• J Pain Symptom Manage · Dec 2022

    Creating KidneyPal: A Specialty-Aligned Palliative Care Service for People with Kidney Disease.

    • Joshua R Lakin, Kate Sciacca, Richard Leiter, Kelsey Killeen, Samantha Gelfand, James A Tulsky, Shelly Anderson, Sophia N Zupanc, Trey Williams, and Ernest I Mandel.
    • Division of Palliative Medicine (J.R.L., K.S., R.L., S.G., J.A.T), Brigham and Women's Hospital, Boston, Massachusetts; Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute (J.R.L., K.S., R.L., K.K., S.G., J.A.T, S.N.Z., T.W.), Boston, Massachusetts; Harvard Medical School (J.R.L., R.L., S.G., J.A.T, E.I.M.), Boston, Massachusetts. Electronic address: jlakin@partners.org.
    • J Pain Symptom Manage. 2022 Dec 1; 64 (6): e331e339e331-e339.

    BackgroundPatients with kidney disease have notable unmet palliative care needs and represent an underserved population for specialty palliative care teams.InterventionWe designed a specialty-aligned interprofessional palliative care service called KidneyPal that is aimed at improving delivery of palliative care to patients with kidney disease through focus groups and iterative improvement cycles.MeasuresWe iteratively measured the development of KidneyPal through clinical process metrics: percent of the inpatient nephrology census followed by KidneyPal, patient demographics, consult origin, clinician feedback, and self-reported team interventions.OutcomesKidneyPal saw 314 unique patients from January 2019 to January 2021. The majority of consultations came from nephrology services though the source of consultation changed over time. We consulted on an average of 13.5% of the entire inpatient nephrology patient hospital census with highest involvement with patients on the inpatient nephrology hemodialysis service (mean of 29.9%). KidneyPal was rated highly by surveyed nephrology clinicians and provided high rates of psychosocial support and goals of care interventions.Lessons LearnedThe creation of KidneyPal led to us to serve a new cohort of patients with specialty palliative care. We grew over time to serve the full range of patients with kidney disease as defined by our nephrology service lines. We succeeded in doing so by embedding in nephrology and building relationships with those caring for people with kidney disease while tailoring our service and interventions over time.Copyright © 2022 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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