title: Developing a CKD registry in primary care: provider attitudes and input.
abstract: BACKGROUND
  Chronic disease registries have been successful at promoting the delivery of guideline-concordant primary care for patients with diabetes and hypertension, but not for chronic kidney disease (CKD). To understand whether a registry could be designed to improve CKD management in primary care, we explored primary care provider attitudes about the benefits (or lack thereof) of a CKD registry compared with other chronic diseases and the key facilitators of successfully implementing a CKD registry in safety-net primary care.
  
  
  METHODS
  Qualitative, using semistructured interviews.
  
  
  METHODS
  We conducted and recorded semistructured 1-hour interviews with medical directors and quality improvement champions from safety-net adult primary care clinics in San Francisco.
  
  
  METHODS
  Recordings were transcribed and analyzed using a grounded theory approach until thematic saturation was achieved.
  
  
  RESULTS
  20 primary care providers were interviewed. 4 themes relevant to the development of a successful CKD registry for safety-net primary care were identified: (1) provider beliefs that a CKD registry could aid in the delivery of team-based high-quality CKD care; (2) clinic workflow redesign and staffing are key facilitators to successful implementation of a CKD registry; (3) unique complexities of CKD, such as varying etiologies, may limit the use of a CKD registry by nonphysicians; and (4) a CKD registry is aligned with current primary care priorities and health care delivery strategies.
  
  
  CONCLUSIONS
  Small sample size and reliance on clinician leaders within one health care delivery system.
  
  
  CONCLUSIONS
  A CKD registry directed at the entire health care team, with the functionality to track, standardize, and enhance CKD care through decision support, has the potential to improve the management of CKD in safety-net primary care settings. These data directly informed the development of a CKD registry in these settings in San Francisco.
authors.affiliation: Johns Hopkins School of Medicine, Baltimore, MD.
authors.forename: Dannielle
authors.initials: D
authors.lastname: McBride
authors.affiliation: Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA; Department of Anthropology, History and Social Medicine, University of California, San Francisco, CA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Dohan
authors.affiliation: Division of General Internal Medicine at San Francisco General Hospital, University of California, San Francisco, CA; Center for Vulnerable Populations, San Francisco General Hospital, University of California San Francisco, San Francisco, CA.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Handley
authors.affiliation: Division of General Internal Medicine at San Francisco General Hospital, University of California, San Francisco, CA; Center for Vulnerable Populations, San Francisco General Hospital, University of California San Francisco, San Francisco, CA.
authors.forename: Neil R
authors.initials: NR
authors.lastname: Powe
authors.affiliation: Division of Nephrology at San Francisco General Hospital, University of California San Francisco, San Francisco, CA. Electronic address: delphine.tuot@ucsf.edu.
authors.forename: Delphine S
authors.initials: DS
authors.lastname: Tuot
mesh_terms: D001291:Attitude of Health Personnel; D003661:Decision Support Techniques; D019468:Disease Management; D005260:Female; D006292:Health Priorities; D006801:Humans; D008297:Male; D011320:Primary Health Care; D016730:Program Development; D012042:Registries / Q000592:standards; D051436:Renal Insufficiency, Chronic
keywords: Chronic kidney disease (CKD) registry; chronic disease management; chronic kidney disease (CKD) awareness; decision support; guideline implementation; health information technology (IT); primary care; safety net