The Centers for Medicare & Medicaid Services (CMS) has incorporated in the 2018 transplant quality improvement activity (QIA) a series of standardized steps toward transplant. According to the 2012 Clinical Journal of American Society of Nephrology article, “Impact of Navigators on Completion of Steps in the Kidney Transplant Process: A Randomized, Controlled Trial,” these steps were first defined and performed in 23 hemodialysis facilities in Ohio. The steps are: (1) Suitability for Referral to Transplant Center; (2) Interest in Transplant; (3) Referral Call to Transplant Center; (4) First Visit to Transplant Center; (5) Transplant Center Workup; (6) Successful Transplant Candidate; (7) On Waiting List or Evaluating Potential Living Donor.
Research has identified that the guidance offered by a transplant navigator –or mentor- helps patients move further and faster through the seven steps than they would without a navigator. If you are interested in starting a Peer Mentorship Program at your facility, contact the Network.
Did you know that peer mentoring has been proven to be a successful strategy to educate patients about their options for treatment, including transplant? The Network has resources and tools available to help train patients who are interested in becoming peer mentors. Contact the Network today to sign up your facility for the Network’s new peer mentorship training program.
According to the National Kidney Foundation, peer support is reported to be effective in helping kidney patients adjust to kidney disease, long-term dialysis therapy and kidney transplantation. Peer support programs utilize someone who is living with the same disease to assist patients in managing their own health. This can be particularly effective when the patient is newly diagnosed or is having trouble coming to terms with the disease. In addition, peer support has become strongly linked with attempts to increase patients’ ability to self-manage their condition, and the drive to improve healthcare outcomes. Peer support works because patients are able to give each other something the clinician does not have, shared life experience.
A peer mentor empowers fellow patients to move forward with their lives after being diagnosed with ESRD. Peer mentoring provides support and increases the confidence that many new patients need, and offers patients access to someone who has been through the similar experiences and can understand their concerns. Peer mentors can come from all backgrounds. Mentors should be individuals with positive outlooks on managing kidney disease. Individuals who are succeeding at achieving their treatment goals can provide insight to help others successfully manage kidney disease.
In 1988, researchers from the Harvard Medical School, on behalf of the Pickler Institute, developed the model known as the Eight Dimensions of Patient-Centered Care. The model challenges clinicians to cultivate a better understanding of a patient’s illness and address their needs. Secondary to knowledge gain, patients are viewed as equals to clinicians when making decisions about their healthcare.
A component of patient-centered care includes the concept of shared decision making or a process where patients work alongside their clinicians to make decisions about their treatments and care plans. Clinical evidence is reviewed to weigh the risks and outcomes associated with the decisions keeping a focus on the patient’s preferences and values. Benefits that come from patients engaging in the shared decision process include understanding their health along with the pros and cons of different options, being better prepared to collaborate with their healthcare team, and most importantly they are more likely to follow through on their decisions. For more information and tools on shared decision making, visit the New England Journal of Medicine at www.nejm.org and the National Learning Consortium at www.healthit.gov.
The IPRO ESRD Network program provides technical assistance to facilities in multiple ways including education and resources to support patient engagement at the facility level. One way the Network encourages patient engagement is through the assistance we offer to local facilities in implementing or learning more about available peer mentorship/ambassador programs.
According to an article published in 2015, “Potential Impact of Peer Mentoring on Treatment Choice in Patients with Chronic Kidney Disease: A Review,” written by Nasrollah Ghahramani MD, FACP, FASN, peer to peer programs have shown to help patients become more involved in their health care. Patients who work with a peer as a mentor are able to make more informed decisions about their dialysis treatment options and are better informed about transplant processes. Being informed about health care decisions by peers with shared experiences can build self-confidence which then leads to overall better health outcomes.
To read more about Ghahramani’s findings, click here.
To learn more about patient programs offered by your Network or local agencies, contact your ESRD Patient Services Department. Our Patient Services Team is here to assist with resources on the benefits of implementing patient peer programs or other patient support programming at your facility.
For many years, Vocational Rehabilitation (VR) and Employment Networks (EN) were thought of as programs for individuals without a disability. Today, more people with disabilities are finding out that is not true and that VR/EN is more than just about employment. In the article titled “Vocational Rehabilitation for People with Disabilities” Gloria K. Lee describes employment as a fundamental right for people with disabilities. She goes on to define VR from an intervention perspective describing the complex process of VR and the different components involved. By reading this article you will understand the importance of assisting ESRD patients in obtaining in VR/EN services to improve their quality of life.