Renal News Annual Edition 2023

RENAL NEWS YEAR IN REVIEW

ANNUAL EDITION

H I GH LI GH TI NG OUR PROVI NCI A L RENA L NETWORK’ S D ED I C ATI ON TO H EA LTH A ND WELLNESS

2 0 2 3 | 5 TH E D I T I O N

WELCOME Welcome to Renal News 2023! In this 5th annual edition, we provide you with an overview of our evolving network and many of its accomplishments of the past year.

Our initiatives - carried out by provincial committees and working groups, professional groups, and BC Renal teams - continue to focus on improving care, experiences and outcomes of kidney patients, creating better work environments, and promoting better kidney health and wellness for all in BC. Our articles within are based on submissions provided by many of the committees, groups and

teams that make up our network and we are very thankful for their contributions. Throughout, you will find links to related information and resources on BCRenal.ca and beyond.

With this special edition of Renal News 2023, we once again hope you enjoy getting to know our network better!

We would like to acknowledge that BC Renal’s main office is located on the traditional and ancestral territories of the Coast Salish peoples – xʷməθkʷəy̓əm (Musqueam), Sḵwx̱wú7mesh (Squamish), and Səl̓ílwətaʔ/Selilwitulh (TsleilWaututh) Nations, and the Métis Chartered Community of the Lower Mainland Region.

TA BL E OF CONTENTS Message from BC Renal Executive Director .............................................1 About the BC Renal network ................................................................2 Meaningful Outcomes..........................................................................4 Strategic Planning................................................................................7 Indigenous Health and Wellness............................................................8 Environmental Sustainability..................................................................10 Patient & Family Engagement Advisory Committee..................................12 PROMIS..............................................................................................14 Education and Knowledge Translation....................................................16 Annual Campaigns...............................................................................26 Special Feature: BC Children’s Hospital Renal Program.............................32 Improvements Driven by BC-Wide Committees.......................................34 Improvements Driven by BC-Wide Professional Groups............................54 Connect with BC Renal.........................................................................64

ME SSAGE FROM BC RENA L E X E CUT IVE DIR EC TOR Dear BC kidney community, I am deeply grateful to each and everyone in the BC kidney community, for all that you do each day.

Our health-care professionals and people living with kidney disease, our multiple partners in care delivery, research and education, our BC Renal staff: Your dedication to health and wellness, whether in providing care, in bravely facing health challenges or in generating and sharing new knowledge, inspires us all.

Over the past year, many of you generously shared your insights and perspectives to inform the development of BC Renal’s new five-year strategic plan. We are excited to embark on a transformative journey together, focused on four pivotal priorities: •

• • •

Capacity (focusing on People, Funding, and Facilities) Early Intervention and Safer Care Technology and Innovation Partnering for Improvement

We have also identified three foundational principles – Environmental Sustainability, Indigenous Wellness, and Equitable and Optimal People-Centered Care – which will be integrated into every aspect of our work.

We are mindful of the link between a healthy environment and a healthy population, and the important role we can play in both reducing our collective environmental footprint and ensuring our ability to respond to current and future environmental threats.

We remain steadfast in our commitment to eradicate Indigenous-specific racism in the health system and to close the health gap for Indigenous peoples with or at risk of kidney disease in BC. And we continue to model and facilitate truly patient-centred care, and include patient and family voices across our work, ensuring we support their partnership within our committees and activities.

In 2023, our provincial committees, working groups, professional groups, and the BC Renal team have continued to support a range of projects, and have embraced opportunities for innovation. You can read about their efforts in this publication.

As we reflect on the past year and look ahead to the new one, we extend our deep appreciation to this amazing community of caring individuals and teams working directly and indirectly to improve the lives of people living with kidney disease. Thank you again for being a part of our journey.

Respectfully,

Dr. Adeera Levin Executive Director

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A B O UT THE BC RENA L NETWORK Our network model is unique in Canada and internationally, designed to improve kidney patient quality of life and outcomes, and to support sound fiscal management and system sustainability. No matter where kidney patients live in the province, we provide a fully coordinated system of care.

the northern way of caring

(province-wide) 2

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12

HEALT H AU THO RI TI E S

H OME H EMODIALYSIS T R AINING SIT ES

13

13

PERITO N E AL DIALYSI S C L I N I C S

H OSPITAL DIALYSIS UNITS

16

29

KIDNEY C A RE CLINICS

COMMUNIT Y DIALYSIS UNITS

18,510

3,659

REGIST E RE D NON-DI A LYSI S KIDNEY PATI E N TS IN B C

K IDNEY PAT IENTS ON DIALYSIS IN BC

Figures as of July 2023

OUR PA RTNERS HI PS • • • • • •

BC Transplant BC Centre for Palliative Care British Columbia Institute of Technology Can-SOLVE CKD Centre for Advancing Health Outcomes First Nations Health Authority

• • • • • •

The Kidney Foundation of Canada - BC & Yukon Branch PKD Foundation of Canada Providence Research University of British Columbia University of Northern British Columbia Vancouver Coastal Health Research Institute Renal News Annual Edition 2023

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M EA NIN GF U L OU TCOM ES Together over the past 25 years, BC Renal and our provincial network of health authority renal programs and other partners have made progress in improving patient experiences and the delivery of care for people living with kidney disease.

Highest survival rate in the country

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BC clinical outcomes data meet or exceed national standards

Highest rates of patients on independent dialysis in Canada

Most extensive financial support for kidney medications in Canada across 4 pharmacy formularies

PROMIS: BC-wide integrated registry and clinical information system for kidney and transplant patients

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Later in the year, core elements of the 2023-2028 strategic plan were established, including an update on our vision, purpose and strategic priorities. In addition, we confirmed our existing values still held true for the next five years, and we identified foundational principles to be woven through all work across the network.

In 2024 and beyond, watch for regular updates on the many ways in which we are following through on these core elements through the work of our many teams, committees and other network members.

Our values provide a focus for how we approach our work and the work of the BC Renal network. They collectively inspire a culture that is dynamic, engaged and results-oriented.

• People • Knowledge • Creativity • Transparency • Accountability • Community

FOUNDATIONAL PRINCIPLES • • •

Environmental Sustainability Equitable & Optimal, PeopleCentered Care Indigenous Wellness

Early & S Inte afe r

no Te c h ova Inn

BC Renal Strategic Priorities 2023-2028

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n ntio rve are C

, ple s) o e ilitie c Fa

er i ve n g fo me r nt

In 2022 and early 2023, network-wide consultations took place involving all provincial committee and working group members, patient partners, BC Renal employees, representatives of partner organizations, and kidney care leaders.

OUR VALUES

Capac Fund ity (P ing &

ST R ATE GIC P L ANNING

tn Pa r pro Im

View the full Vision, Purpose and Foundational Principles infographic here.

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IN D IGE N OUS H E ALT H A ND W ELLNESS Indigenous Wellness is a foundational principle of BC Renal’s 2023-2028 Strategic Plan. We are committed to co-developing an Indigenous kidney health strategy and improving care for Indigenous peoples with, or at risk of, kidney disease across British Columbia. This includes a range of efforts and initiatives across our

Supporting kidney wellness in Indigenous communities BC Renal continues our collaboration with the CanSOLVE CKD Network, First Nations Health Authority, and regional health authority renal programs to provide kidney, diabetes and blood pressure checks

provincial committees and in collaboration with our partners.

