I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: Centers => Topic started by: dwcrawford on March 10, 2009, 09:00:57 PM
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I'd appreciate your opinions. What do you consider important in selecting a dialysis center. Equipment, staff, cleanliness, doctor's access, etc. I'm going to visit some in the next week. What are some clues to watch for?
I'm new to the whole scene so please go easy on the acronyms and other jargon...lol
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I'd appreciate your opinions. What do you consider important in selecting a dialysis center. Equipment, staff, cleanliness, doctor's access, etc. I'm going to visit some in the next week. What are some clues to watch for?
I'm new to the whole scene so please go easy on the acronyms and other jargon...lol
Yes.
Good Luck. I hope you have some good ones close by! :beer1;
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To be honest, when I went on hemo for the 2nd time, I chose one 30 minutes from my home, rather than the one 5 minutes away, because I wanted to be rounded on by the doctors I knew. It turned out to be a good choice, because I have the most caring nurse who works with me. He even serenades me! How funny; he just called me and asked me to come in early today. Wonder if his ears were burning?!
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that's kind of what I'm looking for (information wise) pelerosa (oops). My Neph uses a specific center while others are closer to me. I could save lots of money with the closer ones (I could maybe drive myself vs. an expensive shuttle. But I think you may be right.
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Since I live in northern Massachusetts where the winter weather can make driving treacherous, ease of travel is high on my list of priorities.
I also look for a center which has a surplus of HD machines, so there is never a wait.
The HD center I go to now is about 6 miles from my home. And it's never full.
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I had not a clue on what I should look for but this Davita is about 10 minutes from me and
there is one down the street from it.
My doc said to go to this one and so I did.
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I noticed that Natalie Cole said (in the Larry King interview) that she can eat during her dialysis at Davita.
I think that's an important question to ask when deciding on a clinic.
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Where's the beer! :o
:beer1;
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Zach, which center serves beer? That might make the 4 hours pass faster.
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Noo- you don't want that. Wwhen you dialyze drunk you end up hung over atg the end of it. That would suck.
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When selecting a dialysis center think about:
What mode of dialysis are you going to be doing?
Comfy chairs?
Staff to patient ratio?
Go talk to patients at the center you are going to choose.
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the doctor says if I don't go to the one he supports that I'll have to change nephrologist...It is Davita and the nurses are nice (so far). But it is 9 miles from my house. I think it may be one of the better equiped ones... but what do I know.
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one with nurses who do not put bleach in the machines
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one with nurses who do not put bleach in the machines
:thumbup; good advice
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Flipbob ( :'( ) always said that dialysis is the best thing for a hang-over
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Zach, which center serves beer? That might make the 4 hours pass faster.
When I was traveling (and dialyzing) in Frankfurt, Germany and Innsbruck, Austria.
They also served sandwiches.
:beer1;
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The main thing I look for is if they offer home hemo, and whether or not I would have to change doctors. Other than that, for me every thing else is irrelevant, since I will never return to in-centre if I can possibly avoid it.
Adam
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Adam, what is it about in center that you dislike so much? Should I make extra effort to have home?
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Here's some ideas from ESRD Network of Texas:
http://www.esrdnetwork.org/patients/facility-information/questions.asp
8)
Questions for Patients to ask a Prospective Clinic
Suggested Questions for Patients to Ask a Prospective Clinic
Clinic - Choice of Clinic & Scheduling Treatments
Do I have to get my treatments at the dialysis clinic that my doctor recommends?
What time do I have to be at the clinic for my treatment?
Does the clinic have scheduled start times for treatments? Or are start times first come - first serve?
If I arrive at the scheduled time, how long will I usually have to wait to start my treatment?
Can I choose my dialysis shift, or are dialysis shifts assigned to me?
If I want to work or go to school, can I request the shift that works best for my schedule?
If the dialysis shift that I want is not available, can I be put on a waiting list for that shift?
Questions about Cost:
What will my out-of-pocket costs be at the clinic?
Will the clinic charge me for things that aren't covered by Medicare, insurance or other financial aid?
Transportation:
Does the clinic provide transportation?
Do I have to pay for parking?
Is the clinic close to public transportation like a bus line or train station?
Personal Touch:
Can I visit the dialysis unit and talk to other patients?
Is there a patient from the clinic that I can meet with or call on the phone?
Are there support groups for patients and families at the clinic?
If there are support groups, how often, when and where do they meet?
Clinic Rules:
Can I eat and drink a) in the waiting room and b) in the dialysis treatment area?
Can I have visitors?
Are there rules about when visitors can be in the treatment room?
Can someone (for example, a family member or pastor) sit with me during my dialysis treatment?
Facility Services:
How far is the doctor's office from the clinic?
Do I have to bring my own sheet, blanket and pillow?
Will I have my own TV?
Does the clinic provide headphones for TV and radio to decrease the noise?
What is the clinic's dialysis schedule during holidays (Christmas, Thanksgiving, New Years, etc.)?
How long will the clinic hold my chair (on the same shift) if I go on vacation or have to go in the hospital?
Does the clinic provide free coffee in the waiting room?
Is there someone who speaks the same language as me (or as the patient)?
Does the clinic have a patient newsletter?
Does the clinic have a patient representative or mediator?
What transplant clinics are the patients sent to?
Does the clinic provide training for patients who want to learn home hemodialysis?
What area of the city is the clinic located in?
