How a multidisciplinary vascular access care program enables implementation of the DOQI guidelines. Part I.
This comprehensive, proactive, multidisciplinary team approach to access management has enabled the achievement of center-specific best-demonstrated clinical practiCes for vascular access care. It has also resulted in significant cost savings to the health care delivery process. It has not been an easy task; if it were, access care outcomes would be better nationally than they are today. The VACP approach to vascular access care improvement employs four key implementation principles that ensure the success of Gambro's program and form the infrastructure supporting any successful team approach to care. These core processes, known as the four "C's, include: 1. Commitment, 2. Continuous Quality Improvement, 3. Core Competency, and 4. Communication.
Duda
C R
CR
Dialysis Management Medical Group, San Francisco, Calif., USA.
Spergel
L M
LM
Holland
J
J
Tucker
C T
CT
Bander
S J
SJ
Bosch
J P
JP
D001166:Arteriovenous Shunt, Surgical / Q000191:economics / Q000523:psychology / Q000592:standards*; D001900:Boston; D002140:California; D002983:Clinical Competence / Q000592:standards; D003142:Communication; D017046:Cost Savings; D019317:Evidence-Based Medicine; D005845:Georgia; D019983:Guideline Adherence; D006279:Health Maintenance Organizations / Q000592:standards; D006801:Humans; D010348:Patient Care Team / Q000458:organization & administration; D017410:Practice Guidelines as Topic / Q000592:standards*; D016730:Program Development; D011788:Quality of Life; D006435:Renal Dialysis / Q000191:economics / Q000295:instrumentation / Q000523:psychology; D017749:Total Quality Management / Q000458:organization & administration*; D016896:Treatment Outcome