ACTIONS

to rural and remote Indigenous communities. The program works with each person to build a kidney health plan that includes follow-up care or goals for kidney wellness.

A learning journey for truth and reconciliation BC Renal has embedded the San’yas Core Indigenous Cultural Safety Health Training into our organizational action plan, supporting all leaders, staff, affiliated researchers, patient partners, and provincial committee chairs/leads to complete the 8-hour program. In addition, all staff are expected to complete the additional 4-hour Anti-Indigenous Racism Response Training (ARRT).

Land acknowledgement video and webinar learning series In collaboration with the Can-SOLVE CKD Network (including 10 Indigenous Knowledge Keepers from across Canada) webinars and a guidebook were developed to support authentic, purposeful territorial land acknowledgements. This learning series is being shared across the BC Renal network.

“At BC Renal, we are deeply committed to facing the truth of our past and present in terms of Indigenous-specific racism and disparity of care in the health system. We are actively engaged in understanding Indigenous ways of knowing and being, and how we can integrate that knowledge and wisdom into the delivery of culturally safe care and support better health outcomes.”

Dr. Michael Copland, Senior Medical Lead, BC Renal

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Shifting perspectives in research BC Renal works with Indigenous patients, researchers and Knowledge Keepers in the Can-SOLVE CKD Network on socializing the pathway to support ongoing journeys of looking, listening, learning and leading in health research among non-Indigenous and Indigenous researchers, policy makers and patient partners.

Photo by Melody Charlie, a professional photographer from Ahousat First Nation. Her work is a clear reflection of the love and respect she holds for her culture and ways of life as an Indigenous being. Always focusing on the strengths and resilience of her people.

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E N V IRON M E NTAL S USTA INA BILITY Environmental sustainability is an emergent priority for BC Renal – one that we continue to expand upon with the addition of green initiatives and partnerships with environmental committees, as well as ongoing research and awareness-raising about how best to align kidney care practices with planetary health principles.

FOUNDATIONAL PRINCIPLE IN STRATEGIC PLAN Part of the work of advancing environmental sustainability is identifying our organization’s targets and goals. In our 2023-2028 strategic plan, BC Renal formally designated environmental sustainability and planetary health as a foundational principle, and our strategy continues to evolve in conjunction with deepening knowledge and understanding. We’ve pinpointed numerous areas of focus to guide our approach – among them, building relationships and leveraging already-developed programs, policies and resources, and working towards the integration of green nephrology strategies across the network.

We’ve also developed an Environmental Sustainability web page that includes an overview of our work and updates in this area.

MEDICAL LEAD IN PLANETARY HEALTH In 2023, Dr. Caroline Stigant was appointed to the newly developed position of Medical Lead in Planetary Health for BC Renal. In this role, Dr. Stigant will serve as a facilitator and leader, working with regional health authority renal program (HARP) representatives, as well as the leadership of BC Renal provincial committees, to embed planetary health principles and practices, and advance low-carbon, high-quality care.

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A FOCUS ON PARTNERSHIPS Also in 2023 BC Renal continued to partner with numerous networks and committees to support and facilitate advancements in green nephrology.

In collaboration with the UBC Planetary Healthcare Lab, we are supporting ‘life cycle assessments,’ or LCAs, of kidney therapies, to systematically quantify environmental impacts throughout the entire life cycle of products and services. Members of our network actively participate in the Sustainable Nephrology Action Planning (SNAP) committee – a Canada-wide group of providers dedicated to aligning kidney care with planetary health principles – while BC Renal itself is a member of the Green Care Network, uniting efforts across the BC health-care community to transform our system towards environmentally sustainable and resilient care.

EARTH DAY BC Renal rang in Earth Day (April 22) with an article outlining our latest strategies and developments in environmental health and sustainability. This included a link to an April 21 webinar, “Environmentally Sustainable Kidney Care,” led by Dr. Caroline Stigant, as well as a quote from Director of Strategic Initiatives, Education and Development, Gloria Freeborn: “There’s no doubt kidney care services have a significant environmental impact, and that climate change itself negatively affects kidney health and outcomes. BC Renal is committed to better understanding and reducing our collective environmental footprint.”

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PATIENT & FAMILY ENGAGEMENT ADVISORY COMMITTEE FEATURED WORK ELEVATING PATIENT AND CARE PARTNER VOICES ACROSS THE BC RENAL NETWORK In 2023, the BC Renal Patient & Family Engagement Advisory Committee provided valuable input on the dissemination of the 2022 provincial patient experience survey results. Advising on the best communication channels was a vital step in closing the loop with the kidney community and specific clinical teams and linking them with resources to inform actions in response to the survey results.

To further promote patient partnerships opportunities at BC Renal and encourage involvement, the committee also developed a new “Your Voice Matters” poster for patients and their care partners living with kidney disease. This poster will be distributed along with promotional postcards and pamphlets. The committee is also engaging with community partners, such as the UBC InterCultural Online Health Network (iCON) and the Chinese Renal Association, to extend its multicultural reach, focusing on underserved BC populations such as Indigenous peoples, people who speak Chinese or Punjabi, and rural and remote communities.

As well, the first in-person BC Renal Patient Partner Connect event took place during BC Kidney Days.

130

Patients & family members in the network*

29

Active patient partners**

27

Engagement opportunities

(April ‘22 March ‘23)

* All network members receive updates about volunteer and educational opportunities as well as other key network activities ** All active patient partners have completed an orientation

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This special gathering brought together patient partners from various BC Renal committees, fostering connections, celebration, and the sharing of volunteer experiences. It also served as an opportunity for attendees to be updated about patient partnerships across BC Renal and the new strategic plan.

OTHER HIGHLIGHT •

Shared patient partnership impacts in “Spotlight” articles within the monthly patient and family engagement newsletter, Advancing Insights.

“I have been working with the Patient & Family Engagement Advisory Committee members for the past year because after my transplant I felt a strong desire to give back to the system that gave me back my life. I wanted to see if there was some way to contribute in a meaningful way. By joining this committee, I found a group of individuals willing to give of their time, knowledge and experience to help patients, and at the same time, the health-care system.

The feeling of gratitude I get from working with this group is very fulfilling. I strongly recommend becoming a patient partner and joining one of the provincial committees that really need input from us to humanize the health-care system today.”

William (Bill) Dear, Co-Chair, Patient & Family Engagement Advisory Committee

CELEBRATING THE LIFE AND LEGACY OF DENNIS MCCANN

With heavy hearts and fond memories, we honour the remarkable life of Dennis McCann who passed away in 2023. Dennis has left behind a profound legacy of love, service, and unwavering commitment to improving the lives of those affected by kidney disease.

Dennis was known for his generosity, thoughtfulness and humble demeanor. He was a dedicated patient partner and advocate within the kidney community provincially and nationally. Since 2012, he was actively involved in BC Renal. He served as the inaugural patient co-chair of the working group responsible for

developing the BC Renal Patient & Family Engagement Framework, a project of which he was very proud. His tireless efforts extended to many other BC Renal efforts and reached into the broader health care and research communities.

