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Kidney Week

Abstract: TH-PO298

Vascular Access Management Story in Outsourcing Hemodialysis Program in Saudi Arabia

Session Information

Category: Dialysis

  • 703 Dialysis: Vascular Access

Authors

  • Mousa, Dujanah Hassan, Diaverum AB, Riyadh, Saudi Arabia
  • Ibrahim, Elhussein Kandil Mohamed, Diaverum AB, Riyadh, Saudi Arabia
  • Alqadhi, Abdulaziz O Hafedh, Diaverum AB, Riyadh, Saudi Arabia
  • Assiri, Ibrahim Abdullah, Diaverum AB, Riyadh, Saudi Arabia
  • Abouras, Ahmed Ismail, Diaverum AB, Riyadh, Saudi Arabia
  • Altaher, Badawi Amin Badawi, Diaverum AB, Riyadh, Saudi Arabia
  • Ismail, Mohammed Hashem, Diaverum AB, Riyadh, Saudi Arabia
  • Musa, Hassan Ali, Diaverum AB, Riyadh, Saudi Arabia
  • Alharbi, Ali, Diaverum AB, Riyadh, Saudi Arabia
Background


VA is the backbone of successful Hemodialysis. AVF is longer in survival and less in complications than an AVG or CVC.
Outsourcing Program in Saudia has looked after more than 5K pats since 2014 and Provides VA management as part of the bundle service.
Aim: To show our experience in managing VA challenges.

Methods

We retrospectively analyzed a VA project between 2014 to 2021.

Results

In 2014, we had an AVF of 60% and a high rate of CVC of almost 33%. Over time, more clinics are established and ramping up pats with a challenge to achieve the CVC contractual target of 15% or less. During the first 2years, limited resources in three main cities serving all patients. Providing the services at local hospitals is on the contract's terms, and patients were resistant to travel for vascular procedures. Targets could not deliver, and the cost was high. We analyzed patient factors such as dialysis vintage, resistance to change, and education. We headhunted for the right VA surgeon who is committed and willing to travel between different cities. Also looked for accredited theater facilities in different cities where our clinics are allocated and rented to deliver the VA procedures. A structured VA Management team was created with dedicated and knowledgeable staff to lead the roadmap to success. Our surgeons in one geographical region were inspired to start a new business model, and they were sub-contracted per capita to deliver our targets, which proved to be successful and valuable. Digitization to support and coordinate between clinics, surgeons, and regional vascular supervisors, keeping finance in the loop to eliminate discrepancies and secure budget efficiency. Therefore, a strategy was implemented, supervised, re-evaluated, and improved over time. Patient care is delivered as near home as possible, and patient satisfaction is ensured. Medical targets achieved and cost observed.
Patients grew to 4300 in 2021; we achieved AVF/G 83.8% and CVC 16.1%, with a cost reduction of 25%

Conclusion

Organized and keen VA team with custom Designed System for Tracking and close supervision of different clinic's VA status and procedures will improve VA services, deliver targets and reduce costs in any hemodialysis setup.