Background: More than 554,000 patients receive dialysis in the U.S., a majority of which receive hemodialysis treatment at outpatient dialysis facilities. Dialysis facilities are complex organizations with providers from multiple disciplines collaborating and using advanced technology to care for patients with kidney disease, often resulting in unintended consequences for patients. However, PCORI has funded twenty comparative effectiveness research (CER) studies focused on improving the care of individuals with kidney disease. When disseminated into clinical practice, research supports evidence-based, patient-centered care. However, barriers exist that require targeted efforts to increase the reach of healthcare workers in the dialysis setting.
Proposed Solution to the Problem: In collaboration with a large network of stakeholders (i.e., technical expert panel or TEP), the team will synthesize PCORI-funded CER and disseminate the evidence through the development of educational training. The project will utilize a virtual education platform, 5-Diamond Program, to increase awareness, accessibility, availability, and understanding of research among dialysis healthcare workers across the U.S. and therefore maximize the impact of the research to ultimately improve the health outcomes of patients with kidney disease. The educational modules developed through this award will be promoted to all dialysis facilities as new modules and marketed to increase engagement due to their alignment with CMS and ESRD Network goals. Upon completion of the modules, continuing education credits will also be provided, creating an appealing offer to dialysis facility staff to engage with the content. When the modules are made available on the 5-Diamond website, a press release will be distributed and a direct email blast will be sent to all 5-Diamond registered participants and the ESRD Networks.
Objectives: The primary objective is to increase dialysis healthcare workers’ understanding among four defined domains of evidence focused on kidney disease including: advance care planning, care coordination/care transitions, mental/behavioral health, and patient engagement/patient-centered care.
Activities: The team will convene a diverse TEP to oversee the integration of PCORI-funded research into the 5-Diamond Program, through the development of educational modules to support understanding of research findings by healthcare workers in the dialysis setting. The TEP will develop pre- and post-tests to evaluate dialysis workers’ understanding of evidence presented and implementation assessments to understand how dialysis staff are translating evidence into practice.
Projected Outcomes and Outputs: Short-term outcomes at the end of the project period include increasing the number of dialysis healthcare workers reached and enhancing the quality of educational content offered through the 5-Diamond Program. After the project, medium-term outcomes include increasing the number of program participants completing modules with PCORI content annually; increasing facility understanding of PCORI-funded research as evidenced by performance on pre- and post-tests; and to understand evidence application through implementation assessments. Long-term outcomes are to continue to pursue funding to incorporate kidney focused PCORI-funded research into the 5-Diamond Program. Outputs from this dissemination project will include four educational modules on the previously defined domains; a peer-reviewed journal publication, two TEP summary reports, two white papers reflecting the TEPs synthesis of material for dissemination; and an Annual Report reflective of the success of the 5-Diamond Program’s outreach to dialysis facilities in the U.S.
Patient and Stakeholder Engagement Plan: The project team has engaged a diverse network of stakeholders, including PCORI-funded project investigators who previously led kidney disease-focused studies, patient SMEs, an interdisciplinary team of 5-Diamond program participants, and industry experts including Fresenius Kidney Care, a Large Dialysis Organization, and three ESRD Networks (8, 11, and 14).
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Project Resource: 5-Diamond Patient Safety Program Website