Reducing early mortality in patients on dialysis: lessons from the RightStart program.
RightStart, a specially designed program for patients new to dialysis, incorporates case manager-driven patient education, encouragement, and empowerment in conjunction with facilitation of prompt and appropriate care provided by the interdisciplinary team. Compared with patients who were not in RightStart, participants exhibited a 41% decrease in the risk of death within the first 90 days of dialysis (hazard ratio 0.59, P < 0.001). The results suggest that a program targeted to new patients on dialysis can significantly reduce early mortality and morbidity while increasing job satisfaction for professionals in the case manager role.
Wingard
Rebecca
R
Fresenius Medical Services, Brentwood, TN, USA.
D019985:Benchmarking / Q000458:organization & administration; D019090:Case Management / Q000458:organization & administration*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D009017:Morbidity; D024802:Nurse's Role; D010348:Patient Care Team / Q000458:organization & administration*; D010353:Patient Education as Topic / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D015397:Program Evaluation; D016016:Proportional Hazards Models; D006435:Renal Dialysis / Q000009:adverse effects / Q000401:mortality / Q000451:nursing* / Q000592:standards*; D012307:Risk Factors; D040242:Risk Reduction Behavior; D017749:Total Quality Management / Q000458:organization & administration*; D014481:United States / Q000453:epidemiology