Evaluating the implementation of a Kidney Supportive Care Program into a Hospital and Health Service

The Project

The Kidney Supportive Care Program (KSCp) was established in 2016 to support people with advanced kidney disease facing complex health decision-making. The innovative program has integrated kidney health professionals with palliative care health professionals to help patients manage the burden of symptoms and assist with their decision-making about end of life care.

An AusHSI implementation grant has helped to evaluate the implementation of a KSCp service in Metro North Hospital and Health Service (MNHHS).

The evaluation investigated whether the program improved health services and clinical outcomes for people with advanced kidney disease. Many of these patients receive dialysis treatments, which account for 35% of all same day visits to hospital in Australia. The evaluation provided evidence that could support a change in policy or guidelines and support changes to best practice.

AusHSI’s Role

AusHSI funding helped the research team to produce evidence for effective and sustainable health service changes. AusHSI also supported the project’s research and translation activities by providing:

  • an Implementation Scientist to help develop an evaluation strategy
  • training in implementation science as well as opportunities for the team to discuss their project with international leaders in implementation science
  • dissemination and networking activities
  • identification of stakeholders
  • advocacy for a wider implementation of the project’s innovation in health service

Outcomes

The evaluation of the KSCp demonstrated the value of providing person-centred programs for the management of patients required to make complex health decisions. These programs support patients to achieve the right care in the right place. Fifty-nine percent of KSCp patients reported an improvement in overall symptom burden and 75% of deaths were reported to have occurred at the patient’s preferred final place of care.

As a result of the evaluation and development project with AusHSI, the KSCp has achieved the following:

  • progression from a pilot proof-of-concept program to a sustainable usual care service, with ongoing recurrent funding obtained from MNHHS
  • potential for translation into a clinical blueprint for support care programs across Queensland Health
  • a Clinical Excellence and Patient Safety Award as part of the 2017 ACHS Quality Improvement Awards
  • a Health Services and Implementation Research Award as part of the 2017 MNHHS Research Excellence Awards
  • highly satisfied patients and carers
  • strong clinician and health executive engagement
  • growing research reputation of the team.