A Primer on Quality Assurance and Performance Improvement for Interprofessional Chronic Kidney Disease Care: A Path to Joint Commission Certification.

Linda Awdishu,Michelle Morrison,Teri Moore,Christy Turner,Danuta Trzebinska

doi:10.3390/pharmacy7030083

Linda Awdishu, Michelle Morrison + Show 3 more

Open Access

https://doi.org/10.3390/pharmacy7030083

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Abstract

Interprofessional care for chronic kidney disease facilitates the delivery of high quality, comprehensive care to a complex, at-risk population. Interprofessional care is resource intensive and requires a value proposition. Joint Commission certification is a voluntary process that improves patient outcomes, provides external validity to hospital administration and enhances visibility to patients and referring providers. This is a single-center, retrospective study describing quality assurance and performance improvement in chronic kidney disease, Joint Commission certification and quality outcomes. A total of 440 patients were included in the analysis. Thirteen quality indicators consisting of clinical and process of care indicators were developed and measured for a period of two years from 2009–2017. Significant improvements or at least persistently high performance were noted for key quality indicators such as blood pressure control (85%), estimation of cardiovascular risk (100%), measurement of hemoglobin A1c (98%), vaccination (93%), referrals for vascular access and transplantation (100%), placement of permanent dialysis access (61%), discussion of advanced directives (94%), online patient education (71%) and completion of office visit documentation (100%). High patient satisfaction scores (94–96%) are consistent with excellent quality of care provided.

Highlights

Interprofessional (IP) care for chronic kidney disease (CKD) facilitates the delivery of comprehensive care to a complex, at-risk population
We describe the development of an IP CKD program and the pathway to The Joint Commission (TJC) disease specific certification in CKD care
Clinical data including patient demographics, comorbidities, laboratory results, vital signs measured during clinic visits, medications, process of care measures as well as outcomes of dialysis initiation, transplantation or death were extracted from the electronic health record (EHR)

Summary

Introduction

Interprofessional (IP) care for chronic kidney disease (CKD) facilitates the delivery of comprehensive care to a complex, at-risk population. Interprofessional teams focus on implementing evidenced based care to slow down the progression of CKD, educating patients about their disease and streamlining the transition to end stage renal disease (ESRD). This comprehensive care has been shown to reduce hospitalizations [1,2,3,4,5,6] lower mortality [1,3,4,7,8,9], slow the progression of CKD [1,2,3,10,11] and prepare patients for transitions in care [4,7,8]. We describe the development of an IP CKD program and the pathway to TJC disease specific certification in CKD care

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