Dennis was also passionately dedicated to speaking for patients and families who, for various reasons, couldn’t or weren’t yet ready to speak for themselves.

He sought to make a meaningful impact on the lives of those living with chronic kidney disease. His aspiration was to inspire more patients to become actively involved in the community.

A few years ago, Dennis was featured in a BC Renal “People in Kidney Care” Q&A article. Asked about his hopes for current and future patient partners and their involvement with BC Renal, he said, “For them to continue moving forward and to especially have the ongoing interest in continuing for a fair length of time on an individual basis. Growing that interest word-of-mouth, patient to patient to patient. There are opportunities there. That’s my hope, that it continues growing, growing externally with new patient partners and moving forward internally with existing ones.”

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P R OM IS PROMIS – the Patient Records and Outcome Management Information System – is the only province-wide integrated registry and clinical information system for kidney disease and transplant patients.

FEATURED WORK PROMIS MODERNIZATION CONTINUES The PROMIS team continued to make progress on the migration of functionality from PROMIS Classic over to PROMIS 4.

2023 saw the movement of functionality related to Home Hemodialysis, Dialysis Status, Clinical Trials, and the entire Dialysis Scheduling module. The re-release of the Medications module in PROMIS 4 was another critical module scheduled to move before the end of the year.

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High levels of end-user input have been incorporated in the development of both the Dialysis Scheduling and Medications modules to ensure they meet the needs of our user community. For Medications, this meant the module was redesigned after multiple stakeholder engagement sessions – including reaching out to those who shared concerns after the first release – in order to come up with a design that allowed for improved efficiency within the PROMIS 4 user workflow. For Dialysis Scheduling, it meant onboarding user feedback late in the development cycle, even though that required us to make changes very close to our release date.

While we also continue to address initiatives that need urgent attention, the PROMIS Modernization project is the team’s top priority. Supported by additional funding from PHSA, we will be accelerating our redevelopment of the remaining Classic modules.

OTHER HIGHLIGHTS New functionality to support BC Transplant programs including:

•

New Transplant Vaccination Status report

•

Inclusion of HistoTrac lab management system “Willing to Cross” values in Recipient Immunology

•

Support for the Interprovincial Organ Sharing of Hearts for High-Status Recipients project (referred to as the “IPOS Heart project”)

“It’s important that we modernize PROMIS to ensure the ongoing stability and usability of the application, which is foundational to the renal funding model and to delivery of care. Moving over the larger modules this year ensures those key elements will continue to be available to support life support care provincially. With every module migrated, we also aim to improve the end user experience.”

Karin Jackson, Director of Operations, PROMIS

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EDUCATION & KNOWLEDGE T R A N S L AT I O N

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L E A R N IN G A ND E V E NTS

Learning is a continuous activity across the BC Renal network, with our educational events, webinars and annual conference supporting knowledge-sharing and translation as well as community connection.

OPPORTUNITIES TO LEARN AND CONTRIBUTE Patient Education Webinars are primarily intended for patients with kidney disease who are not on dialysis; however, some topics may be of interest to dialysis patients, and family and friends of all patients are welcome to take part.

Province Wide Rounds, a collaboration between BC Renal and the UBC Division of Nephrology, are regular one-hour webinars open to all health-care professionals and patient partners. A wide range of kidney care topics are covered by local and international kidney experts.

Additional opportunities to learn more about living with and treating kidney disease are shared on the Learning and Events page of the BC Renal website and on the BC Renal YouTube channel.

“As a patient partner, I enjoy taking part in BC Renal webinars because it keeps me current with what is being researched, considered and recommended. I like how information is presented with slides and narration, and it reminds me how many people with expertise are committed to kidney care.”

Tamara Graham, Patient Partner

“I attend Province Wide Rounds to keep myself updated and allow me to benefit from the expertise of my colleagues and other invited presenters. Province Wide Rounds are an excellent educational resource.”

Dr. Ron Werb

“The unknown magnifies fear and stress, the two invisible enemies of the body.

Knowing more about kidney disease is a powerful medicine.”

Paul Zambas, Patient Partner

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BC KIDNEY DAYS

BC Kidney Days is the opportunity for kidney care professionals and patient partners from across BC and beyond to connect and share knowledge and experiences.

BC KIDNEY DAYS 2023 All of us at BC Renal were thrilled to have BCKD23 return to an in-person event for the first time since 2019. Held November 9-10th at the JW Marriott Parq Vancouver Hotel, the conference was sold out and set an attendance record, with about 500 people taking part.

SOMETHING FOR EVERYONE Participants enjoyed an engaging mix of plenary and concurrent sessions led by subject matter and livedexperience experts. Professional breakout sessions, an important part of every BC Kidney Days, offered profession- and patient partner-specific presentations and discussion. Over 25 e-posters provided an engaging forum for BC health professionals to showcase their clinical and patient-care knowledge, as well as answer questions from conference delegates during e-poster viewing times.

WILMA CROCKETT MEMORIAL AWARD The Wilma Crockett Memorial Award is an opportunity for the BC kidney care community to recognize individuals who have made an outstanding contribution to patient care in this province.

The 2023 Wilma Crockett Memorial Award was awarded posthumously to Heather Johnson.

Heather, who passed away in 2023, was Director of Programs with The Kidney Foundation of Canada - BC & Yukon Branch for 15+ years, and made many remarkable and lasting contributions to improving the lives of people living with kidney disease.

BC KIDNEY DAYS GOALS

•

Through knowledge sharing and translation, support improved care for patients with kidney disease at all stages

•

Provide networking and team building for the kidney care community

•

Promote collaboration among all clinical disciplines, as well as patient partners

•

Effectively incorporate patient experiences into the education process

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As part of the BC Renal network, Heather shared her knowledge and expertise with a number of provincial committees, working groups and initiatives, including the Kidney Care, Glomerulonephritis (GN), Home Hemodialysis, Peritoneal Dialysis, Palliative Care, BC Kidney Days Planning and Patient and Family Engagement committees, and the Social Work Professional Practice Council.

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R ESE A RC H AND QUA L IT Y IMP ROVEME NT Kidney health professionals in BC engage in a range of local, provincial, and international research and quality improvement (QI) projects, many in collaboration with BC’s educational institutions. Research topics are diverse – ranging from early detection and prevention to palliative care – and address a number of research and quality improvement questions. Researchers’ work is frequently published in peer-reviewed journals.

KNOWLEDGE SHARING AND TRANSLATION By broadly sharing findings from these research and QI initiatives across the renal network, we aim to translate new knowledge into practice to support evidencebased patient care and better health outcomes.

The Research section of the BC Renal website includes research information, publications and presentations, opportunities for participation in current studies and clinical trials, as well as our research newsletter and related stories.

