Pathways Project: Kidney Supportive Care

Completed

Conditions studied: Kidney Diseases, Chronic Kidney Diseases, End Stage Renal Disease, End Stage Renal Disease on Dialysis, Chronic Kidney Disease Requiring Chronic Dialysis

In brief

The Pathways Collaborative is the first attempt to implement supportive (palliative) kidney care at multiple sites in the United States. While supportive kidney care is growing in other countries, notably Canada, Australia, and Great Britain, it is not yet known how to integrate it into the unique nephrology environment in the United States. In Phase 1 of Pathways (completed), we developed an evidence-based change packet of 14 best practices for integrating supportive care practices into the continuum of care for patients with end stage kidney disease (ESKD). In Phase 2 (described in this application), we will conduct a learning collaborative to help up to 15 dialysis and CKD centers implement these best practices. The learning collaborative is based on the IHI Collaborative Model for Achieving Breakthrough Improvement. This model is a tested systematic approach to quality improvement designed to help organizations close the gap between current and future practice based on evidence-based best practices. The Pathways Project faculty will work with up to 15 change teams at dialysis centers to create a system to identify seriously ill patients with kidney disease; conduct conversations with them so that their values, preferences, and goals for current and future medical treatment are known and respected; assess and address patients' physical, psychological and spiritual needs; and coordinate care throughout the healthcare system so patients receive only the care they want in settings in which they wish to be.

Key facts

Study ID

NCT04125537

Run by

George Washington University

People needed

476

Starts

2018-11-01

Expected to finish

2020-10-31

Last updated by the study team

2023-09-13

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Criteria
• Patients at least 18 years old who are currently being treated by participating dialysis center.
• Dialysis patients identified as "seriously ill" by screening with "surprise question"- a validated tool that identifies patients with elevated mortality risk. The treating nephrologist or nurse practitioner or dialysis nurse answers whether they would be surprised if the patient died in the next 6 months.

You may not qualify if…

• Patients with impaired cognitive decision making processes as determined by a screening tool.
• Patients who speak language other than English or Spanish.

Where it is running

• Kidney Center of Arvada — Arvada, Colorado, United States
• Thornton Kidney Center — Thornton, Colorado, United States
• Kidney Center of Westminster — Westminster, Colorado, United States
• George Washington University — Washington D.C., District of Columbia, United States
• Washington DC VA Medical Center — Washington D.C., District of Columbia, United States
• Atlantic Dialysis Astoria — Astoria, New York, United States
• Rogosin Institute Auburndale — Flushing, New York, United States
• Atlantic Dialysis Newton — Long Island City, New York, United States
• Rogosin Institute Manhattan East — New York, New York, United States
• Atlantic Dialysis Ridgewood — Ridge, New York, United States
• Rogosin Institute Woodside — Woodside, New York, United States
• Dallas Nephrology Associates — Dallas, Texas, United States
• Desoto Regional Dialysis Center — DeSoto, Texas, United States

Full record on ClinicalTrials.gov

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