HOLLYWOOD, Fla.—Renal CarePartners’ Woodbridge, Va., facility was recently featured in the Mid-Atlantic Renal Coalition’s (MARC) quarterly newsletter, REMARCS for how it overcame common obstacles and barriers to raise their arteriovenous fistula (AVF) rate to 68.2 percent “through a mixture of creativity, passion, and preparedness.”
“We are extremely proud of our extraordinary patient care team at RCP-Woodbridge,” said Orestes Lugo, CEO and president of Renal CarePartners. “Renal CarePartners is committed to the highest standard of patient care in the industry and achieving recognition from MARC’s Fistula First Recognition Program is a true testament to that commitment. Our Facility Administrator for RCP-Woodbridge, Naomi Carbone, and her patient care team are nothing short of exceptional. We applaud them for their continuous efforts in improving patient outcomes.”
The full article can be views at the Mid-Atlantic Renal Coalition’s web site at the following link: http://www.esrdnet5.org/REMARCSFebruary2011.pdf.
MARC’s Fistula First Recognition Program acknowledges Network facilities that have above-average AVF rates. When the program was launched Carbone immediately saw it as an opportunity to improve the health of the patients that she and her team serve. Her enthusiasm for the program spread and as a result Renal CarePartners announced a company-wide bonus program designed to reward facilities that could reach a 65 percent AVF rate by December 2010.
Carbone approached this challenge by working to identify the barriers that prevented patients from beginning dialysis with a functioning AVF. She learned that physicians were missing opportunities to be more proactive about vascular access education with their patients and could often refer earlier for evaluation. She also found that hospitalized patients were not being consistently referred for AVF assessment prior to discharge. Her research revealed that catheter patients were more challenging to educate for a number of reasons. Based on her findings Carbone developed an early education and intervention plan designed to provide all patients with comprehensive information about vascular access options.
The plan focused on working with a nephrologist to discuss the benefits of AVF use with patients prior to their first treatment. As a result, it is now standard practice for hospital patients to have an AVF evaluation and to be scheduled for placement prior to discharge. To complement the physician’s early education efforts Carbone began to meet with every catheter patient during their first visit to the facility to explain the benefits of having an AVF.
In addition, she designated Sheila Benzie, RN, as the facilities vascular access manager. Benzie started monitoring all AVF patients with Vasc-Alert, which is a computer-based surveillance program that recognizes access problems early before the access clots.
A strong relationship with the medical staff at a local vascular access center helped facilitate patient’s access problems being resolved quickly. Carbone has also instituted many other creative practices to further the progress of improving quality of care including patient representatives that are available to discuss perceived issues related to AVF use and various rewards programs designed to motivate patients to seek information about AVF placement.