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Published twice annually (Spring/Summer and Fall/ Winter), our research newsletter BC Kidney Research in Focus highlights the depth and breadth of studies and projects carried out by health professionals and patient partners working on research and QI teams. Produced in consultation with a scientific editorial team, the newsletter includes feature articles, publication

links as well as people profiles. The latter provide a behind-the-scenes look at project leads, research staff and patient partners, highlighting their invaluable contributions and offering insight to those who may be considering a research project and want to learn more about what’s involved.

QI PROJECTS SUPPORTED BY “VALUE-ADDED” FUNDS Each year, BC Renal and the health authority renal programs use “value-added” funds from provincial contracts to implement a variety of QI projects. Annual reports on these regional and provincial initiatives, which include everything from home dialysis, culinary medicine and patient journey mapping to vascular access, PD in long term care, cultural safety and more, are available on the BC Renal website.

In addition to reporting on the use of funds, the reports provide kidney care teams across the province with examples of work they may be able to draw from to improve their own practice, and can also help them avoid replicating what has already been done elsewhere in BC.

“It’s such a privilege to be part of the innovative and exciting research in kidney diseases being led by BC researchers.

Advancements in therapies to prevent the progression of chronic kidney diseases, targeted therapies for autoimmune kidney diseases, and methods to improve dialysis care have been tremendous over the last 10 years. BC Renal, along with the community of those living with kidney disease, continue to play an essential role in supporting and growing this research and I’m excited to see where it leads to next!”

Zainab Sheriff, Research Manager, BC Kidney Research Unit

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ON L IN E E N GAGEM EN T GLOBAL VISITORS These Nov. 2022 Nov. 2023 analytics provide insight into the breadth of BC Renal’s online reach.

We collect data from our website, social media, and e-newsletters, tracking engagement across multiple platforms and mediums. This data plays an important role in guiding future projects and initiatives, and helping BC Renal maximize our reach and accessibility.

BC Renal’s website drew visitors from over 100 countries, with Canada, the US, and India forming the top 3, followed by Australia, the UK, and the Philippines.

+12K VISITS

to BC Renal’s top web page for health-care providers— Pharmacy & Formulary

+10K VISITS

to BC Renal’s top web page for patients—Diet

#1 PATIENT HANDOUT

Management of Constipation in Patients with Chronic Kidney Disease averaged 1,220 views/month

#1 CLINICIAN HANDOUT

Non-Prescription Medication and Your Kidneys received an average of 1,163 views/month 24 Renal News Annual Edition 2023

MOST SEARCHED by visitors to our website: 1. Anemia 2. Tolvaptan 3. Potassium 4. PROMIS 5. Dapagliflozin 6. Diet 7. Constipation 8. Formulary 9. Peritoneal dialysis 10. Cinacalcet

1,661,3498

Total number of lab results loaded into PROMIS to date in 2023

52,289 REPORTS

on average are run per month in PROMIS

9,374 HOURS

combined watch time of our YouTube videos

TOP VIDEO

Click to watch our most-viewed video of 2023, which garnered 30,646 views

4,277 SELF ASSESSMENTS

were taken online via KidneyHealthCheck.ca in 2023

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ANNUAL C A M PA I G N S

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K IDN E Y HE ALTH AWA R ENESS KIDNEY HEALTH MONTH Every March, through Kidney Health Month and World Kidney Day, BC Renal promotes public awareness about how to keep our kidneys healthy, risk factors for kidney disease, and early diagnosis.

In 2023, BC Renal once again partnered with The Kidney Foundation of Canada – BC & Yukon Branch on a public health campaign, called “Could you be the 1 in 10 with kidney disease?” Initially launched in March 2022, the campaign was promoted via print, web, and social media, as well as transit ads in the Lower Mainland. Periodically throughout 2023, we also ran ads of the same campaign on Facebook and Instagram, plus our previously popular “Could you lose 80%?” campaign.

As in prior years, our campaign messaging directed audiences to KidneyHealthCheck.ca and our online kidney health assessment (both updated in 2022).

Available in English, Chinese and Punjabi, this selfassessment tool provides an overview of kidney disease risk factors and encourages those at higher risk to discuss kidney function testing with their primary care provider.

In March, we also reignited our popular 31-day #KidneyHealthChallenge social media campaign, featuring daily food, fluid and lifestyle tips for the general population.

We were grateful to have patient partners Sheryl Straza and Rozelle Callagnan support our campaigns for the

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second year in a row. In a newsletter story posted on our website and promoted on social media, they once again shared their perspectives on the value of the annual campaigns, as well as tips for other patients with kidney disease.

Gloria Freeborn, BC Renal Director of Strategic Initiatives, Education and Development, also took part in this year’s story to share the importance of early diagnosis and the role it plays in supporting better health outcomes and patient experiences.

WORLD KIDNEY DAY World Kidney Day takes place annually on the second Thursday of each March. This year’s World Kidney Day theme was “Kidney Health for All, Preparing for the Unexpected, Supporting the Vulnerable.” In the wake of recurring environmental crises throughout the province, BC Renal sought to promote education via social media around emergency preparedness for kidney patients, drawing on materials first developed for Emergency Preparedness Month.

For more about our variety of campaigns, see our Kidney Health Month web page.

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E M ERGE N C Y P R E PA R EDN ESS READINESS AT ANY TIME CAN BE LIFE-SAVING Situations beyond our control can arise with little to no warning - wildfires, flooding, earthquakes or other unpredictable events can quickly change “normal” into “dangerous.” While emergency preparation is important for everyone, it’s essential for kidney patients, especially those on dialysis.

With this in mind, BC Renal has developed robust materials and guidelines to help kidney patients, health professionals, caregivers, and family and friends prepare for an urgent situation. We continually update and revise our emergency prep materials to ensure the latest information is easy to access, and many are translated into Chinese and Punjabi.

EMERGENCY PREPAREDNESS AND RESPONSE MATERIALS

• • • • • • • • • •

NEW in 2023: Emergency Kit Essentials graphic NEW in 2023: BC Renal Emergency Management Plan for health professionals How Dialysis Patients Can Prepare for Power Outages and Other Disasters video Emergency Preparedness Information for Dialysis Patients booklet Planning for Disaster wallet cards Planning for Disaster poster Kidney patient emergency information forms Emergency disconnect procedures for home dialysis patients Staying Cool in the Summer – Tips for Dialysis Patients Staying Cool in the Summer poster

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BC Renal’s patient and health professional resources are complemented by the Provincial Renal Emergency Management and Business Continuity Plan, which is maintained by our provincial Emergency Management Committee.

EMERGENCY PREPAREDNESS MONTH For BC Renal, May means Emergency Preparedness Month, when we make a point of promoting the importance of being prepared for life-disrupting situations. During our month-long campaign, we share the latest emergency preparedness information and resources, as do team members from the health authority renal programs.

In 2023, Kathy Kho and her renal team colleagues at Island Health’s Royal Jubilee Hospital in Victoria created an eye-catching Emergency Preparedness presentation on the team’s Patient Education board.

Kathy notes, “As a kidney patient, it is most important to be prepared at all times. This can be done by making a checklist of what is needed the most such as medications, food, medical supplies, an emergency kit, and a list of emergency contacts for

doctors and dialysis units in your local area. Disaster is unpredictable, planning and preparing ahead will make you feel secure.”

