09-29-2009, 10:40 PM
Not long ago a group of Australian nephrologists paid a visit to
Vancouver to learn more about the workings of the BC renal network
and our provincial model of renal care.
Apparently the Aussies were impressed by what they found, as
reflected in an online newspaper item from The Australian. Written
by Dr. Robyn Langham, director of nephrology at St Vincent’s Hospital
in Melbourne, and past president of the Australian and New Zealand
Society of Nephrology, the article urges the Australian government to
develop a more collaborative and multidisciplinary approach to renal care.
the article...
Vancouver to learn more about the workings of the BC renal network
and our provincial model of renal care.
Apparently the Aussies were impressed by what they found, as
reflected in an online newspaper item from The Australian. Written
by Dr. Robyn Langham, director of nephrology at St Vincent’s Hospital
in Melbourne, and past president of the Australian and New Zealand
Society of Nephrology, the article urges the Australian government to
develop a more collaborative and multidisciplinary approach to renal care.
the article...
Quote:We can get on top of kidney diseaselink
Article from: The Australian
Research suggests that one in seven, or up to two million Australians, could have some form of kidney disease and not know about it ... this fact alone makes awareness-raising activities extremely important.
-- Health Minister Nicola Roxon, May 2008
PEOPLE suffering from chronic kidney disease rarely experience any physical warning signs and it is all too often that irreversible damage has occurred by the time patients present for treatment. There is an imperative to develop community-based programs for early recognition and treatment of CKD so progression of kidney damage can be minimised, ultimately preventing or delaying the need for dialysis or kidney transplantation.
There are about 10,000 Australians on dialysis, with numbers increasing by about 7 per cent every year.
In an attempt to understand how we in Australia can develop programs that will address the increasing demand in CKD, a small group of Australian nephrologists travelled to Vancouver to learn first-hand from the work of Canadian colleagues. The Canadian-Australian Chronic Kidney Disease Workshop in Vancouver provided a valuable opportunity to share insights and learn about the models of care used in the two countries.
The British Columbia Provincial Renal Agency, led by Adeera Levin, has developed integrated programs that aim to improve patient outcome across the spectrum of kidney disease. Critical to the management of Levin's renal program has been the development of a robust, user-friendly and web-based renal database enabling measurement of outcomes that follow practice change. With the institution of clinical programs that include community workshops that improve public awareness, provision in the community of a kidney general practitioner and the development of multi-disciplinary clinics centred on CKD management, the Vancouver team has been able to demonstrate fewer patients commencing dialysis.
The BCPRA team has a unique role in Canadian healthcare, as fund managers for delivery of renal services to patients in the province. The high cost of dialysis means that even a small impact in improving CKD outcomes has an important effect on overall cost. With data collection, the team in British Columbia has been able to demonstrate improved clinical outcomes for CKD patients that have led to opportunities for resourcing and expenditure in other areas.
Their multidisciplinary clinics use the knowledge and resources of a CKD nurse as well as dieticians, pharmacists and other allied health professionals. The patients benefit from established processes and protocols, particularly as there is increased opportunity to learn more about their condition, often resulting in better self-management.
As CKD is a progressive and chronic illness, collaborative programs that use all aspects of the health delivery sector improve outcomes. Engaging patients in self-care and disease management is a critical aspect of this.
Australia is well-placed to develop innovative collaborative programs that involve all stakeholders of the kidney health fraternity. The economic benefits that flow from models such as those in Canada have been clearly demonstrated by Australian studies.
There is an imperative for all levels of government to engage clinicians, consumers and health services to jointly develop policies and models of care aimed at reducing the burden of kidney disease in our community. The establishment of clinician-led renal health networks under the auspices of most state governments represents an ideal framework through which policies and projects may be implemented.
Already, Queensland Health and WA Health have developed strategic plans for renal health care, along with models for healthcare delivery with integrated patient data collection.
I would encourage the federal Government and the health minister to consider the application of a "whole of renal health" model here. Improving public awareness, allowing early identification of disease, ensuring adequate delivery of treatment at primary healthcare level and identifying new opportunities will reduce the burden of kidney disease in our community.
Such an approach offers enormous potential for improvements in patient outcomes and a more efficient use of health funds. Considering the burden of CKD on the Australian health and hospital system, changes in practice that result in improved patient outcomes and a decreased need for dialysis and transplantation should be welcomed by all.