Utility of the advanced chronic kidney disease patient management tools: case studies.

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Patwardhan, MB; Matchar, DB; Samsa, GP; Haley, WE

Published Date

  • 2008

Published In

Volume / Issue

  • 23 / 2

Start / End Page

  • 105 - 114

PubMed ID

  • 18305098

International Standard Serial Number (ISSN)

  • 1062-8606

Digital Object Identifier (DOI)

  • 10.1177/1062860607313142


  • eng

Conference Location

  • Netherlands