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Author Topic: What do you look for in selecting a dialysis Center?  (Read 11045 times)
dwcrawford
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« on: March 10, 2009, 09:00:57 PM »

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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Come to think of it, nothing is funny anymore.

Nothing that I post here is intended for fact but rather for exploration into my personal thought processes.  Any slight, use of words with multiple connotations or other percieved insults are totally unintended.  I reserve my insults for private.
kellyt
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« Reply #1 on: March 10, 2009, 09:40:39 PM »

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;
Logged

1993 diagnosed with glomerulonephritis.
Oct 41, 2007 - Got fistula placed.
Feb 13, 2008 - Activated on "the list".
Nov 5, 2008 - Received living donor transplant from my sister-in-law, Etta.
Nov 5, 2011 - THREE YEARS POST TRANSPLANT!  :D
peleroja
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« Reply #2 on: March 11, 2009, 08:58:48 AM »

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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dwcrawford
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Getting the heck out of town.

« Reply #3 on: March 11, 2009, 06:57:18 PM »

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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Come to think of it, nothing is funny anymore.

Nothing that I post here is intended for fact but rather for exploration into my personal thought processes.  Any slight, use of words with multiple connotations or other percieved insults are totally unintended.  I reserve my insults for private.
RightSide
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« Reply #4 on: March 20, 2009, 04:06:17 PM »

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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twirl
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« Reply #5 on: April 03, 2009, 03:28:10 AM »

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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okarol
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« Reply #6 on: April 03, 2009, 11:52:32 AM »


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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Admin for IHateDialysis 2008 - 2014, retired.
Jenna is our daughter, bad bladder damaged her kidneys.
Was on in-center hemodialysis 2003-2007.
7 yr transplant lost due to rejection.
She did PD Sept. 2013 - July 2017
Found a swap living donor using social media, friends, family.
New kidney in a paired donation swap July 26, 2017.
Her story ---> https://www.facebook.com/WantedKidneyDonor
Please watch her video: http://youtu.be/D9ZuVJ_s80Y
Living Donors Rock! http://www.livingdonorsonline.org -
News video: http://www.youtube.com/watch?v=J-7KvgQDWpU
Zach
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« Reply #7 on: April 03, 2009, 02:14:25 PM »

Where's the beer! :o
 :beer1;
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Uninterrupted in-center (self-care) hemodialysis since 1982 -- 34 YEARS on March 3, 2016 !!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
No transplant.  Not yet, anyway.  Only decided to be listed on 11/9/06. Inactive at the moment.  ;)
I make films.

Just the facts: 70.0 kgs. (about 154 lbs.)
Treatment: Tue-Thur-Sat   5.5 hours, 2x/wk, 6 hours, 1x/wk
Dialysate flow (Qd)=600;  Blood pump speed(Qb)=315
Fresenius Optiflux-180 filter--without reuse
Fresenius 2008T dialysis machine
My KDOQI Nutrition (+/ -):  2,450 Calories, 84 grams Protein/day.

"Living a life, not an apology."
dwcrawford
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Getting the heck out of town.

« Reply #8 on: April 03, 2009, 05:01:22 PM »

Zach, which center serves beer?  That might make the 4 hours pass faster.
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Come to think of it, nothing is funny anymore.

Nothing that I post here is intended for fact but rather for exploration into my personal thought processes.  Any slight, use of words with multiple connotations or other percieved insults are totally unintended.  I reserve my insults for private.
Wallyz
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« Reply #9 on: April 03, 2009, 05:16:25 PM »

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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kitkatz
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« Reply #10 on: April 03, 2009, 05:52:23 PM »

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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lifenotonthelist.com

Ivanova: "Old Egyptian blessing: May God stand between you and harm in all the empty places you must walk." Babylon 5

Remember your present situation is not your final destination.

Take it one day, one hour, one minute, one second at a time.

"If we don't find a way out of this soon, I'm gonna lose it. Lose it... It means go crazy, nuts, insane, bonzo, no longer in possession of ones faculties, three fries short of a Happy Meal, wacko!" Jack O'Neill - SG-1
dwcrawford
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Getting the heck out of town.

