Abstract: FR-PO517
Evaluating Home Dialysis Training Requirements: A Survey of Nephrology Program Directors and Division Chiefs
Session Information
- Home Dialysis, Policy, Novel Approaches
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 702 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Reddy, Yuvaram N.V., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
- Berns, Jeffrey S., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
- Bansal, Shweta, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
- Simon, James F., Cleveland Clinic, Cleveland, Ohio, United States
- Murray, Ryan, American Society of Nephrology, Washington, District of Columbia, United States
- Jacob, Molly, American Society of Nephrology, Washington, District of Columbia, United States
- Perl, Jeffrey, St. Michael's Hospital, Toronto, Ontario, Canada
- Gould, Edward, Vanderbilt University Medical Center, Nashville, Tennessee, United States
Group or Team Name
- ASN Home Dialysis Task Force
Background
The American Society of Nephrology (ASN) convened a Home Dialysis Task Force in 2021 to improve awareness and outcomes of home dialysis. An identified need was to ensure universal and adequate training, education, and exposure to home dialysis during nephrology fellowship. As a first step, The Task Force surveyed program directors and division chiefs to explore perspectives on 1) what constitutes adequate home dialysis training, and 2) what home dialysis training resources are needed.
Methods
Using REDCap, we anonymously surveyed program directors and division chiefs of US adult nephrology fellowship programs from 03/04/22-04/05/22. Program directors were asked to 1) select the minimum training fellows should receive before they could provide home dialysis without supervision (defined by number of clinics attended or patients seen) and 2) select home dialysis training resources that ASN could support. Division chiefs were asked to select the minimum training fellows should receive before they could be hired as faculty to manage home dialysis patients.
Results
Among 158 program directors and 170 division chiefs in ASN’s database, 43 and 31 responsed (response rate, 27% and 18%, respectively). When asked about the minimum training fellows should receive before they could provide peritoneal dialysis without supervision, the most common answers were 10-12 clinics (53% of program directors and 35% of division chiefs), and 11-15 patients (33% of program directors and 29% of division chiefs). For home hemodialysis training, please see Table 1. When program directors were asked which resources they would like ASN to faciliate, 74% requested a virtual case-based home dialysis mentorship program.
Conclusion
Most program directors and division chiefs felt that fellows could provide home dialysis independently if they attended a minimum of 10-12 home dialysis clinics. Most program directors wanted ASN to help create a virtual case-based home dialysis mentorship program.
| Survey question | Program Directors (n=43) | Division Chiefs (n=31) |
| In your opinion, upon graduation, how many of your fellows can provide home dialysis without supervision? Peritoneal dialysis All fellows Most fellows Some fellows Home hemodialysis All fellows Most fellows Some fellows None of our fellows No response | _ _ _ 31 (72%) 8 (19%) 4 (9%) _ 13 (30%) 14 (33%) 12 (28%) 3 (7%) 1 (2%) | _ _ _ 22 (71%) 6 (19%) 3 (10%) _ 14 (45%) 6 (19%) 5 (16%) 6 (19%) _ |
| In your opinion, how many home dialysis clinics should a fellow attend before they can provide home dialysis without supervision? Peritoneal dialysis < 4 clinics 4-6 clinics 7-9 clinics 10-12 clinics 13-18 clinics 19-24 clinics > 24 clinics Home hemodialysis < 4 clinics 4-6 clinics 7-9 clinics 10-12 clinics 13-18 clinics 19-24 clinics > 24 clinics | _ _ _ 2 (5%) 3 (7%) 4 (9%) 23 (53%) 3 (7%) 6 (14%) 2 (5%) _ 3 (7%) 5 (12%) 3 (7%) 24 (56%) 3 (7%) 4 (9%) 1 (2%) | _ _ _ 1 (3%) 6 (19%) 3 (10%) 11 (35%) 5 (16%) 2 (6%) 3 (10%) _ 8 (26%) 5 (16%) 4 (13%) 7 (23%) 3 (10%) 1 (3%) 3 (10%) |
| In your opinion, what is the minimum number of patients on home dialysis that a fellow should see before they can provide home dialysis without supervision? Peritoneal dialysis 3-5 patients 6-10 patients 11-15 patients 16-20 patients 21-30 patients > 30 patients Home hemodialysis 1-2 patients 3-5 patients 6-10 patients 11-15 patients 16-20 patients 21-30 patients > 30 patients | _ _ _ _ 4 (9%) 10 (23%) 14 (33%) 8 (19%) 1 (2%) 6 (14%) _ 1 (2%) 13 (30%) 12 (28%) 10 (23%) 3 (7%) 2 (5%) 2 (5%) | _ _ _ _ 2 (6%) 3 (10%) 9 (29%) 5 (16%) 7 (23%) 5 (16%) _ 6 (19%) 8 (26%) 6 (19%) 6 (19%) 1 (3%) 1 (3%) 3 (10%) |
| Does your program use any of the following resources? Home dialysis rotation within the program National home dialysis conference (e.g., Home Dialysis University, Home Dialysis Academy of Excellence) Home dialysis rotation at an outside academic or private practice setting | _ 23 (53%) 36 (84%) _ 5 (12%) _ | _ _ _ _ _ _ |
| Would your program want ASN to facilitate the creation of the following training resources? Year-long virtual case-based home dialysis mentorship program Home dialysis rotation at an outside academic or private practice setting | _ _ 32 (74%) 5 (12%) _ | _ _ _ _ _ |
Funding
- Other NIH Support