maintaining the prescribed dialysis schedule, improvement in the time the staff spend with each patient, increase fun activities for patients during dialysis, improved referrals for positive depression screening, and improvement in the albumin level.


Creating an environment and formalized QI program that empowers employees to notice problems and create solutions was able to make an impact on the quality of care provided in this small dialysis center. This simple curriculum could be translated into larger dialysis units to improve the quality of care and satisfaction of the patients or employees of the unit.