« Reply #11 on: April 03, 2009, 06:10:32 PM »

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.
Logged

Come to think of it, nothing is funny anymore.

Nothing that I post here is intended for fact but rather for exploration into my personal thought processes.  Any slight, use of words with multiple connotations or other percieved insults are totally unintended.  I reserve my insults for private.
twirl
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« Reply #12 on: April 03, 2009, 06:14:12 PM »

one with nurses who do not put bleach in the machines
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okarol
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« Reply #13 on: April 03, 2009, 11:42:09 PM »

one with nurses who do not put bleach in the machines

 :thumbup; good advice

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Admin for IHateDialysis 2008 - 2014, retired.
Jenna is our daughter, bad bladder damaged her kidneys.
Was on in-center hemodialysis 2003-2007.
7 yr transplant lost due to rejection.
She did PD Sept. 2013 - July 2017
Found a swap living donor using social media, friends, family.
New kidney in a paired donation swap July 26, 2017.
Her story ---> https://www.facebook.com/WantedKidneyDonor
Please watch her video: http://youtu.be/D9ZuVJ_s80Y
Living Donors Rock! http://www.livingdonorsonline.org -
News video: http://www.youtube.com/watch?v=J-7KvgQDWpU
twirl
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« Reply #14 on: April 04, 2009, 03:10:36 AM »

Flipbob ( :'( )  always said that dialysis is the best thing for a hang-over

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Zach
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"Still crazy after all these years."

« Reply #15 on: April 04, 2009, 04:56:15 AM »


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;
Logged

Uninterrupted in-center (self-care) hemodialysis since 1982 -- 34 YEARS on March 3, 2016 !!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
No transplant.  Not yet, anyway.  Only decided to be listed on 11/9/06. Inactive at the moment.  ;)
I make films.

Just the facts: 70.0 kgs. (about 154 lbs.)
Treatment: Tue-Thur-Sat   5.5 hours, 2x/wk, 6 hours, 1x/wk
Dialysate flow (Qd)=600;  Blood pump speed(Qb)=315
Fresenius Optiflux-180 filter--without reuse
Fresenius 2008T dialysis machine
My KDOQI Nutrition (+/ -):  2,450 Calories, 84 grams Protein/day.

"Living a life, not an apology."
Adam_W
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Me with Baron von Fresenius

« Reply #16 on: April 04, 2009, 03:35:08 PM »

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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-Diagnosed with ESRD (born with one kidney, hypertension killed it) Jan 21st, 2007
-Started dialysis four days later in hospital (Baxter 1550-I think, then Gambro Phoenix)
-Started in-centre dialysis Feb 6th 2007 (Fres. 2008H)
-Started home hemo June 5th 2007 (NxStage/Pureflow)
-PD catheter placed June 6th 2008 (Bye bye NxStage, at least for now)
-Started CAPD July 4th, 2008
-PD catheter removed Dec 2, 2008-PD just wouldn't work, so I'm back on NxStage
-Kidney function improved enough to go off dialysis, Feb. 2011!!!!!
-Back on dialysis (still NxStage) July 2011 :(
-In-centre self-care dialysis March 2012 (Fresenius 2008K)
-Not on transplant list yet.


"Don't live for dialysis, use dialysis to LIVE"
dwcrawford
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Getting the heck out of town.

« Reply #17 on: April 04, 2009, 03:37:03 PM »

Adam, what is it about  in center that you dislike so much?  Should I make extra effort to have home?
Logged

Come to think of it, nothing is funny anymore.

Nothing that I post here is intended for fact but rather for exploration into my personal thought processes.  Any slight, use of words with multiple connotations or other percieved insults are totally unintended.  I reserve my insults for private.
Zach
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"Still crazy after all these years."

« Reply #18 on: April 06, 2009, 09:01:17 PM »

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
Logged

Uninterrupted in-center (self-care) hemodialysis since 1982 -- 34 YEARS on March 3, 2016 !!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
No transplant.  Not yet, anyway.  Only decided to be listed on 11/9/06. Inactive at the moment.  ;)
I make films.

