how to increase patients’ adherence to homedialysis · digital care pathway in pre dialysis and...
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HOW TO INCREASE PATIENTS’ ADHERENCE TO HOMEDIALYSISPIRGIT SILVAST-ÄIKÄS
DEPUTY WARD MANAGER IN DIALYSIS TRAINING CENTER
PROJECT CORDINATOR IN KIDNEY HOUSE
BACKGROUND
DIALYSIS TRAINING CENTER IN HUS IN THE YEAR 2017
Peritoneal Dialysis = PD
• 98 patients active in PD in the end of 2017
• 47 new patients,
• Training time 1-2 weeks
Homehemodialysis = HHD
• 72 acitive patients in the end of 2017
• Training time 4-6 weeks
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BACKGROUND
PROBLEMS TO BE SOLVED
• Some choose the dialysis modality with very little
knowledge of different options.-> Adherence to the
chosen dialysis modality is low
• Training time is short and patients get a lot of new
information
• In the training period it takes most of the time to learn
new technical skills
• Patients remember only minor part of the
instructions
• Patients have assistants who need to get advice as well
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OBJECTIVE
TO INCREASE UNDERSTANDING OF KIDNEY DISEASES , TREATMENTOPTIONS AND DIALYSIS, SO THAT
• All citizens can take better care of their kidneys
• Patients understand the key points of kidney diseases and itstreatment
• Patients in all parts of Helsinki University district have equalknowledge of kidney trasnplantation and dialysis options
• Every kidney patient knows that you can do dialysis at home
• Every patient can have better instructions and rehearsethem at home
• To get safier treatment
• Patients stay at home longer
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METHODS
WHAT HAVE WE DONE SO FAR? A BIG TABLET FOR PD PATIENTS
We lend a big tablet which
contains step by step
instructions to CAPD and
APD
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METHODS
AND VIRTUAL KIDNEY HOUSE IN HEALTH VILLAGE
• Kidney
house in
so called
• ”Terveys-
kylä”
• Health
Village
• In the
Internet
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KIDNEY HOUSE HTTPS://WWW.TERVEYSKYLA.FI/MUNUAISTALO
• One part is open to
all citizens
• One part patients’
personal Digital
carepathways
• One part is open to
professionals
METHODS
KIDNEY HOUSE IS OPEN TO EVERYBODY 24/7
• Contents:
• Kidneydiseases in common
• Acute kidneyinjury
• Cronic Kidneydisease
• Dialysistreatments
• Kidneytransplantation
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METHODS
PILOT IN OCTOBERFOR PATIENTS IN PREDIALYSIS STAGE
• Patient cando
• ”DialysisModalityChoosingCourse” digitally
• =Digital carepathway to Dialysis
• Open only to predialysispatients
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CONTENT OF THESE DIGITAL DIALYSIS CARE PATHS
•
METHODS
”DIALYSIS MODALITY CHOOSING” -DIGITAL PATHWAY
• Modality choosing
– How to cope with forthcoming
dialysis.
– PD and HHD videos made
with patients in their homes
– 11 videos in all
– Social issues
– Nutrition issues, videos
– Questionaries
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METHODS
DIGITAL CARE PATHWAY IN PRE DIALYSIS AND IN TRAINING
• One path containsmaterial before PD and other path beforeHHD
• Instructions to operations, how to manage the machineetc
• One part contains allthe training material to PD or HHD
• Can be ”opened” to patients partly
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RESULTS
ENCOURAGING RESULTS FOR THE USE OF TABLET
• Both patients and nurses valued tablet very useful.
• Patients were positively influenced to take better care
of themselves after watching teaching material from
tablet.
• Patients reported that tablet was easy to use, even to
them who had no experience of computers.
• Content of the tablet was illustrative, useful and
added patients’ sense of security.
• All the patients and nurses could recommend the use of
tablet to the others.
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RESULTS
CUSTOMERS/ PATIENTS INCLUDED IN DEVELOPMENT
CROWDSOURCIN
GENGAGING TEST PANEL
CUSTOMER
PANEL
Mapping
otakantaa.fi
Service planning
Experience experts
ProductionImplementation
Constant
improvement
CONCLUSION
OUR SERVICES NOW ... AND IN THE FUTURE
