Better Care and Outcomes for Dialysis Patients: Implementation of PCORI Findings Using ESRD Networks

Background: Currently, approximately 700,000 end-stage renal disease (ESRD) patients undergo dialysis to sustain life. PCORI has funded several large-scale dialysis-related studies that have the potential of informing practice and improving patient outcomes.

Proposed Solution to the Problem: The United States is divided into 18 ESRD networks to monitor quality of care and implement evidence-based dialysis practice. The project team proposes to partner with Mid-Atlantic Network 5 covering Maryland, Virginia, and West Virginia to disseminate findings from four PCORI dialysis studies by leveraging existing network dissemination infrastructure.

Objectives: The project aim is to disseminate findings from four large PCORI-funded dialysis studies into ESRD Network 5 facilities and create national scalability potential. The project’s objectives are:

• Enhance awareness and use of new evidence from PCORI-funded ESRD research among dialysis patients and their providers, specifically to increase home dialysis use via a PCORI-funded online decision aid; disseminate treatment options for depression; disseminate a peer-led mentoring program to augment ongoing Network 5 peer programs; and increase use of shared decision making and renal supportive care.
• Identify barriers and facilitators regarding dissemination and implementation (D&I strategies at the local network level for supporting further D&I at the national level

Activities: The project’s approach will utilize the Network 5’s existing multifaceted dissemination networks and, for each PCORI dialysis project:

• Align each study with a specific Network 5 program/initiative
• Target selected dialysis facilities by conducting workshops, site visits, training, and providing educational materials
• Select project-specific effective and efficient dissemination strategies by engaging stakeholders to tailor strategies to settings, targeted groups, and identify barriers and facilitators
• Collect evaluation data to determine change in knowledge, attitude, and systems.
• Scale up via dissemination at sister Networks 3 and 4, via patient liaisons (reps in each dialysis facility), and nationally to all 18 networks

Outcomes and Outputs (projected): These include measures on knowledge, attitude, and systems change related to dialysis treatment options and increased uptake of home dialysis, depression referrals, and appropriate treatment, role of peer mentoring, and tool to address end-of-life issues. A dissemination network roadmap will also be created for all future dissemination activities, throughout the 18 networks.

Patient and Stakeholder Engagement Plan: Network 5’s council is comprised of representatives from the renal community that include patients, nephrologists, social workers, nurses, technicians, and dietitians. This project is proposed as a partnership between MTPPI (host institution) and ESRD Network 5. The project team proposes to meet monthly with Network 5’s patient advisory committee (PAC) to obtain feedback and recommendations for all dissemination activities and related evaluation forms.

Project Collaborators: The team is partnering with Network 5 staff and Network 5 PAC members to conduct this project.