Fig. 7 |. Innovation in vascular access and process of care.

a | Innovation in process of care to increase incident arteriovenous (AV) fistula use. Note the multiple barriers (red lines) in the process of care multistep pathway, all of which could also potentially be opportunities for local process of care innovation. b | The process of innovation in the vascular access field requires a multipronged and multidisciplinary approach right from the point at which the concept is first ideated based on an understanding of biological and physiological processes, through investment, the identification of druggable and deviceable targets, to clinical trial design and infrastructure development, and completion of well-defined regulatory and reimbursement pathways. As a community the field needs coordination of these aspects to truly create an innovation substrate for the development and adoption of novel and effective patient-centred therapies and process of care pathways. GFR, glomerular filtration rate (mi/min/1.73 m²); GP, general practitioner; OR, operating room; PCP, primary care physician.