Abstract: FR-PO0103
How to Improve Your CRRT Program: A Qualitative Assessment of Health Care Professionals' Perspectives on CRRT Care
Session Information
- AKI: Epidemiology and Clinical Trials
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Rehman, Aqeeb Ur, University of Alabama at Birmingham Health System, Birmingham, Alabama, United States
- Lee, Heather, University of Alabama at Birmingham Health System, Birmingham, Alabama, United States
- Rewa, Oleksa G., University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
- Tolwani, Ashita J., University of Alabama at Birmingham Health System, Birmingham, Alabama, United States
- Garimella, Pranav S., University of California San Diego Department of Medicine, La Jolla, California, United States
- Neyra, Javier A., University of Alabama at Birmingham Health System, Birmingham, Alabama, United States
Background
Continuous renal replacement therapy (CRRT) is the preferred dialysis modality for critically ill patients with acute kidney injury, yet its delivery and quality vary across institutions. This study aimed to identify current gaps in CRRT practice and explore strategies to improve programmatic CRRT delivery from the perspective of multidisciplinary healthcare professionals.
Methods
A qualitative study was conducted during the 2024 University of Alabama at Birmingham (UAB) CRRT Academy using five focus group discussions. Participants included fellows in training, staff (nurses, nurse practitioners, pharmacists) and clinicians (nephrologists, intensivists) with varying CRRT experience. CRRT Academy faculty joined a separate focus group for comparison. Transcripts were analyzed using a combined inductive-deductive thematic approach in NVivo 15.
Results
There were 81 participants: 54 fellows in training, 9 staff and 18 faculty. Four key themes were identified as relevant to improve CRRT delivery: 1) teamwork and multidisciplinary communication, 2) collection of CRRT performance and process metrics and development of quality improvement (QI) initiatives, 3) protocol standardization while allowing flexibility to individualize care, and 4) education for clinicians, pharmacists, and nurses. Faculty emphasized the need for monetary investment and support from administration and leadership of QI initiatives, noting nephrologists must advocate more proactively for improvement in CRRT care. Participants reported significant variability in CRRT prescription, data collection, and training across institutions. Most participants cited limited adoption of CRRT performance/process indicators due to lack of consensus on definitions and difficulty accessing or integrating these metrics into clinical workflows.
Conclusion
This qualitative study underscores key areas for improving CRRT delivery, including interprofessional collaboration, data-driven QI, protocol standardization, and targeted education. Addressing these themes may help improve CRRT processes of care and patient-centered outcomes.