There is also time for some fun during Emergency Preparedness Month. During his dialysis treatment at the Penticton Regional Hospital’s hemodialysis unit, Bruce Talbot won a BC Renal water bottle.

In addition to the fun aspects of the awareness campaign, Bruce said, “I have always felt supported being a part of this dialysis centre and I have no hesitation that I would be supported through a true emergency situation by this team. They would take care of us without doubt or hesitation.”

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SPECIAL FEATURE

BC C HIL D RE N’S HOSPITAL R E N A L PR OGR AM

MULTIDISCIPLINARY DIALYSIS PROGRAM PROVIDES SPECIALIZED CARE AND CONTRIBUTES TO NATIONAL AND INTERNATIONAL RESEARCH AND QUALITY IMPROVEMENT BC Children’s Hospital is the only tertiary care centre in the province serving pediatric patients who require acute and chronic kidney replacement therapy. We offer both home-based peritoneal dialysis (PD) and hospital-based hemodialysis (HD). With BC’s large geography and the preference for home therapy to maximize quality of life and school attendance, the majority of our patients choose the PD option whenever possible.

Patients are followed in monthly clinics with a combination of virtual and in-person visits, and parents of PD patients are in regular (sometimes daily) contact with the team, with frequently needed changes to dialysis prescriptions, medications and nutritional support.

Patients who are unable to perform PD at home for medical and/or social reasons receive HD in the

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dialysis unit two-to-four times per week, depending on their needs, and are offered school/teacher support during their runs.

For patients with recurrence of kidney disease following transplant and specific types of transplant rejection, the program also offers plasma exchange/ plasmapheresis treatments at the hospital. Since BC Children’s is the only centre to offer this specialized care, many families have to relocate to the Lower Mainland while on HD and plasmapheresis treatments, or during the weeks to months of training and starting PD. With the involvement of their dialysis social worker, these families stay at the Ronald McDonald House on site or in BC Children’s Kidney Suite located in Vancouver and funded by the Kidney Foundation of Canada.

The overarching goal of the pediatric dialysis program is to support the growth, development and quality of life of patients in order to optimize their health for a successful kidney transplant while empowering caregivers/parents to continue to provide comprehensive support at home.

One of the most unique aspects of the program is that patients range considerably in terms of age/size, diagnosis, co-morbidities, neurodevelopmental stage, and degree of family support. In the past year, dialysis patients have ranged from small infants on PD with congenital kidney anomalies diagnosed antenatally to adolescents starting HD after their kidney transplant failed.

Even though the program’s overall patient numbers are small compared to adult dialysis, the time and effort it takes to care for this population is significant, and this past year saw some of the highest dialysis patient volumes in recent history. With relatively limited HD nursing resources (four regular part-time RNs along with one Clinical Nurse Leader), the team was able to provide 630 chronic outpatient HD treatments, 230 acute inpatient HD treatments, and 80 plasmapheresis treatments. The PD program cared for as many as 19 chronic patients at once the largest number in recent years.

Dr. Cherry Mammen says,“With these challenges, we are fortunate to have a strong, dedicated, multidisciplinary pediatric team consisting of dialysis providers, nurses, dietitians, pharmacists, social workers, child life specialists and psychologists to help these vulnerable patients and families through their journey.”

OTHER HIGHLIGHTS •

Members of the dialysis team, in particular, Dr. Cherry Mammen and dietitian Nonnie Polderman, are involved in local, national, and international dialysisrelated research and quality improvement projects and are regularly invited to present at the annual international dialysis conference.

“We are always striving to improve. Over the next years, our goals are focused on improving upon our existing dialysis technology. In the world of automated PD, we are planning on changing to newer machines that have the ability for remote/real time online monitoring of dialysis data from patients’ homes. For HD, we are also joining with our Canadian colleagues to decide which of the newer HD devices will best suit the needs of our patient population including neonatal/ infant HD in the future.”

Dr. Cherry Mammen, Director of Dialysis, Division of Nephrology, BC Children’s Hospital

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IMPROVEMENTS DRIVEN BY B C -W I D E CO M M I T T E ES

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E M ERGE N C Y MANAGEMENT CO MM IT T EE FEATURED WORK

PROVINCIAL TABLETOP EXERCISE INFORMS EMERGENCY PLANNING The BC Renal Emergency Management Committee hosted a provincial emergency response tabletop exercise in the fall. With the help of our Health Emergency Management BC colleagues, BC Renal facilitated a real-time earthquake response scenario over the course of a full day to test our newly published Emergency Management Plan. Learnings will help us improve the quality of the plan and our collective efficiency in addressing any real life scenarios our renal teams may face in the future.

Following the exercise, the team prepared a report to identify areas where our planning documents could be improved and areas where similar exercises could be more effective in the future.

“Our renal community has an incredible track record of delivering the highest quality patient care under extreme circumstances such as COVID, floods and wildfires, and I am confident in what we can accomplish together as we face and overcome obstacles that challenge our ability to provide life-saving kidney services to our patients.”

Sarah Thomas, Chair, Emergency Management Committee

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GLOME RULO NEPHRITIS CO MM IT T EE FEATURED WORK GN COMMITTEE HAS BEGUN WORK ON NEW VERSION OF THE GN ANNUAL REPORT The Glomerulonephritis (GN) Committee has begun work on the new version of the GN Atlas, a first-of-kind annual report that seeks to describe the incidence and prevalence of GN overall and its sub-conditions in BC. A pilot version of the Atlas based on a limited dataset was developed and presented to the BC kidney community in 2019.

With additional resources allocated by BC Renal to the project this year, the project team aims to expand from the existing foundation to incorporate several additional years of patient data available in the GN Registry of PROMIS (the Patient Records and Outcomes Management System) and integrate more robust methodological approaches and tools in the development of the Atlas.

OTHER HIGHLIGHTS •

Continued ongoing work to evaluate new drugs and health technologies that might be used in the treatment of GN, such as Belimumab and Avacopan

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Worked with the Kidney Foundation of Canada – BC and Yukon Branch to encourage people living with GN in BC to participate in training and become peer supporters

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Continued to manage the GN formulary, one of the four key BC Renal formularies, which is specifically tailored for people living with GN in BC

“The next version of the report is expected to be available in 2024 and will help clinicians and health-care administrators better understand the trends in this patient population within the province, refine treatment strategies, and improve resource allocation to care programs.”

Yuriy Melnyk, Project Manager, Glomerulonephritis Committee

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HE MOD IALYSIS CO MM IT T EE

FEATURED WORK

OTHER HIGHLIGHTS

FIRST HEMODIALYSIS QUALITY INDICATOR INTERACTIVE DASHBOARD RELEASED

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Established a Vascular Access (VA) Quality Indicator Improvement Working Group with a focus on using the VA Quality Indicator Report and related PROMIS reports as a basis for improving VA care

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Continued to review critical incidents and supply shortages that impact HD care, making recommendations and taking action to minimize the impact on patients and staff

The development of provincial hemodialysis (HD) quality indicators has been part of the BC Renal Hemodialysis Committee workplan for several years. HD quality indicators are important in guiding province-wide HD care and improvements.

