Full Report

RENAL
The experience of Hay River staff highlights the need
for strategic communication at all levels of the pilot to
ensure all staff and stakeholders are aware of changes
in process and direction related to their work.
Opinions of staff were mixed on the value of
using the WOLF system as the renal database tool
until interfacing issues and the establishment of a
dedicated database coordinator were addressed.
As a result, in January 2013, the Department
postponed development of the WOLF database
beyond completion of the piloting phase; however,
the Department was exploring other solutions. That
same month, Stanton Territorial Health Authority
created and funded the position of renal care
coordinator to lead development of a new database,
serve as a single-point of entry for all future program
referrals and reduce the workload of current staff.
Encouraged that database development would
proceed as the EMR system continues to develop,
staff saw creation of the new position as a significant
endorsement of their work in renal care. Overall, the
pilot project validated the importance of merging
the two databases to form a single territorial database
containing records of all NWT residents.
Clinicians are identifying and properly
referring more clients into the renal
program – clear evidence that patient
care is improving.
A range of positive patient outcomes
Findings overall from the renal improvement project
show considerable success in developing a cohort of
healthcare providers and managers now skilled in the
use of renal disease CPGs and referral processes.
The Department now has baseline renal-patient data it
can use to make informed resourcing decisions for the
system. Clinicians are identifying and properly referring
more clients into the renal program – clear evidence
that patient care is improving. For example, there has
been a decrease in early referrals while using the same
referral criteria, a decrease in disease progression, and
a decrease in use of dialysis. Tools such as the consultation
fax-back form better equip clinicians to care for
patients in their own communities.
Looking ahead, staff identified a number of key health
outcomes they expect to flow from the sustained and
expanded use of CPGs, including:
• earlier disease detection and diagnosis
• improved, consistent care delivery within
a streamline continuum of care
• reduced use of dialysis
• delayed disease progression and overall
better quality of life for the patient
• greater accuracy in baseline data related to
renal disease (once a database is established)
• standardized care across all communities
Staff believe the project has led to a more coordinated
and efficient system for managing chronic kidney
disease. Despite the challenges, the implementation
team noted significant support for the project
throughout the system. Perhaps most encouraging,
staff consider the wider use of CPGs and referral
processes to be a relatively efficient way for NWT to
improve patient care in other chronic disease areas.
43
Making the Case for Change