Dialysis Facility Characteristics Influence Patient Survival

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Dialysis Facility Characteristics Influence Patient Survival
Last Updated: October 04, 2010.

Practices at patient, provider, and facility levels partly explain above- or below-average mortality
      
The difference in patient survival rates among dialysis centers could be due to facility characteristics such as patient engagement, physician communication, and staff coordination, according to research published online Sept. 30 in the Clinical Journal of the American Society of Nephrology.

MONDAY, Oct. 4 (HealthDay News) -- The difference in patient survival rates among dialysis centers could be due to facility characteristics such as patient engagement, physician communication, and staff coordination, according to research published online Sept. 30 in the Clinical Journal of the American Society of Nephrology.

Brennan Spiegel, M.D., of the VA Greater Los Angeles Healthcare System, and colleagues surveyed the staff members of 90 dialysis centers on their perception of their units' patient-, provider-, and facility-level practices to distinguish what sets top-performing apart from low-performing facilities by standardized mortality ratios (SMRs).

The researchers found that dialysis facilities with mortality below the expected rate reported more active and engaged patients, stronger physician communications and interpersonal relationships, a high level of resourcefulness and knowledge among dieticians, and better overall coordination and staff management compared to facilities with higher-than-expected mortality. Thirty-one percent of variance in SMRs was explained by staff ratings of these practices.

"Patient-, provider-, and facility-level practices partly explain SMR variation among facilities. Improving SMRs may require processes that reflect a coordinated, multidisciplinary environment (i.e., no one group, practice, or characteristic will drive facility-level SMRs). Understanding and improving SMRs will require a holistic view of the facility," the authors write.

Amgen provided support for the study and employs one of the study authors.

Abstract
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[jbeany]

Wait, what?  They surveyed the staff but none of the patients?

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