The Role of Key Performance Indicators (KPIs) in Clinical Self-assessment of Quality of Service Offered to the Patients Under Chronic Hemodialysis in Low Income Countries
Keywords:
KPIs, hemodialysis service, RwandaAbstract
Introduction: Hemodialysis is the procedure using the dialysis machine and artificial kidney (dialyzer) in presence of the patient`s vascular access, to remove fluids and solutes (waste) in kidney failure patients, It gives supportive care and does not cure the kidney failure. Chronic kidney disease is clinical syndrome associated with definite change in kidney structure and function, it is mainly irreversible. KPIs are measurable metrics used to set goals in a certain period followed by assessment of the performance, and set the recommendations and the way forward. Methods: We analyzed the data which were recorded in Clinicea (electronic file) between February and November 2022 in early December 2022 using Key Performance Indicators (KPIs). Results: In all (3) centers, during the above-mentioned period, all sessions were recorded; more than 94% of patients, their Kt/V urea was recorded and the target was varying between 69% to 85%; almost half of the patients did their blood tests and less than three four met the target. Few patients had AVF (30% in November). The beds were under-used; no center has met 2 shifts per day at100%, the same for the nurses where there was less than 2.5 sessions per nurse per day. Conclusion: This study showed that KPIs are the best tools to monitor dialysis centers activity, as they help to keep updated about the current clinical state of patients for improving the quality of care and patients` quality of life especially in Low-Income Countries, where there is shortage of Physicians and Nephrologists.
References
NATIONAL KIDNEY FOUNDATION, 17th December 2022. https://www.kidney.org/treatment-support
National Institute of Diabetes and Digestive and Kidney Diseases, 17th December 2022. https://niddk.nih.gov/health-information/kidney-disease/kidney-failure/hemodialysis
Adriano Luiz Ammirati. Chronic Kidney Disease. REV ASSOC MED BRAS 2020; 66(SUPPL 1): S3-S9. http://dx.doi.org/10.1590/1806-9282.66.S1.3
Glassmann A, Gioberg S, Moeller S, et al: ESRD patients in 2004: global overview of patient numbers, treatment modalities and associated trends. Nephrol Dial Transplant. 2005;20-2587-2593.
John W Stanifer, Bocheng Jing, Scott Talan, et al. The epidemiology of chronic kidney disease in sub-Saharan Africa: a systematic review and meta-analysis. Lancet Glob Health 2014; 2: e174-181. http://dx.doi.org/10.1016/S2214-109X(14)70002-6.
Carolina Renz Pretto, Eliane Roseli Winkelmann, Leila Maariza Hildebrandt, et al. Quality of life of chronic kidney patients on hemodialysis and related factors. Rev. Latino-Am. Enfermagen 2020;28:e3327. DOI: 10.1590/1518-8345.3641.3327.
Mr Daniel Ussher, Professor Kevan Polkinghome, Dr Timothy Pianta, et al. Renal Key performance indicators review. Safer Care Victoria, August 2019. ISBN 978-1-76069-950-5.
NIGEL D TOUSSAINT, LAWRENCE P MCMAHON, GREGORY DOWLING, et al. Implementation of renal key performance indicators: Promoting improved clinical practice. Nephrology 20 (2015) 184-193. doi: 10.1111/nep. 12366.
National Institute of Statistics of Rwanda (NISR), Ministry of Finance and Economic Planning (MINECOFIN) [Rwanda], 2012 Fourth Rwanda Population and Housing Census. Final Results: Main indicators report.
Chironda G, Ngendahayo F, Mudasumbwa G, Dushimiyimana V, Jeanne Tuyienge M, Kayitesi J, at al. Renal replacement therapy (RRT) in Rwanda: benefits, challenges and recmmendations. Rwanda Medical Journal, Vol. 76, No. 3, 2019, pp. 1-6. http://www.rwandamedicaljournal.org.
Dawn Opgenorth, Sean M. Bagshaw, Vincent Lau et al. A study protocol for improving the delivery of acute kidney replacement therapy (KRT) to critically ill patients in Alberta – DIALYZING WISELY. BMC Nephrology (2022) 23:369. https://doi.org/10.1186/s12882-022-02990-6.
Akira Fukui, Takashi Yokoo, Masaomi Nangaku et al. New measures against kidney diseases in Japan since 2018. Clinical and Experimental Nephrology (2019) 23:1263-1271. https://doi.org/10.1007/s10157-019-01786-7.
Wiam A. ALASHEK, Christopher W. MCINTYRE, Maarten W. TAAL. Provision and quality of dialysis services in Libya. https://doi.org/10.1111/j.1542-4758.2011.00588.x
Elangovan, Loganathan, Shinaberger et al. HEMO Equilibrated Kt/V Goals Are Difficult to Achieve in Large Male Patients. ASAIO Journal 47(3):p 235-239, May 2001.
Manuel Naves-Diaz, Jutta Passlick-Deetjen, Adrian Guinsburg et al. Calcium, phosphorus, PTH and death rates in a large sample of dialysis patients from Latin America. The CORES Study. Nephrol Dial Transplant (2011) 26: 1938-1947. doi: 10.1093/ndt/gfq304.
Rajiv Agarwal, Joyce L. Davis and Linda Smith. Serum Albumin Is Strongly Associated with Erythropoeitin in Hemodialysis Patients. Clin J Am Soc Nephrol 3: 98-104, 2008. doi: 10.2215/CJN.03330807.
A. RASHID QURESHI, ANDERS ALVESTRAND, ANDERS DANIELSSON, et al. Factors predicting malnutrition in hemodialysis patients: A cross-sectional study. Kidney International, Vol. 53 (1998), pp. 773-782.
PACIFIC PRIME Simplifying Insurance. Rwanda Health Insurance 18th December 2022. https://www.pacificprime.com/country/africa/rwanda-health-insurance/
Grace Igiraneza, Vincent Dusabejambo, Frederic O. Finklestein et al. Challenges in the Recognition and Management of Acute Kidney Injury by Hospitals in Resource-Limited Settings. Kidney Int Rep (2020) 5, 991-999. https://doi.org/10.1016/j.ekir.2020.04.003.
Nieltje Gedney. Arteriovenous Fistula or Dialysis Catheter: A Patient`s Perspective. KIDNEY360 3: 1109-1110, 2022. doi: https://doi.org/10.34067/KID.0001462022.
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