Abstract: SA-PO917
Home Hemodialysis Assisted by Personal Support Workers Among Eight Pilot Programs in Ontario
Session Information
- Dialysis: Home Hemodialysis
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 702 Dialysis: Home Hemodialysis
Authors
- McFarlane, Philip, St. Michael's Hospital, Toronto, Ontario, Canada
- Graham, Janet Lynn, The Ottawa Hospital, Ottawa, Ontario, Canada
- Hebert, Marc, Ontario Renal Network, Toronto, Ontario, Canada
- Patel, Monisha, Ontario Renal Network, Toronto, Ontario, Canada
- Taji, Leena, Ontario Renal Network, Toronto, Ontario, Canada
- Yeung, Angie, Cancer Care Ontario, Toronto, Ontario, Canada
- Pierratos, Andreas, University of Toronto, Toronto, Ontario, Canada
Background
Increasing the uptake of home dialysis is a strategic priority of the Ontario Renal Network (ORN). Home hemodialysis (HHD) is associated with a higher quality of life and improved symptom control. Barriers to the adoption of HHD can include patient inability to manage HHD independently, psychological barriers such as fear of catastrophic events, concerns about burdening family, or lack of appropriate support.
This pilot project utilized Personal Support Workers (PSWs) to support patients who required additional assistance to dialyze at home.
Methods
The ORN funded 8 Regional Renal Programs (RRPs) to initiate PSW-assisted HHD. PSWs were trained in a manner consistent to that of independent HHD patients. Patient information was collected via the Ontario Renal Reporting System. Patients, PSWs, nurses and administrators were surveyed to gather feedback on patient experience and outcomes, model feasibility, training success, safety, and monitoring and support processes(e.g. including ongoing focus groups to obtain information about project progress).
Results
Between October 2015 and March 2018, approximately 65 patients participated in the PSW-assisted HHD project. As of March 2018, 35 prevalent patients were actively receiving PSW-assisted HHD. Rates of HHD increased by 0.1% to 2.2% across the 8 RRPs due to PSW-assisted HHD since the implementation of the project. The main challenge of the pilot was the PSW turnover rate (41%).
Key survey measures include:
94.5% (n=35) of patients indicated that they switched to HHD due to the PSW support received.
91% (n=33) of patients indicated that are happier dialyzing at home than in an in-centre dialysis unit.
Conclusion
Successful implementation of a PSW-assisted HHD was achieved across 8 RRPs in Ontario. PSW-assisted HHD appears to be a promising model of care to increase uptake of HHD and was associated with high patient satisfaction scores. Further evaluations of the program are underway to inform the operational and financial sustainability of this model of care.
Funding
- Government Support - Non-U.S.