Authors (including presenting author) :
Lam MK, Cheung CMB, Tsang MC
Affiliation :
K18 Renal Unit, Queen Mary Hospital
Introduction :
Patient with end-stage renal failure will receive renal replacement therapy. Hospital Authority adopts a Peritoneal Dialysis (PD) first policy in Hong Kong. Patients will be offered PD unless they are contraindicated. They need to undergo Intermittent Peritoneal Dialysis (IPD) in renal wards of QMH or TWH twice a week after PD catheter insertion until they are ready to receive PD training to start home dialysis.
Currently, the waiting time for PD training after PD catheter insertion was around 8 -10 weeks in average. In view of long queues and waiting time for PD training, an enhancement program was established to shorten the waiting time of PD training by grouping suitable patients for training together, associate with use of technology to facilitate PD training and to adopt an integrated approach with cluster hospital (TWH) to facilitate the PD patients training pathway.
Objectives :
1. To enhance the PD training pathway and to shorten the waiting time for PD training
2. To increase the training capacities for PD service in HKWC
Methodology :
Patients are grouped and assigned training site at QMH or TWH by demographic background regardless the original follow-up clinic with the aim to fully utilized the training capacity of the two cluster renal unit. Suitable patients will be grouped together for PD training with similarities such as age, mentality and choice of dialysis systems by respective renal unit. Besides, new patients will be invited to start PD training early when previous groups of patients are ready for assessment prior to self home dialysis. During the training, innovative methods will be used to enhance the training efficiency, such as using of QR codes to display the training educational materials and sharing of video materials earlier. An integrated approach to shortlist the patient priorities who are ready for PD training according to the training capacities in each PD centre.
Result & Outcome :
The program was started since Dec 2023. After the initiation of training pathway enhancement, the capacity of PD training has increased from four to six patients per month. As a result, the PD catheter implantation to PD training time was shorten from 71.5 to 60.7 days (a reduction of 15.1%).
The enhanced PD training program is effective to increase the training capacities as well as shortening of the waiting time for PD training in both PD centres in HKWC.
