Factors | Demonstrated by |
---|---|
Clinical pathway | A clear and up-to-date home dialysis pathway is in place and used by staff |
Patient choice of treatmenta | Patients are provided with timely and relevant information in a variety of formats to support their choice of treatment |
Staff promote home dialysis positively | |
Equipmenta | There is an appropriate range of dialysis equipment available |
All staff have a good working knowledge of the dialysis equipment | |
Patients can try out equipment before making a choice about treatment | |
Property adaptations are timely | |
Technical support, maintenance and adjustment to dialysis equipment is provided | |
Patient training and supporta | High-quality patient training for home dialysis is provided using a variety of methods and techniques |
Peer support is available | |
Ongoing support is provided to patients and carers | |
Patient feedback | Patient and carer feedback mechanisms are in place and are used by staff to adjust how they work |
Vision | All staff share the vision and understand the home dialysis target |
Leadership | There is visible and clear clinical and managerial leadership for home dialysis from trusted and influential individuals |
Leaders take personal responsibility, giving time to be involved and actively promote home dialysis | |
Mechanisms are in place and used to overcome resistance to change | |
Staffing | Staffing competencies, grades and levels are consistent with the target |
The home dialysis target is reflected in job descriptions and appraisals | |
Skill and training gaps are identified; training and development is put in place to address gaps | |
Culture | Staff have positive attitudes and support the target |
Staff at all levels are involved in planning and making changes to home dialysis, and their ideas and input are valued and used | |
Innovation and change are actively promoted and staff are encouraged to try out new ideas for home dialysis in practice | |
Resources | Sufficient resources are available to meet the target (staff, equipment and funding) |
Strategy | The target contributes to the organisation’s current vision and strategy and is reflected in existing plans |
There is director-level sponsorship and senior leaders understand and actively promote the target | |
Incentives | Incentives for home dialysis are aligned with achievement |
Policy | National and regional policy supports the target |
Commissioning | The commissioner’s strategy and contracting is aligned with the target |
The tariff and incentives/penalties are aligned with the target | |
Level 5: change management [20] | |
Planning | A clear and realistic plan is in place for increasing uptake rates |
The baseline is mapped, and timely and accurate information is available to track progress | |
Achievement against the plan is reviewed regularly, communicated to staff and adjusted when needed | |
Resources | Staff with the right skills and available time are leading the required changes |