Amherst Dialysis staff honored with End Stage Renal Disease Patient Safety Improvement Award

Laura Simms has spent 12 hours a week receiving hemodialysis treatment since last fall, when her kidneys failed as a result of high blood pressure. The 50-year-old Monroe resident says the staff at University of Virginia Health System's Amherst Dialysis clinic have become like family to her.

"They pamper you," she said. "They are continuously checking on you, making sure you're okay and asking if they can get you anything. I'm very pleased, and I love the staff there."

Recently, the Renal Physicians Association recognized the dedication of the Amherst Dialysis staff with its second annual End Stage Renal Disease Patient Safety Improvement Award. Amherst Dialysis was nominated by Mid-Atlantic Renal Coalition Executive Director Nancy Armistead, MPA, and board member Frank Maddux, MD. The award is given annually to nephrology professionals who submit their best practices to the Keeping Kidney Patients Safe website. UVA's submission addressed hand hygiene, patient falls and adherence to protocols.

W. Kline Bolton, MD, professor of internal medicine in the Division of Nephrology at the UVA School of Medicine and medical director of UVA Renal Services, accepted the award on behalf of the Amherst Dialysis staff at the RPA's annual meeting earlier this month.

Hemodialysis removes harmful waste products and excess fluid from the blood, replicating some of the functions healthy kidneys normally perform.

Kim Smith, RN, CHN, CNN, Amherst's RN administrative coordinator, wrote in the Keeping Kidney Patients Safe submission that the dialysis facility used the educational modules offered by the Mid-Atlantic Renal Coalition's 5-Diamond Safety Program to educate its 35-person staff on various patient safety topics, including emergency preparedness, medication reconciliation, hand hygiene and fall prevention. Staff then formed eight groups, and each month, one group was responsible for presenting a patient safety topic to fellow employees and patients.

The presentations prompted staff to implement many new safety practices and educational tools for the facility's 96 patients. Those included auditing to identify safety concerns and to ensure that handwashing protocol was followed, adding more hand sanitizer stations throughout the facility, and taking surveillance cultures to identify earlier potential cases of MRSA and other infections. The clinic's Continuous Quality Improvement Committee also developed a brochure to educate patients on infection prevention and a patient newsletter and now offers nutrition education.

As a result, patient satisfaction scores have increased. In a December 2009 survey, 94 percent of the clinic's patients said that they were satisfied with the effectiveness of patient education and the availability of medication information. Ninety-nine percent were satisfied with the "degree to which staff explain." In June 2008, the scores for those same items were 78 percent, 79 percent and 78 percent, respectively.

"The staff really got behind the education and safety measures, and as a result, all of our numbers have really improved," said Richard Giles, MD, medical director of Amherst Dialysis and an assistant clinical professor in the University of Virginia School of Medicine's Department of Internal Medicine. "Ninety-six percent of our patients were vaccinated for seasonal flu this year, which is really outstanding. More patients are exercising. Patient falls have decreased. Infection rates have decreased significantly. Seeing these positive outcomes has encouraged the staff to learn even more and share their knowledge."

The clinic's 5-Diamond status from the Mid-Atlantic Renal Coalition has also been extended through March 2012. More information about the 5-Diamond program is available here.

Mark Okusa, MD, chief of the Division of Nephrology at the UVA School of Medicine, and Larry Fitzgerald, UVA Medical Center associate vice president for business development and finance, visited the clinic March 22 to congratulate the staff. "They are really excited to see their hard work recognized by a national organization," Okusa said. "Their tremendous dedication is obvious both in their interactions with their patients and in their careful attention to safety and infection prevention. What's significant about this award is that these efforts really do have a direct benefit to the patients."

Several other UVA services are recognized as having best practices on the Keeping Kidney Patients Safe website. UVA Renal Services is recognized for hand hygiene, and the Altavista Dialysis center is recognized for fall prevention.

UVA Renal Services operates eight hemodialysis facilities throughout central Virginia. Patients with kidney failure must undergo some form of regular dialysis treatment or receive a kidney transplant. Hemodialysis patients typically require the treatment for nine to 12 hours a week.