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Change Ideas
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Focus on data discipline to support to support primary care providers to screen populations to identify patients at risk of CKD with the intent to test eGR and urine ACR
- EMR use for capturing identification of eligible patients
- EMR use for capturing screening rates
- EMR use for capturing patients who refuse or are not ready for screening
- Implement an evidence-informed CKD screening flow sheet for standardized, consistent assessment and documentation in the EMR
- Map the CKD patient journey from diagnosis including modification of vascular risk factors including lipid management & referral to nephrology/CKD regional program where relevant
- Complete outreach to patients
- Letters
- Phone calls
- Focus groups
- Collaborate with the Regional CKD Program
- Work with the early CKD team in Nephrology on a referral process to assist in preventing risk of CKD progression
- Decision support aids for Patients
- Provision of website links (e.g., http://www.renalnetwork.on.ca/#&panel1-1), paper-based information tools to support screening decision
- Decision support aids for Health Care Providers (HCP)
- HCP and staff training/education
- Use of a CKD screening medical directive (e.g., Vascular Health Medical Directives when available) to enhance capacity for interprofessional team collaboration in screening
Vascular Health Primary Care Work Group
Last Updated: April 30, 2017