With leadership from the BC Renal data analytics team, patient partner input on the committee level, and the active involvement of a working group that included clinicians, the first HD Quality Indicator Interactive Dashboard was released in spring 2023. This first report covered the period October 1, 2022 – March 31, 2023. Dashboards will continue to be developed and released every six months.

The HD Dashboard provides data on the following indicators: Vascular Access Prevalence, Vascular Access Infections, Tuberculosis Screening, and Survival on HD. Additional indicators will be added over time. Information can be viewed in multiple ways and is applicable at provincial, health authority and HD unit levels. Graphs provide comparisons over time, as well as across health authorities and HD units.

“Hemodialysis indicators are an important component of a comprehensive quality improvement program. Indicators provide guidance on what we are doing well and what areas we need to improve. Indicators ensure change is data driven and monitored over time.

The working group that developed the indicators were as passionate about objective measurement as they were about hemodialysis. The combined efforts of clinicians, data analysts and the PROMIS team were what made this project a success.”

Dr. John Antonsen, Chair, Hemodialysis Committee

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HOME HE MO DIALYSIS CO MM IT T EE FEATURED WORK

OTHER HIGHLIGHTS

HELPING PATIENTS MOVE TO HOME-BASED THERAPY WITH A CLEAR PATHWAY

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Reviewed and updated our procedures and protocols related to patient safety

Building on the work done in the last couple of years with the CRASH (Curriculum to Recruit Acute Starts to Home Dialysis) pilot project, we continued to develop and move this project to a province-wide implementation plan.

•

Welcomed many new home hemodialysis educators to the program

During the work with the CRASH pilot project, a number of opportunities were noted. Around the province, there has been inconsistency in the nurse navigator roles, but additionally a lack of clarity of the process by which patients – both unplanned acute dialysis starts and planned starts from the Kidney Care Clinics – are referred to and assessed for home therapies.

As we move toward implementation of this project, we are taking time to get this right. As such, the work is being broken into complimentary ‘bite size’ projects that will support one another when completed.

Included with this work will be projects and tools to help with: 1.

Finalization and implementation of a curriculum for all new hospital-based hemodialysis patients to identify potential home dialysis candidates

2. Referral process for patients suitable for home therapies 3. Standardized assessment tools for evaluation of patients for independent therapies

“This initiative will provide greater clarity for entire teams to understand who would benefit from assessment for home therapies, and a clear pathway for referral. I think the standardized approach to potential home patients will lessen variability that we see from one program to another as well.”

Dr. Michael Copland, Chair, Home Hemodialysis Committee

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K IDN E Y C A RE CO MM IT T EE FEATURED WORK

TRANSPLANT FIRST INDICATOR REPORT DEVELOPED, NEW COORDINATOR ROLES ADDED Transplant First, a joint BC Renal/BC Transplant initiative, focuses on implementing and sustaining enhanced pre-transplant clinical processes across BC’s regional kidney care clinics (KCCs), transplant clinics and provincial transplant centres. The goal is to ensure every KCC patient who is a potential kidney transplant candidate is identified, assessed and supported along the path toward transplantation as the treatment of choice, including assistance in finding a living donor.

Transplant First’s early focus was to standardize pretransplant clinical processes and identify key data points along the pathway. This led to the current year’s

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development of a “Transplant First Indicator Report,” which provides a better shared understanding of what is working well and where the gaps are so we can focus our efforts on improvement.

To address changes in processes and an anticipated increase in transplant referrals, BC Renal and BC Transplant received Ministry of Health funding to create new roles and additions to existing roles.

Several new Regional Transplant Coordinator positions are being implemented across the health authority renal programs to support KCCs, regional transplant clinics and provincial transplant centres with challenges in the pre-transplant process and enhance communication across teams and settings.

“The Transplant First initiative has focused on pre-transplant clinical processes and the challenges that continue to exist along the journey towards living donor kidney transplant. By working collaboratively with BC Transplant, patient partners and the regional health authority renal programs on addressing the gaps in the system, we will improve the process and the experience for everyone.

It’s been a great collaboration from the getgo towards a common goal. We continue to grow and learn from each other, whether we’re working as an administrator, healthcare provider or patient. Our different perspectives and experiences feed into creating a better system for staff and our patients.”

Sharon Gradin, Project Manager, Transplant First

OTHER HIGHLIGHTS •

Completed an evaluation of virtual care in BC’s KCCs and updated the guidance document on in-person and virtual visits; KCCs are working to integrate both types of visits in accordance with patient needs

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Started phase 2 of the Orientation/First Few Visits to KCC project; phase 1 focused on a needs assessment and phase 2 focuses on ways to improve the experience of patients who are newly referred to a KCC

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Established regular case-round education sessions for clinicians to discuss relevant topics related to autosomal dominant polycystic disease (ADPKD)

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Completed the ADPKD annual report which enhances our understanding of ADPKD in BC, including basic demographics, management patterns and clinical outcomes

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Continued offering 6 patient education webinars per year, working closely with the Kidney Foundation’s Kidney Wellness Hub to coordinate and help promote offerings

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PA L L I ATIV E C ARE CO MM IT T EE FEATURED WORK INTEGRATED PALLIATIVE EDUCATION STRATEGY LAUNCHED We were excited to recently launch our Integrated Palliative Nephrology (IPN) Education Strategy.

This milestone was made possible through the IPN Evaluation Project, completed in 2022, and the continued exploration of innovative approaches by our committee.

Our first face-to-face committee meeting since the pandemic, held in October in Vancouver, was an opportunity to connect, celebrate the work completed in recent years and discuss next steps. This inspiring event started with a sharing circle where attendees spoke about where they are from, their ancestral background and who they are within that context. This was followed by a discussion on Indigenous health views, their significance on a personal and community level, within the context of end of life care.

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Andrea Aleck, Director of Health and Wellness for the Tsleil-Waututh Nation and a fierce advocate for improving health outcomes for Indigenous communities, graciously shared her wisdom. She gave an exceptional presentation that highlighted how cultural and spiritual connections influence perspectives on the end of life journey, and provided specific examples of how health-care providers can be more supportive and trustworthy allies by being empathetic to those who are dying, as well as those grieving:

•

“We should never apologize for tears – we believe that tears are expressing our truth and when we don’t allow tears to come, that’s when we get sick.”

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“The hair is sacred and holds special meaning, especially at end of life. The braid signifies the three strands of health: mental, physical and spiritual all woven together.”

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“This is their journey, only their journey. Their experience is unique.”

Following this enlightening session, our Vice-Chair, Sherri Kensall, facilitated a session where participants tackled the three key areas from the IPN evaluation:

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Inconsistent awareness and uptake of educational tools and resources

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Barriers to engaging in goals of care discussions at a practice level

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The need for a person-centred approach

Drawing on the creativity of clinicians and patient partners, we generated novel ideas to address these challenges. Our aim is to support all kidney care providers to deliver high-quality, comprehensive care that aligns with the individual needs of patients, their families and communities.

