An ounce of prevention is worth a pound of cure. Just ask Dr. David Perkins, Division Head, Nephrology for Trillium Health Partners’ Regional Chronic Kidney Disease Program. The old adage is the philosophy behind the hospital’s new Regional Nephrology Clinic’s mandate to help patients with kidney disease manage their illness better in order to slow its progression and delay the need for treatment such as dialysis.
“The Regional Nephrology Clinic is really focused on getting our patients the best possible care at the right time,” says Dr. Perkins. “We know that patients with chronic kidney disease benefit from being seen by a nephrologist early in the onset of their disease. By making it easier for primary care providers and specialists to refer their patients for renal assessment to the clinic, and for patients and their families to receive the care, education, and support they need, we are helping to improve the quality of care and treatment and slow down disease progression.”
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Launched this past April, the clinic is located on the main floor of the Carlo Fidani Peel Regional Cancer Centre and Ambulatory Care building at Credit Valley Hospital and is staffed with a team of experts. Nurses, nephrologists and clinical educators incorporate best practices in chronic disease management including self management and education.
The clinic features a new centralized intake model, which is the key to the method of prevention. Using a simple, standardized referral form, primary care providers and specialists now have a single point of contact for their referral, and appointments can be made within days.
In the past, there were challenges ensuring patients with kidney disease had quick access to the most appropriate care. Primary care physicians would refer their patients with kidney disease to a nephrologist. But as with many specialist referrals, securing an appointment could take months. In the meantime, there could be visits to pharmacists for medication to manage the symptoms all while waiting in the community. By the time patients met with nephrologists, the disease may have progressed beyond early stages.
”It can be frustrating for patients who had to make multiple trips from primary care to pharmacists and then back again. If they missed an appointment it could be weeks or months before they were seen again,” says Sandy Beckett, Manager, Regional Chronic Kidney Disease Program.
Once patients are diagnosed by a nephrologist, they meet with a nurse who provides education on managing their disease, and helps them understand options for treatment. This enables patients to make better decisions, sooner.
This type of early intervention also brings families into the equation so they will have the information they need to assist with managing the disease at home.
For the patient, the convenience of going to one location to meet with health care providers, receive information and pick up medication can make the task of disease management that much easier.
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“It’s a much more proactive, patient-centered model of care, as opposed to a provider-centric model,” says Beckett. “Now, there is one entry-point.”
In addition, once patients enter the clinic’s system they are easily tracked. Not only does this allow for closer monitoring of the patient’s progress, but it enables Trillium Health Partners to compile data for research that can eventually lead to better health care outcomes.
The clinic is aligned with the Ontario Renal Network (ORN), the provincial government’s advisor on renal care in Ontario. ORN provides overall leadership and strategic direction to organize and manage the delivery of dialysis and chronic kidney disease services in Ontario.
“At ORN, our mission is to work together with our regional partners, patients and stakeholders to improve the life of every person in Ontario with kidney disease,” says Dr. Peter Blake, ORN provincial medical director. “This new clinic aligns with the Ontario Renal Plan, which lays out strategic priorities aimed at delivering high quality patient-centred care while driving improvements in the renal system. We are extremely pleased to support and help improve care for chronic kidney disease patients in the community.”
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The establishment of the Regional Nephrology Clinic supports Trillium Health Partners’ strategic priority to provide the right care in the right place at the right time. The clinic’s centralized intake approach will bridge gaps to improve the patient’s journey, deliver better patient outcomes and respond to the most pressing needs of patients with chronic disease.
As Ontario’s population continues to grow and age, the prevalence of chronic kidney disease is expected to rise. According to the Kidney Foundation of Canada, approximately, 1 in 10 Canadians has kidney disease, while an estimated 1.5 million Ontarians have or are at increased risk for developing kidney disease.
