4. Pre Dialysis 1993
Pressures on patients and their families
• Sick, elderly patients driving in excess of 300 kilometres 3 times per week
• 3-5 hours total driving time from various communities in Renfrew County
• After treatment feeling fatigued
• Cost of gas, parking, meals
• Driver needed
• Driving in all kinds of weather i.e. snowstorms, ice storms
• Unable to keep a job due to treatment time
• Ottawa at over-capacity
• No treatment - you die
• Everyone left Renfrew County for dialysis services
5. Fast Forward 2013
• Renfrew Victoria Hospital designated by the Ministry of Health
& Long Term Care as the Regional Centre for Renfrew County
Nephrology Services.
• 12 station Hemodialysis Unit at Renfrew Victoria Hospital
• 6 station Satellite Unit at St. Francis Memorial Hospital,
Barry’s Bay
• 6 station Satellite Unit at Pembroke Regional Hospital
• Peritoneal Dialysis offered (home dialysis)
• PRI (prevention) clinics
• Today, very few leave Renfrew County for their treatment
7. RVH Regional Dialysis Program
• 2 Nephrologists, Dr. Nicole Delbrouck & Dr. Amtul Musawir
• General Practitioners educated with additional knowledge and
experience in hemodialysis in Renfrew, 2 General Practitioners in
Barry’s Bay
• Nurse Manager, Janice Verch-Whittington
• 29 Registered Nurses
• 9 Registered Practical Nurses
• 2 Dialysis Bio Medical Technologists
• 2 Dietitians
• 1 Social Worker
• Pharmacist Support
Unbelievable knowledge and expertise in Renfrew County
8. • Renfrew Victoria Hospital
• Primary Care Physicians
in Renfrew County
• Ministry of Health
• Patient Focus Groups
• Ontario Renal Network
• The Ottawa Hospital
Vascular Access Program
• The Ottawa Hospital
Transplant Program
• CCAC, PD Case Manager
and Palliative Care
Services for end of life
support
• Kidney Foundation of
Canada, Eastern Ontario
Branch, Patient Services
Committee
• Regional Clinical Practice
Committees for
Hemodialysis and
Peritoneal Dialysis
• Champlain LHIN Regional
Chronic Kidney Disease
• St. Francis Memorial
Hospital – Satellite
• Pembroke Regional
Hospital - Satellite
How Did We Get There?
Linkages & Partnerships
9. Stage 2
Chronic Kidney Disease
• Nephrology Clinics
• Initial assessment, diagnosis
and early intervention to
slow progress of kidney
disease
Stage 3 & 4
Chronic Kidney Disease
• Progressive Renal
Insufficiency (PRI) clinic
– Dietitian
– Social Worker
– Nephrologist
– Nurse
– Pharmacist
Goal to slow progression of
kidney disease
PATIENT CONTINUUM OF
CARE
10. Stage 5 – 4 Options
Option 1
Home Peritoneal Dialysis
• Home training at RVH
• RVH support 24/7
• Surgical insertion PD
catheter by The Ottawa
Hospital
Option 2
In-centre Hemodialysis
- 3 sites available
- Vascular access creation/
insertion at The Ottawa
Hospital
PATIENT CONTINUUM OF
CARE
11. Stage 5 – 4 Options
Option 3
Transplant
• Complete pre-transplant
workup at RVH
• Transplant and post-
transplant care at The
Ottawa Hospital
Option 4
Treatment without Dialysis
- Nephrology palliative care
- Working with family
physician
PATIENT CONTINUUM OF
CARE
12. Pre Dialysis 1993
Pressures on patients and their families
• Sick, elderly patients driving in excess of 300 kilometres 3 times per week
• 3-5 hours total driving time from various communities in Renfrew County
• After treatment feeling fatigued
• Cost of gas, parking, meals
• Driver needed
• Driving in all kinds of weather i.e. snowstorms, ice storms
• Unable to keep a job due to treatment time
• Ottawa at over-capacity
• No treatment - you die
• Everyone left Renfrew County for dialysis services
14. The patient must be at the centre of health care.
• Provide seamless access to the continuum of
care in a timely manner.
• Be based on need
• Take into consideration the individual needs
and preferences of the patient and his/her
family.
• Treat the patient with respect and dignity.
LESSONS LEARNED
15. • Provide services that are appropriate,
respectful of individual choice and delivered in
a manner that is timely, safe, effective and
based on the latest evidence.
QUALITY
16. • The health system must support residents in the
Champlain LHIN in the prevention of illness and the
enhancement of their well being.
• The health care system has a duty to provide and
advocate access to quality care sensitive to the
challenges of rural Renfrew County.
IMPROVE POPULATION HEALTH
17. ONE TAXPAYER
• There are significant financial challenges
for all health care providers
• Increasing demands
• Less resources
• How can we provide services to maintain
or improve access especially in rural
communities?
