For Your Practice

Home allows you to see more patients in your practice

Adapting to greater time constraints

By 2020, End-Stage Renal Disease (ESRD) patient prevalence is expected to exceed 770,000, a 15-fold rise since 1980.1 The rapid rise in ESRD cases is straining resources at a time when fewer medical students are specializing in nephrology, and while half of U.S. nephrologists are projected to retire in the next 20 years.2 For nephrologists to address growing patient incidence rates, it may be necessary to balance time spent in practice attending to Chronic Kidney Disease (CKD) patients with managing rounds for in-center dialysis patients.

 

Increase care and staff efficiencies

While nurses and other physician extenders can help, hiring qualified staff can be expensive. Peritoneal Dialysis (PD) allows staff resources to go further because home patients usually only require one physician visit per month, which can be accomplished during usual rounds. This permits nephrologists to see more patients—both dialysis patients and patients in earlier stages of CKD—while also allowing those visits to be high-quality, one-on-one consultations. 

 

Additional reimbursement for Kidney Disease Education

Changes in Centers for Medicare and Medicaid Services rules allow practices to bill for Kidney Disease Education (KDE) sessions, and extend this benefit earlier, so that patients in stage 4 CKD can become more knowledgeable about slowing the progression of the disease and study therapy options before the need for dialysis becomes urgent. With the time saved visiting dialysis patients, nephrologists can better attend to CKD patients. 

 

Patients first

Home therapies can provide efficiencies without sacrificing patient care. Educating patients about home therapy options empowers each patient as an individual with unique lifestyle, scheduling and care concerns. Many facilities are open to developing or expanding their home programs, and you can work in partnership with them, and with Baxter, to help clinically-appropriate patients move home with confidence.

 

Working together to care for patients

How a PD program operates: overview of the care team roles. Click on a title to learn more about each role.

For Your Facility

Home can extend your facility to help more dialysis patients

In the United States in 2007, there were 367,704 patients on dialysis, a number expected to swell to 774,386 patients in 2020.3 A home program can help your dialysis facility enhance its operations to continue providing excellent care in a more challenging environment.

Coping with the nursing shortage

It is estimated that the U.S. shortage of registered nurses will reach one million by 2020.4 Home helps you stretch your staff to accommodate the growing population of End-Stage Renal Disease patients. With home, one nurse can manage approximately 20 patients. With In-center Hemodialysis, one nurse and three technicians support just 12 patients per shift.

Making the most of existing infrastructure

Nearly half of all dialysis facilities in the U.S. are reaching full capacity, but financial and regulatory barriers often stand in the way of building new facilities.5 A home program lets you handle more patients without adding chairs or square footage.

Putting patients first

The option to choose a home therapy empowers patients as individuals with unique lifestyle, scheduling and care concerns. Working in partnership with your referring nephrologists and with help from Baxter, you can move clinically appropriate patients home with confidence.

 

Working together to care for patients

How a Peritoneal Dialysis program operates: overview of the care team roles. Click on a title to learn more about each role. 

  • Refers ESRD patients to education sessions
  • Identifies patients who need dialysis
  • Specifies clinically appropriate modality or modalities
  • Identifies possible catheter placement sites
  • Monitors patients monthly for dialysis adequacy
  • Educates patients on modality options or works closely with educators
  • Communicates with patients, physicians, dialysis facilities and hospitals as needed to initiate PD
  • Answers questions and ensures patients understand instructions
  • Maintains relationships with dialysis facilities
  • Builds long-term relationships with PD patients
  • Maintains relationships with nephrology practices
  • Trains patients on PD therapy
  • Assesses possible complications of PD
  • Works to resolve wide scope of patient issues
  • Coordinates lab work on monthly check-in visits with care team
  • Possesses an assertive, enthusiastic and responsive attitude regarding PD
  • Builds long-term relationships with PD patients
  • Aids in patient modality selection and training
  • Maintains relationship with entire care team to inform of patient status
  • Builds long-term relationships with PD patients
  • Communicates with patients and nephrology practices regarding catheter placement issues
  • Develops expertise in PD catheter placement
  • Places catheters
  • Cares for patients during catheter placement procedures
  • May provide urgent start PD or supine PD during patient hospitalizations
  • Engage in dialysis decision-making process
  • Participate in patient education sessions and home training
  • Comply with diet, medication and lifestyle requirements
  • Follow home PD prescribed regimen
  • Provides consulting services for a reasonable fee with nephrology practices and dialysis facilities on building a home program
  • Educates nurses, social workers, patients, nephrologists and others on Baxter products and related therapies
  • Provides patients with cyclers, PD solution and 24/7 support through Baxter HomeCare Services

 


1 USRDS 2009 Annual Data Report: Atlas of End-Stage Renal Disease in the United States, Vol. 2, 2009; 174–417, U.S. Renal Data System.
2
Bizzozero, Judie. Is there a nephrologist in the house? Renal Business Today. October 2009; 4:14–18.
3
USRDS 2009 Annual Data Report: Atlas of End-Stage Renal Disease in the United States, Vol. 2, 2009; 174-417, U.S. Renal Data System.
4
What Is Behind HRSA’s Projected Supply, Demand, and Shortage of Registered Nurses, September 2004; First Consulting Group, Projections based on HRSA; available at http://www.fcg.com.
5
ESRD Network Data, 2006; Center for Medicare and Medicaid services.

Continue providing excellent care in a more challenging environment.