Document Detail

A case management model to improve hemodialysis outpatient outcomes.
MedLine Citation:
PMID:  17403178     Owner:  NLM     Status:  MEDLINE    
Optimal outpatient dialysis care is often difficult to achieve and a case management model to augment conventionally applied nursing and physician resources focusing on continuous quality improvement presents a possible solution to improving outcomes in this setting. We applied this model to patients followed by our physician group. Continuous quality improvement data generated from the dialysis unit database were used to analyze outcomes in patients enrolled in this model. Data from the cohort of patients followed in 2003 served as the reference source for comparative purposes. The nurse case manager assumed responsibility during the second quarter of 2004. Comparing outcomes data from 2005 with data from 2003, we were able to achieve a 3.12% improvement in the annualized mean percent crude mortality per 100 patient years (p<0.003). There was a 3.46-day trend to improvement in patient hospital days per year (p<0.06). The percentage of catheters used as primary access decreased by 9.59% (p<0.025), and the percentage of patients meeting an eKdrt/V goal > or =1.2 increased by 15.33% to 92.37% (p<0.001). These data appear to support the utility of a case manager model in our system.
David J R Steele; Emel Hamilton; M Amin Arnaout
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hemodialysis international. International Symposium on Home Hemodialysis     Volume:  11     ISSN:  1492-7535     ISO Abbreviation:  Hemodial Int     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-04-03     Completed Date:  2007-06-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101093910     Medline TA:  Hemodial Int     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  247-51     Citation Subset:  IM    
Nephrology Division, Department of Medicine, Massachusetts General Hospital (MGH), Boston, Massachusetts 02114, USA.
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MeSH Terms
Case Management*
Catheterization / utilization
Nurse Administrators
Renal Dialysis*
Retrospective Studies
Survival Rate
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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