Amy D. Waterman, Christina Goalby, Shelley S. Hyland, Melanie McCabe and Katrina M. Dinkel
When senior leadership endorses quality improvement priorities, their staff is more likely to comply. To honor Centers for Medicare and Medicaid Services’s (CMS) mandates, dialysis clinic managers must ensure that transplant education takes place within their centers. We surveyed 131 dialysis clinic managers in End Stage Renal Disease (ESRD) Network 12 (the Heartland Kidney Network) to understand their transplant attitudes, knowledge, active educational programs, and perceived barriers to transplant. Few reported that there was a designated transplant educator (40%) or formal transplant education program (33%) available at their dialysis centers. Transplant education most commonly occurring with all patients included educators (53%) or physicians (49%) discussing transplant with the patient, giving them handouts or brochures (40%), the transplant center phone numbers (36%), and referring them to other transplant educational resources (22%). Over half were dissatisfied with transplant education available (56%) and felt that their educators did not have sufficient time to educate (57%). Most did not know that a kidney transplant from a living donor is expected to last 15-20 years (78% incorrect) or that almost 90% of kidneys function for at least one year (71% incorrect). Managers with formal transplant education programs in their dialysis centers were more likely to report that their patients were talking to educators (80% vs. 49%, χ2=11.13, p<.01) and given handouts or brochures about transplant (67% vs. 33%, χ2=14.63, p<.01). Unless dialysis corporations implement specific transplant education policies and procedures, transplant centers support these initiatives, and CMS ensures compliance, transplant education within dialysis centers will be intermittent.
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