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Utility of the Advanced Chronic Kidney Disease Patient Management Tools: Case Studies

^* To whom correspondence should be addressed. E-mail: meenal.p{at}duke.edu.

	Abstract

Appropriate management of advanced chronic kidney disease (CKD) delays or limits its progression. The Advanced CKD Patient Management Toolkit was developed using a process-improvement technique to assist patient management and address CKD-specific management issues. We pilot tested the toolkit in 2 community nephrology practices, assessed the utility of individual tools, and evaluated the impact on conformance to an advanced CKD guideline through patient chart abstraction. Tool use was distinct in the 2 sites and depended on the site champion’s involvement, the extent of process reconfiguration demanded by a tool, and its perceived value. Baseline conformance varied across guideline recommendations (averaged 54%). Posttrial conformance increased in all clinical areas (averaged 59%). Valuable features of the toolkit in real-world settings were its ability to: facilitate tool selection, direct implementation efforts in response to a baseline performance audit, and allow selection of tool versions and customizing them. Our results suggest that systematically created, multifaceted, and customizable tools can promote guideline conformance. (Am J Med Qual XXXX; XX:xx-xx)

First published on February 27, 2008, doi:10.1177/1062860607313142

American Journal of Medical Quality 2008;23:105.

A more recent version of this article appeared on April 1, 2008


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