title: Implementation of an agency to improve chronic kidney disease care in Ontario: lessons learned by the Ontario Renal Network.
abstract: In 2009, Ontario's Ministry of Health and Long-Term Care initiated the transfer of oversight and coordination of chronic kidney disease (CKD) care to the Ontario Renal Network (ORN) under the auspices of Cancer Care Ontario (CCO). The aim was to replicate the quality improvement and change management practices used for cancer control within CKD. Much of the ORN's first three years were dedicated to building the infrastructure necessary to bridge the gap between provincial policy and clinical practice. This article explores the accomplishments, challenges and lessons learned over that period. The results, which are applicable to the management of chronic diseases in Ontario, Canada, and internationally, confirm that sustainable change takes time and requires strong leadership, transparency, accountability and communication, supported by a solid foundation of data and evidence.
authors.affiliation: Director of Clinical Programs and Reporting at the Ontario Renal Network and has worked there since its inception in 2009.
authors.forename: Graham L
authors.initials: GL
authors.lastname: Woodward
authors.affiliation: Senior Manager within the Health System Integration unit of the Waterloo Wellington Local Health Integration Network. Alex was a founding staff member of the Ontario Renal Network, working there from 2009 until 2013.
authors.forename: Alex
authors.initials: A
authors.lastname: Iverson
authors.affiliation: Vice President, Ontario Renal Network, Cancer Care Ontario.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Harvey
authors.affiliation: Professor of Medicine at Western University, London, Ontario; a Nephrologist at London Health Sciences Centre; and Medical Director of the ORN.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Blake
mesh_terms: D006801:Humans; D009864:Ontario; D016730:Program Development; D011785:Quality Assurance, Health Care / Q000379:methods; D058996:Quality Improvement; D012041:Regional Medical Programs / Q000458:organization & administration; D051436:Renal Insufficiency, Chronic / Q000628:therapy*