title: Shared care, home haemodialysis and the expert patient.
abstract: BACKGROUND
  The key emphasis for health care is to increase patient choice whilst improving effectiveness. Our Haemodialysis Unit in the UK improved standards and patient choice by introducing a 'shared-care' programme-a programme that enabled our patients to manage their own care with nursing support.
  
  
  OBJECTIVE
  The main aims of the programme were to increase efficiency by reviewing home haemodialysis (HHD) processes, reduce waiting times (mean six months), increase patient choice and implement a self-management programme which could be adapted for any patient.
  
  
  METHODS
  A training package was developed using audit results and consultation with patients. All aspects of renal failure and dialysis were included and a training aid was developed to support the package.
  
  
  RESULTS
  Forty-eight percent (69/145) of patients in the unit expressed an interest in taking part in shared care. Thirty-five patients were involved in the pilot, 7 have transferred to HHD, 18 wish to remain in the unit. After training, all patients were able to choose more convenient haemodialysis times. The waiting time for HHD reduced to 10-12 weeks following a seamless transfer from shared care.
authors: Hull & East Yorkshire Hospital Trust, Kingston upon Hull, UK. sharon.appleby@hey.nhs.uk
authors: Sharon
authors: S
authors: Appleby
mesh_terms: D001071:Appointments and Schedules; D002755:Choice Behavior; D003299:Cooperative Behavior; D019091:Critical Pathways; D006436:Hemodialysis Units, Hospital; D006437:Hemodialysis, Home / Q000451:nursing* / Q000523:psychology; D006801:Humans; D007318:Inservice Training; D033183:Interdisciplinary Communication; D007676:Kidney Failure, Chronic / Q000451:nursing* / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010353:Patient Education as Topic / Q000379:methods; D063868:Patient Outcome Assessment; D010358:Patient Participation / Q000523:psychology; D010360:Patient Transfer; D010865:Pilot Projects; D012648:Self Care / Q000379:methods / Q000523:psychology*; D020377:Self Efficacy; D006113:United Kingdom; D014850:Waiting Lists