What are the closest major cross streets to the clinic?
Does the clinic have a place to store my belongings during my dialysis treatments?
Does the clinic have a security guard?
Does the clinic have an exercise program?
Does the clinic have chair exercise bicycles?
What kind of patient education does the clinic offer (when someone first starts and over time)?
Who reviews patients' monthly lab work with them?
Do you have an emergency generator?
What hospital does your ambulance service go to?
Are phone numbers to obtain outside assistance posted?
What days/shifts is the dialysis unit open for dialysis treatments?
Facility Procedures:
Does the clinic re-use dialyzers?
What's the clinic's average number of re-uses per dialyzer?
How do clinic staff hold fistula/graft sites after dialysis? (i.e., clamps, patients hold own, staff)
If I (or the patient) can't hold sites is there enough staff to help hold sites?
Does the clinic "deaden" or numb the skin before the dialysis needles are put in?
If they do "deaden" or numb the skin what do they use (Lidocaine, EMLA cream, etc.)?
Questions About Staffing and the Treatment Team:
Does everyone on your staff speak fluent English?
How, how long and where are new staff members trained?
How often does the doctor see the patients while they are on dialysis?
Will I see the same doctor all the time during dialysis or do other doctors share making rounds at my clinic?
Does the clinic have a nurse practitioner that helps the doctor?
Does the clinic have a physician's assistant who helps the doctor?
How many registered nurses work at the clinic?
What is the ratio of registered nurses to patients?
How long has the nurse in charge been working at the clinic?
Is the charge nurse for the shift assigned patients to take care of?
How many LVN's/LPN's work at the clinic?
On an average shift, how many patients is each staff member responsible for?
Does the ratio of caregivers to patients change during breaks and lunches?
How many full-time and/or part-time social workers work at the clinic?
What is the ratio of social workers to patients?
How often does the social worker visit patients in the dialysis clinic?
Does the social worker at the clinic have office hours for appointments before/after treatments?
What role does the clinic take in helping me make travel plans at other dialysis centers?
How many full-time and/or part-time dietitians work at the clinic?
What is the ratio of dietitians to patients?
How often does the dietitian visit patients in the dialysis clinic?
Does the dietitian at the clinic have office hours for appointments before/after treatments?
Equipment and Maintenance Questions:
How old are the clinic's dialysis machines?
How often do the dialysis machines receive preventative maintenance?
How old are the clinic's dialysis chairs?
When is the last time the clinic's water system was inspected by water experts or state surveyors?
When was the last time the entire clinic was surveyed by state surveyors?
Did they find any deficiencies (problems) during the survey? If so, what were the deficiencies?
What has the clinic done to fix these deficiencies (problems)?
Transient Dialysis Treatments:
Does the clinic take transient dialysis patients?
Do transient dialysis patients have to pay the 20% not paid by Medicare up front?
Are transient dialysis patients charged any extra fees by the transient clinic to cover administrative costs?
Do transient dialysis patients have to be seen by the doctor at the transient clinic before they can receive dialysis treatments at the transient clinic?
Does the clinic have transient patient chairs open during in November and December over the holidays (Thanksgiving, Christmas and New Years)?
Does the clinic have transient patient chairs open during the summer vacation months?
More About the Clinic:
Has the clinic won any awards for its care of patients? If so, from whom?
How many complaints did the clinic get from your patients during the last year?
What were the complaints?
How did the clinic handle these complaints?
How many people from the clinic die every month?
Does the clinic have an isolation room?
How many patients at the clinic have fistulas?
How many patients have catheters?
During a Clinic Tour - Look for These Things:
Cleanliness of clinic - waiting room, bathrooms, treatment area
Noise in treatment area
Attitude of patients to other patients
Attitude of staff to patients
Attitude of patients to staff
Attitude of staff to other staff
How crowded the clinic is
Size of waiting room
Patient education materials in the waiting room
Meet the Head Nurse (or Director of Nursing)
Talk to a patient
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:thumbup; Good list!
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Adam, what is it about in center that you dislike so much? Should I make extra effort to have home?
In-centre is fine for some people, but I personally don't like it mainly for two reasons. One, only three treatments per week. More dialysis = better health. At home, I get six treatments per week. Two, I am fully in control at home, and I'm responsible for my own treatment. I don't have to sit for several minutes with the alarm blaring in my ear waiting for a tech to reset it. Again, that's just me. For others, in-centre may be the best form of treatment. I guess if I HAD to be in-centre, my first priority would be how much of my treatment I can do myself. Because I would preferably be doing my own treatment in the centre, I would want to know what model of dialysis machines are used, and how easy or difficult it is to operate them, how reliable they are, etc. I would obviously like to have good staff. Let's see.....can I eat/drink; can I use a cell phone; can I have visitors; how often would I get to see my doctor/dietitian/social worker etc.; how flexible they are with scheduling treatments, probably more but it's been so long since I've dialyzed in a centre, I've forgotten what all I would want! Oh well.
Adam
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Thanks Adam. That helped a lot. I certainly would rather do home hemo but it seems to be out of the question as I live alone and the possibility of paying someone six days a week is far beyong my financial capabilities. Maybe as time goes on! I'll keep trying.
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That was an awesome list.
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Yeah, that was a great list! :clap; I sure wish I would have that list before I started at a clinic!
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I suppose if we only get a fraction of the items on that list that we are lucky. Zach is always thorough.