OTHER HIGHLIGHTS •

Vice Chair Dr. John Duncan developed a clearly defined and structured curriculum for the Palliative Care Nephrology Advanced Fellowship Training Program; recruitment is underway

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Collaborated with the BC Centre for Palliative Care on multiple projects, including development of quality metrics to measure and evaluate patient and family outcomes and a Palliative Learning Pathway for clinicians

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Observed progressive improvement in health authority renal palliative quality metrics for symptom assessment and management and advance care planning this year

“When we look at our spirituality, we have different practices for different seasons.

Spirituality is so important to palliative care. For us when we light a fire or a candle, that is the gateway and the opening to the other side – it is our connection to the creator.

The biggest thing we as Indigenous people do for one another is we gather. We hold each other up because in that time of grief, that burden is so heavy that we need other people to carry that burden.”

Andrea Aleck, Director of Health and Wellness for the Tsleil-Waututh Nation “Working with passionate colleagues of all disciplines and from across the province on the BC Renal Palliative Care Committee, including our invaluable patient partners, has been a joy and an inspiration for many years. I am grateful for the opportunity for enhanced involvement as vice-chair to continue collaborative work on behalf of patients with kidney disease throughout BC. Our common mission is striving to continually improve the care and quality of life of our patients and their loved ones through integrated efforts to enhance advanced care planning, symptom management and a palliative approach to care throughout their journey. I am also grateful for BC Renal funding for the advanced fellowship in palliative care and nephrology and its potential for enhancing capacity for furthering our goals.”

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P ER ITON E AL DIALYSIS CO MM IT T EE FEATURED WORK HOME DIALYSIS REFERRAL PROJECT LAUNCHED Findings from a 2022 province-wide home dialysis current state review, including inconsistencies and lack of clarity in the existing referral process, became the impetus for the Home Dialysis Referral Project. Initiated in April 2023 as a joint initiative between the provincial Peritoneal Dialysis (PD) and Home Hemodialysis (HHD) committees, project goals include standardizing patient screening and referral, and minimizing practice variations for home therapies across all regional health authorities.

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A diverse working group, led by Dr. Megan Borkum and consisting of patient partners and interdisciplinary group members, conducted an environment scan as well as interviews of patients, their families and caregivers to understand support requirements needed at all stages in the decision-making process.

Next steps in the 18-month project are to identify core themes from the 65 interviews and to develop - and test - a standardized referral guide for determining the true eligibility of patients for home therapies and related outcomes.

Subsequent to the implementation of the provincial guide, an increase in the identification of potentially eligible patients for home therapies is expected.

•

2022 BC Renal patient experience survey results showed that despite the COVID-19 pandemic, most respondents on PD rated overall quality of services very highly

OTHER HIGHLIGHTS •

Dr. Shannon Wong led a five-year evaluation of the PD Assist program, and the related manuscript has been accepted for publication in the journal, Peritoneal Dialysis International

“It is exciting to see the work being done by patient partners and health authority modality staff involved in this project. Our goal is that every patient who would like to pursue home dialysis will have the opportunity. We want patients to receive timely education/resources and be well supported by all BC kidney care providers using a clear, provincial home dialysis referral process.”

Sue Saunders, Director, Home Therapies and Palliative Care

“Working with our interdisciplinary group members, inclusive of our patient partners, has been invaluable. Building their unique insights, perspectives and diverse experiences and work environments into the project has elevated the quality of our work and hopefully our deliverables will be richer and more widely applicable to all teams and patients across BC as a result.”

Dr. Megan Borkum, Nephrologist and Home Dialysis Fellow

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P H A R MAC Y S ERVICES CO MM IT T EE

FEATURED WORK KEY ROLES WITH FORMULARIES, COMMUNITY PHARMACIES, AND RELATED WORK CONTINUED In 2023, the Pharmacy Services Committee continued to manage four BC Renal-funded formularies of medications essential in the care and treatment of people with kidney disease. The committee also continued to oversee BC Renal’s partnerships with 30+ community pharmacies across the province and facilitate medication best practices.

Through the pharmacy formularies – one for patients receiving dialysis treatment, two for non-dialysis patients, and one for patients with glomerulonephritis – BC leads the country in renal medication and nutritional supplement coverage.

Committee members meet at least four times a year to evaluate if new medications should be added to the formularies and if existing ones should be removed.

This is done through an evaluation of clinical evidence and outcomes. Data and reports are discussed and decisions are made regarding the use of drugs. The committee also periodically conducts drug class reviews.

When medications are added to a formulary, patient counseling sheets, algorithms, processes and protocols are created to promote appropriate use.

“We encompass the whole medication use management concept – resulting in up-to-date, evidence-based formularies that also encourage, through policy and guidelines, optimal use of the medications funded

by BC Renal.”

Dan Martinusen, Chair, Pharmacy Services Committee

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R EN A L A D MINISTR ATORS CO MM IT T EE FEATURED WORK PHASES 1 & 2 OF EMERGENCY & DISASTER RELIEF AND CARE MODEL REDESIGN STRATEGY COMPLETED BC Renal has prioritized a multi-phase strategy to support the stabilization of the renal workforce and ensure capacity for agile emergency response within and across health authorities. This work has been a collaboration of the Renal Administrators Committee and the Emergency Management Committee in partnership with the five regional health authority renal programs.

Phase 1 of the strategy is complete, and includes a set of documents to support evidence-based decision making regarding emergency staffing. The resources are available on the BC Renal website: Hemodialysis Staffing Emergency Resources As part of Phase 2 of the strategy, the development of a Hemodialysis Emergency Support Team (HEST) is now complete, with nurses hired in each health authority. In the event of large-scale emergencies or environmental disasters, the HEST team will be available to travel as a mobile team, ensuring life-saving hemodialysis services are available and helping to mitigate hospital admissions and patient transfers to other regions.

During non-emergency times, the nurses will mentor new staff, share knowledge, support emergency preparedness and reduce the need for senior staff to conduct multiple orientations of new staff.

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Also as part of Phase 2, BC Renal’s Emergency Management plan was updated in August 2023, and evaluated at a Tabletop Exercise in September 2023.

(See the Emergency Management Committee page of this publication for more on this.)

OTHER HIGHLIGHTS •

BC Renal Hemodialysis Emergency Support Team Redeployment Manual created to assist the Hemodialysis Emergency Team with redeployment questions and support

•

“Connection Makes the Difference”, renal nursing video created and used by all regional health authorities and BCIT as a valuable tool in their recruitment efforts

“It has been a rewarding experience to collaborate with the renal administrators on a project that will help our workforce. Now that the HEST position has started in British Columbia, we can formally announce it. I’m looking forward to seeing how things develop in 2024 and am reassured that we are more equipped to respond rapidly to climate emergencies.”

Sarah Thomas, Project Manager, Strategic Initiatives, Education and Development

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IMPROVEMENTS DRIVEN BY P R OFESS IONAL GROUPS

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HOME HE MO DIALYSIS E D U C ATOR S GROUP

FEATURED WORK BUILDING NURSING KNOWLEDGE AND SUPPORTING CLINICAL PRACTICE THROUGH RESOURCE REVIEW AND NETWORKING The Home Hemodialysis Educators Group, comprised of home hemodialysis nurses across health authority renal programs, supports the provincial strategy to increase the prevalence of HHD in British Columbia. We ensure patients are cared for using quality metrics as a benchmark and through our efforts in each of our HHD units. Whether supporting a patient who is making a decision to pursue home hemodialysis, providing individualized training or managing day-to-today inquiries from patients, we are dedicated to helping patients stay independent at home.

