Operationalizing anemia management: organizing the program and coordinating the team.
Data indicate that a significant percentage of dialysis patients do not achieve the hemoglobin (Hb) target range of 11 to 12 g/dL. Our dialysis facility undertook a quality improvement program to assess and modify the processes affecting anemia-related outcomes. A 30% reduction in the percentage of patients with Hb levels below 11 g/dL was achieved by: (a) empowering an anemia manager to coordinate the team quality improvement effort, (b) integrating the Epotein alfa and iron protocols, (c) implementing a dose titration model for patients with Hb levels in the upper end of the target range, and (d) devising a "rapid ramping" protocol to ensure timely achievement of target Hb levels in patients who were new to dialysis or returning to the facility after hospitalization.
Krishnan
Mahesh
M
Gambro Arlington, USA.
Adams
Evelyn
E
D000368:Aged; D000740:Anemia / Q000097:blood / Q000628:therapy*; D002985:Clinical Protocols; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000008:administration & dosage / Q000627:therapeutic use; D006454:Hemoglobins / Q000032:analysis; D006760:Hospitalization; D006801:Humans; D007501:Iron / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008991:Monitoring, Physiologic; D017064:Process Assessment, Health Care; D011994:Recombinant Proteins; D006435:Renal Dialysis
D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068817:Epoetin Alfa; D007501:Iron