Just the facts: 70.0 kgs. (about 154 lbs.)
Treatment: Tue-Thur-Sat   5.5 hours, 2x/wk, 6 hours, 1x/wk
Dialysate flow (Qd)=600;  Blood pump speed(Qb)=315
Fresenius Optiflux-180 filter--without reuse
Fresenius 2008T dialysis machine
My KDOQI Nutrition (+/ -):  2,450 Calories, 84 grams Protein/day.

"Living a life, not an apology."
okarol
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« Reply #19 on: April 06, 2009, 09:09:49 PM »


 :thumbup; Good list!
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Admin for IHateDialysis 2008 - 2014, retired.
Jenna is our daughter, bad bladder damaged her kidneys.
Was on in-center hemodialysis 2003-2007.
7 yr transplant lost due to rejection.
She did PD Sept. 2013 - July 2017
Found a swap living donor using social media, friends, family.
New kidney in a paired donation swap July 26, 2017.
Her story ---> https://www.facebook.com/WantedKidneyDonor
Please watch her video: http://youtu.be/D9ZuVJ_s80Y
Living Donors Rock! http://www.livingdonorsonline.org -
News video: http://www.youtube.com/watch?v=J-7KvgQDWpU
Adam_W
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Me with Baron von Fresenius

« Reply #20 on: April 06, 2009, 10:18:42 PM »

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

 
Logged

-Diagnosed with ESRD (born with one kidney, hypertension killed it) Jan 21st, 2007
-Started dialysis four days later in hospital (Baxter 1550-I think, then Gambro Phoenix)
-Started in-centre dialysis Feb 6th 2007 (Fres. 2008H)
-Started home hemo June 5th 2007 (NxStage/Pureflow)
-PD catheter placed June 6th 2008 (Bye bye NxStage, at least for now)
-Started CAPD July 4th, 2008
-PD catheter removed Dec 2, 2008-PD just wouldn't work, so I'm back on NxStage
-Kidney function improved enough to go off dialysis, Feb. 2011!!!!!
-Back on dialysis (still NxStage) July 2011 :(
-In-centre self-care dialysis March 2012 (Fresenius 2008K)
-Not on transplant list yet.


"Don't live for dialysis, use dialysis to LIVE"
dwcrawford
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Getting the heck out of town.

« Reply #21 on: April 07, 2009, 04:45:13 AM »

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.
Logged

Come to think of it, nothing is funny anymore.

Nothing that I post here is intended for fact but rather for exploration into my personal thought processes.  Any slight, use of words with multiple connotations or other percieved insults are totally unintended.  I reserve my insults for private.
kitkatz
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« Reply #22 on: April 07, 2009, 07:37:28 PM »

That was an awesome list.
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lifenotonthelist.com

Ivanova: "Old Egyptian blessing: May God stand between you and harm in all the empty places you must walk." Babylon 5

Remember your present situation is not your final destination.

Take it one day, one hour, one minute, one second at a time.

"If we don't find a way out of this soon, I'm gonna lose it. Lose it... It means go crazy, nuts, insane, bonzo, no longer in possession of ones faculties, three fries short of a Happy Meal, wacko!" Jack O'Neill - SG-1
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Calvin

« Reply #23 on: April 07, 2009, 09:26:40 PM »

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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Diagnosed with ESRD-November 2006
I have had 2 fistuals-neither one worked
I have had 2 grafts the last one finally "took"
I had 3 different catheters from Nov. 06 - Dec. 08
Got on the transplant list - Halloween Day 2008

You can easily judge the character of others by how they treat those who they think can do nothing for them.    I BELIEVE THIS TO BE SOOOOO TRUE!
dwcrawford
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Getting the heck out of town.

« Reply #24 on: April 08, 2009, 12:50:58 AM »

I suppose if we only get a fraction of the items on that list that we are lucky.  Zach is always thorough.
Logged

Come to think of it, nothing is funny anymore.

Nothing that I post here is intended for fact but rather for exploration into my personal thought processes.  Any slight, use of words with multiple connotations or other percieved insults are totally unintended.  I reserve my insults for private.
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