Table 2.
Kidney Palliative Care Intervention | Model of Kidney Palliative Care | Staffing/Intervention | Additional Services Provided |
---|---|---|---|
Baystate Medical Center (22) | Scaling primary KPC | Training for existing dialysis unit social workers and nephrologists | Facilitate advance care planning discussions with social workers and nephrologists for patients on dialysis with poorer prognosis |
University of New Mexico (22) | 60 min lecture, review of training tape, didactic resources disseminated; social workers received additional 1-d intensive training. | ||
NephroTalk (23) | Scaling primary KPC | Academic nephrologists trained to teach KPC skills | Curricular intervention that addresses nephrology fellowship training gap in teaching KPC skills |
Zuckerberg SF General Hospital | Scaling primary KPC | Clinic staffed by academic nephrologist who completed palliative care courses, physician extenders, nurse, dietician, social worker | Fellow education (direct observation in clinic, KPC lectures, serious illness communication skills workshops) |
Kidney CARES, NYU (31) | Embedded KPC | Nephrologist with palliative care training, partnership with Integrative Health Services, access to Nephrology Clinic staff | Embedded KPC provider addresses complex symptoms and patient-centered communication/decision making alongside routine kidney care, including comprehensive conservative care. |
Renal Supportive Care Clinic, University of Pittsburgh | Embedded KPC | Nephrologist with palliative care training; access to Nephrology Clinic staff, Palliative Care home programs, and psychological resources | Embedded KPC provider addresses complex symptoms and patient-centered communication/decision making alongside routine kidney care, including comprehensive conservative care. |
SPIRIT intervention, UNC (34) | Embedded KPC | Nurses undergo 3.5 d training in psychoeducational intervention | Advance care planning with dyads of patients on dialysis and their surrogates over two sessions in the dialysis facility and at home |
Northwest Kidney Centers ESCO | Mobile/home-based KPC | Nephrologist with palliative care training, full-time social worker, and nurse | KPC team addresses complex patient-centered communication/decision making and symptom management in the dialysis facility and/or place of residence alongside routine kidney care. |
Year-long palliative care training for social worker and nurse | |||
Conservative Care Program, University of Calgary (44) | Embedded KPC and mobile/home-based KPC | Nephrologist with palliative care training, nurse dedicated to advance care planning, two half-time nurses for comprehensive conservative care, access to a social worker and dietician | Embedded clinic and home visit support for patients considering comprehensive conservative care |
Kidney-specific symptom management support both before and during enrollment in hospice | |||
Alberta Health Services (45) | State/provincial KPC (KPC integrated in governmental health systems) | Provincial guidelines outline a comprehensive conservative care pathway for primary care providers and kidney care professionals | Scale comprehensive conservative care provision within Canadian provincial health services via centralized tools and pathways |
British Columbia Renal Agency (46) | |||
Renal Supportive Care, Australia (2) | State/provincial KPC (KPC integrated in governmental health systems) | Embedded KPC model with palliative care specialist, senior KPC nurse, and social worker at each Renal Unit | Comprehensive conservative care delivered by embedded KPC team at each Renal Unit |
Concurrent KPC services for patients on dialysis | |||
KPC services scaled within Australian state health service |
KPC, kidney palliative care; SF, San Francisco; NYU, New York University; SPIRIT, Sharing Patient's Illness Representations to Increase Trust; UNC, University of North Carolina; CARES, Comprehensive Advanced Renal Disease and ESKD Support; ESCO, ESKD Seamless Care Organization.