Table 7 Summary of actions taken by hospitals to increase the uptake of home dialysis
Actions taken | Hospitals | |||
|---|---|---|---|---|
1 | 2 | 3 | 4 | |
Resources | ||||
Significant additional resources secured from the hospital for staff and home dialysis machines | ✓ | ✓ | ✓ | ✓ |
Forward-looking resource and capacity plan developed for achieving the 2015 target for home haemodialysis | ✓ | |||
Widening access | ||||
Assisted PD introduced to widen access to more frail patients or those living alone | ✓ | ✓ | ✓ | ✓ |
Rapid/direct access to PD for acute patients to prevent acute patients automatically going onto in-centre haemodialysis | ✓ | ✓ | ✓ | ✓ |
Rapid PD catheter insertion | ✓ | ✓ | ||
Solo home haemodialysis introduced, so patients do not need to have a carer involved | ✓ | |||
Portable home haemodialysis machine introduced | ✓ | |||
Self-care/minimal care routinely available in in-centre haemodialysis units as a possible stepping stone to home haemodialysis | ✓ | |||
One-off reviews of in-centre haemodialysis patients’ treatment options | ✓ | ✓ | ✓ | |
In-centre haemodialysis patients successfully switched to home dialysis | ✓ | |||
Peer support | ||||
Peer support scheme for patients interested in home haemodialysis | ✓ | |||
Informal peer support available for patients interested in home dialysis | ✓ | |||
Staffing, training and induction | ||||
Home dialysis included in the induction of all new staff | ✓ | ✓ | ||
Staff rotation used to increase staff knowledge of home dialysis | ✓ | ✓ | ||
Hospital support | ||||
Visible support secured from hospital senior management | ✓ | ✓ | ||
Home dialysis targets deliberately aligned with the hospital’s strategic plan | ✓ | ✓ | ✓ | |
Approach to the target | ||||
Focus on increasing both home haemodialysis and PD uptake | ✓ | ✓ | ✓ | |
Focus solely on increasing home haemodialysis | ✓ | |||