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Northwest Kidney Centers’ Special Care Program Keeps Patients out of Hospitals Provides Best Quality of Life for Some of the Community’s Sickest Patients

By Joyce F. Jackson States, these patients end up in know the patients they dialyze next President and CEO the hospital for blood-cleansing, to, and they build relationships Northwest Kidney Centers life-sustaining renal replacement with staff members. There’s no therapy. In Washington, there’s admissions paperwork, no lengthy another option. They can remain medical history forms, no additional as outpatients, receiving dialysis cost to the taxpayer. in beds with intensive nursing care and other extra services, through “We know the least intrusive Northwest Kidney Centers’ special environment is best for patients,” care program. says Dr. Andrew Brockenbrough, medical director of special care at Specialized care for patients who Northwest Kidney Centers’ Kent need it most and Auburn facilities. “For these very ill patients, Northwest Kidney Patients in the program, offered at Centers’ special care program is our Cherry Hill location in , that environment. Without it, some People with need a in Kent and in Auburn, still typically would likely decide to discontinue transplant or regular dialysis therapy receive dialysis treatments three treatment.” to survive. Without treatment, life times a week for four to five hours expectancy is a matter of days. at a time. But they dialyze in beds, Irma McQueen fractured her are cared for by additional nursing right knee in July 2010, six Most patients undergo dialysis as an staff and have access to a chaplain. months after starting dialysis. outpatient in a center; others learn For patients near end of life, our Since then, she’s experienced how to give themselves dialysis staff members help coordinate with extensive complications – multiple at home. But for some patients hospice and other nursing services. infections in her knee, shingles and – people with additional health complications due to her diabetes. challenges like spinal cord injuries The special care program provides or amputations, or patients who individual care with the least “One thing led to another and that’s are very frail – dialysis in a chair is disruption to daily life. Instead of how I ended up in special care,” she uncomfortable and challenging. going to a hospital every time they says. “Dialysis in a bed is so much need dialysis, patients come to a better for me. When your kidneys Almost anywhere else in the United place they know well. They get to go bad, it’s very emotionally and -1- physically tiring. The staff here better ways to diagnose and treat special care services. Financial understand that. If it wasn’t for kidney disease but for now, most contributions from generous donors special care, I don’t know where I’d people with kidney failure – that’s make it possible for us to run this be.” 400,000 people in the U.S. – are on program. dialysis. A bridge to recovery, care at end Northwest Kidney Centers spends of life We are seeing a surge in the number a total of $2 million annually on of people with hypertension and special care, but our special care The optimal health and quality of life diabetes—the leading causes patients make fewer demands on the of every patient has been our focus of and larger community health system. since we opened our doors in 1962. ultimately kidney failure. Given that That’s important to us. Then the world’s first and only out- trend and our aging population, we of-hospital dialysis program, we anticipate more and more patients Caring for these patients can treated nine patients in the basement will need dialysis and there will negatively affect pay for quality of Eklind Hall at Swedish Hospital. be some who will benefit from a scores and reflect poorly on the Today, Northwest Kidney Centers program like special care dialysis. dialysis provider in the transparent treats 1,550 patients in King and postings of outcomes. So why offer Clallam counties. Five percent are Broadening the program it? part of the special care program. Ten years ago, we added chaplaincy “It’s a service to hospitals and For some, like Irma McQueen, services to special care. Today, taxpayers,” says Brockenbrough. special care serves as a bridge to we’re working with a specialist to “It’s a gift to the community. But recovery from a short-term setback. integrate more palliative care into above all, it’s the right thing to do Other patients are at the end of life. the program. for patients.”

“We help patients improve “All end stage renal disease patients The nonprofit Northwest Kidney physically and work with them to stand to benefit from palliative Centers’ vision is to be a model get stronger, but if they can’t, we care, no matter where they are in in our field. Financially, it’s not provide the best medical care and the trajectory of the disease,” says possible for every dialysis provider, help preserve their quality of life,” Dr. Daniel Lam, a palliative care or every health care organization, says Brockenbrough. “Because specialist and a nephrology fellow to offer a program like this. We’re of its focus on physical, social at the . proud that we can. and spiritual care, the special care “What one patient needs is different program has allowed many patients from what another needs. We need Northwest Kidney Centers is a to live much fuller lives. It’s really a to address all the different domains regional, nonprofit, community- privilege to be part of it.” of care, from physical pain and based provider of kidney dialysis, symptoms to the social, spiritual, public health information, and The kidney disease epidemic existential and cultural aspects of research into the causes and care.” treatments of chronic kidney Kidney disease is growing at a disease. Founded in Seattle in rapid rate, up 30 percent in the last We spend more, the system spends 1962, it was the world’s first dialysis decade. Currently, one in every less organization. It is a model in the seven adults in the United States field because of its high-quality has it. Investigators at our Kidney reimburses Northwest treatments, community connections Research Institute, a collaboration Kidney Centers for standard dialysis and generous donor support. between Northwest Kidney Centers treatments, but does not provide and UW Medicine, are working on any additional reimbursement for Reprinted with permission from the Washington Healthcare News. To learn more about the Washington Healthcare News visit wahcnews.com.

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