Kidney CARES (Comprehensive Advanced Renal Disease and End Stage Renal Disease Support) Program: Implementation and Pilot Study of an Outpatient Interdisciplinary Renal Palliative Care Program
The primary goal of my project is to design a model of care for patients with advanced kidney disease that incorporates palliative care in the outpatient setting early in a patient’s disease process and as a continuum throughout its trajectory. This goal includes evaluation of the model’s feasibility with the aim of optimizing a concurrent care model for patients with advanced kidney disease. A second goal is to perform pilot effectiveness study of this clinical program initially as observational data, and then to begin to compare patient-centered outcomes and health care utilization of those patients who are in the program to those who are not. The completion of these two goals will prepare the model for wider testing through comparative effectiveness research.
“My dual training in nephrology and palliative care has changed my vision of the optimal delivery of care for patients with serious chronic illness, particularly kidney disease. Never has it been clearer to me that the extreme physical and emotional burden of advanced kidney disease requires a more comprehensive approach to care. I view the future of palliative care as one that builds upon the early evidence of concurrent care models and moves the practice of medicine beyond the current silo practice of multiple specialty practitioners to an integrative approach which incorporates early introduction of palliative care in the outpatient setting. I often get phone calls from renal practitioners, and even patients, throughout the country asking for guidance in addressing the many palliative care needs inherent to advanced kidney disease. These patients and providers are ready for a comprehensive approach to care, and my diverse background positions me well to develop, test, and champion this model if it proves successful. My knowledge of both nephrology and palliative care, and my clinical experience working in academic and community settings, has optimally prepared me to develop an integrative model of care and to apply this work to future national policy change.”