Table 5.

Culture change at UAB Medicine with the urgent start PD program

Nephrologists

Improved access to PD, inpatient and outpatient

Prompt PD catheter placement avoids need for temporary hemodialysis access

Urgent PD protocols “make it easy”

Smooth transition into dialysis unit prevent prolonged length of stay at the hospital

Interventional Radiology/Nephrology

Enthusiastic support in catheter placement

Innovative measures in patients with critical illness such as refractory heart failure

Routine calls to PD team about patients with challenging vascular access to consider PD as an option

Trainees

Choices of modality for unplanned dialysis starts, even in the hospital

Urgent PD led to increasing interest in PD

Multiple calls from trainees to consider patients for urgent start dialysis, either home hemodialysis or peritoneal dialysis

Access/Transplant Surgeons

Tangible increase in surgeons suggesting home modalities to patients, even when evaluating for hemodialysis access

Patients with failing renal allografts, especially sudden onset, referred for urgent home start

UAB, University of Alabama at Birmingham; PD, peritoneal dialysis.