Thursday, August 11, 2011

Self-dialysis in Sweden

Ryhov Hospital in Jönköping, Sweden, had a traditional hemodialysis and peritoneal dialysis center. Now they aim to have 75% of patients be on self-dialysis.

Read that again.

When Maureen Bisognano, CEO of the Institute for Healthcare Improvement, told me this story, I was blown away.  How could this happen?  Here are some of her slides from a recent presentation.

In 2005, a patient named Christian asked about doing it himself.  The nurse in charge thought about it and thought that he could pull it off.  She had trained many other nurses in the procedure, so she just trained him in the same sequence.  Then it went viral. 


They currently have 60% of their patients on self-dialysis and hope to reach 75%.  Christian reports:

The nurse leader says:


Did you notice that?  1/2 to 1/3 less cost per patient.  Better outcomes, far fewer complications and infections.

A staff nurse says:

Did you notice that?  Instead of engaging in vulnerable and helpless behavior during treatment, the patients were energized and would exercise.

What does all this mean?


I can already hear the objections.  "Our patients are sicker."  "The Swedes are all the same ethnicity."  "It would never work here."

Right.

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