Sharing BC’s Expertise: Consultation by Dr. Adeera Levin Benefits Kidney Patients in Australia

Over the years, BC Renal and our executive director Dr. Adeera Levin have shared our made-in-BC kidney care network model - and the many positive health and system outcomes it has enabled - with jurisdictions across Canada and around the world. A recent example is an external Statewide Renal Services Review for Queensland Health in Australia in 2018. As we look back on 2020, we are pleased to relay that the consultation has led to substantial improvements in kidney care for the state.

As part of her assessment, Dr. Levin offered 10 key recommendations, which included actions such as: • Better integration of information and reporting of outcomes • Alterations in funding models to support team-based care irrespective of the location of patients, and • Patient-, clinician- and administrator-led committees to oversee initiatives and change.

Two years later, the region reports successful implementation of many of the recommendations, which have led to substantial improvements in kidney care. One example is a 29% increase in the number of patients receiving chronic hemodialysis with a functioning arteriovenous fistula or arteriovenous graft by the end of 2019-2020 year.

Some other key improvements include:

196% increase in the number of patients who have had a decision recorded about transplant suitability 326% increase in the number of patients who have been approached regarding advanced care planning 9% increase in the number of patients who started home or independent dialysis, and 201 additional patients receiving specialist care at a Primary Health Care clinic.

Importantly, a substantial portion of those who have benefited from these improved outcomes (21%) are Aboriginal or Torres Strait Islander patients, who have traditionally been underserved.

It was a privilege to be able to meet the patients, clinicians, researchers and administrators in Queensland, to hear their frustrations and concerns, and also their willingness to collaborate on making changes. I believe the system was ready for change, and I served as a facilitator and catalyst, but all the hard work was done by those in the state.

I also think that before the work started, I was very clear that I did not want to produce a report to sit on a shelf, but rather wanted to help the group make changes, and so was certain when I started that there was a real willingness to change. - Dr. Adeera Levin

One of the most important recommendations by Dr. Levin included the formation of the AKC2026 Collaborative, a group of patients, clinicians from many disciplines, researchers and administrators dedicated to standardizing the delivery of care, improving equitable access to public kidney care services and aligning resources for the delivery of care. Dr. Levin’s recommendations for the Queensland Health renal network were informed by the work of her and her many BC colleagues in developing and evolving the BC Renal network over the past 20-plus years.