The past year has been a time of farewells to a few of our seasoned HHD educators and an exciting time of welcoming new nurses and rebuilding the team. We continue to focus on enhancing the knowledge of each nurse and providing clinical support through the review of provincial resources.

OTHER HIGHLIGHTS •

Supported the home dialysis referral project through an interactive focus group

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Started AK 98 dialysis machine provincial rollout with Northern Health, Vancouver Coastal Health, and Providence Health Care

“Home hemodialysis has given me such a rewarding and fulfilling experience for many years, unlike any other nursing role.

Home hemodialysis nurses are able to create a very unique and sometimes longlasting partnership with their patients and caregivers. It feels like we get front row seats to watch our patients along their journey with kidney disease.”

Angie Robinson, Chair, Home Hemodialysis Educators Group

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P ER ITON E AL DIALYSIS R E GIST ER ED NURSE S GROU P

FEATURED WORK IMPROVING PERITONEAL DIALYSIS CLINICAL OUTCOMES THROUGH A PROVINCIAL AMIA SHARESOURCE WORKSHOP

potential for improved clinical outcomes. Provincial implementation of Amia Sharesource was completed in 2022.

Amia Sharesource is a patient-friendly automated peritoneal dialysis (PD) cycler system that enables the health-care team to remotely view and subsequently proactively manage patients’ therapy, resulting in the

As part of continuing education, a successful Amia Sharesource workshop was held in June 2023. Nurses and nephrologists representing all PD programs in BC

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enthusiastically spent the afternoon networking with peers while gaining knowledge and experience with this remote patient management system.

The workshop was facilitated by members of the BC Renal provincial Peritoneal Dialysis Committee along with nephrology colleagues from Ontario.

Incorporating a hands-on, interactive case study approach resulted in achieving the following learning goals:

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Understanding basic quality improvement (QI) theory principles

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Incorporating Amia Sharesource as a QI tool

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Managing peritoneal dialysis complications using Amia Sharesource

OTHER HIGHLIGHTS •

Working with BC Renal to complete text and audio translations of the 8 PD Patient Training Modules into Punjabi and Chinese (in progress); the modules are available on the BC Renal website

•

Based on current, evidence-based practice, worked collaboratively to develop, implement and review standardized, provincial PD nursing procedures and policies

“The provincial Amia Sharesource workshop provided an opportunity for the PD nurses to collaborate with each other and to consolidate and improve their understanding of the fundamentals of Sharesource. This will enable them to critically analyze data and highlight changes that can be made to prescriptions and care to improve patient outcomes.

Collaborating with committee/group members has been a wonderful experience, sharing knowledge and being able to learn from each other, as we all have the same goals to improve patient care and quality of life.”

Sara Faulkner, Chair, Peritoneal Dialysis Registered Nurses Group

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R EN A L D IE TITIANS P R AC T ICE GROUP This provincial group consists of about 90 dietitians across BC who are kept upto-date on standards of practice, protocols, nutrition supplements, research, conferences, projects and more. A number of the group’s members participate with BC Renal provincial committees, research activities, funding applications, the PROMIS information system, nutrition supplement prescription procedures, BC Kidney Days programming, BC Renal partner programs, and more.

FEATURED WORK HIGHLIGHT ON INTERIOR HEALTH: RENAL CULINARY MEDICINE PROJECT EXPANDS TO ONLINE RESOURCE It all started three years ago, when the Kelowna General Hospital (KGH) peritoneal dialysis team and KGH dietitian Jean Gibson had the idea to promote healthy cooking and eating habits for peritoneal dialysis (PD) patients based on dietary needs, through in-person, virtual and recorded cooking videos with pre-assembled food baskets. Thanks to support from Interior Health (IH) renal directors Paula Hann and Donna Jansons, the project was approved. A 2022 BC Kidney Research in Focus story, Boosting Patient Knowledge of Kidney-Friendly Foods, provides more information about this quality improvement project.

With the initiative being very positively received by patients/clients, the following year, the idea expanded into supporting patients with PD and chronic kidney disease (CKD) to improve quality of life, manage outcomes and optimize patient experiences through a culinary medicine approach. Culinary

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medicine combines the traditional art and skills of food preparation with the sciences of medicine and nutrition to maintain health and manage disease states.

Jean, in collaboration with KGH dietitian Marie Goyet, did a literature review and environmental scan and then used a survey and focus group for input from patients on their needs and barriers to managing CKD and adding plant-based proteins.

This led to developing a web-based resource.

Two patient partners, Jeane Helmelspeck and Bev Holland, provided valuable guidance throughout the development process.

With assistance from IH eLearning designer Shane Van de Sype, the resource Plant-Based Medicine for Chronic Kidney Disease was completed. It not only focuses on the benefits of plant-based protein for patients with kidney disease, but also includes practical ways to select, store and cook these foods with recipes, cooking videos and an interactive labelreading component. The intent is for this resource to be shared regionally and provincially with other renal programs.

THANKS TO HEALTH PROFESSIONALS AND PATIENTS/CLIENTS Jean and Marie would like to thank: the IH Renal Program team, the renal patients/clients and the dietitians they collaborated with over the past two years, with special thanks to Jeane Hemelspeck, Bev Holland and Eileen Carolan; also the IH steering committee members Mehran Faridani, Renal Program Manager, Dr Marie Michaud, Nephrologist, Lindsay Mitchell, Allied Health Manager, Karin Chand, Renal Program Coordinator, and Lisa Koski, Practice Lead Dietitian for the Central Okanagan, and BC Renal.

“I was very honoured to be asked to participate in helping to create the information included on this site, a site that I thoroughly believe is a huge contribution to all of us with kidney disease. Incorporating the recipes included into the diet we currently have is to all our benefit and is designed to help maintain and/or reduce the impact or decline of our kidney disease.

This site is very easy to navigate and has a wealth of very useful information. It may not be exactly what we are used to, but I wholeheartedly promote change and I suggest that everyone begin to add appealing ingredients to your pantry and try the recipes.”

Jeane Hemelspeck, Patient Partner

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SOC I A L WORKERS P R OFESS IONAL P R AC TICE CO U NCIL FEATURED WORK THE IMPORTANCE OF COMMUNITY PARTNERSHIPS IN SUPPORTING AND PROMOTING PATIENT CARE

when working with these provincial and regional organizations.

Renal social workers build strong working relationships with community agencies to address the economic, social and emotional barriers kidney patients face to improve their overall well-being.

They help patients access provincial resources such as BC Renal, Ministry of Social Development and Poverty Reduction, BC Transit (including the health connection bus and HandyDART), and health authority programs. Social workers also act as patient advocates

In addition, social workers assist with connections that are local to each community such as meal programs, food banks, seniors activity centres, mental health counselling, addiction services, hospice societies, immigration services and many more! Through our community partnerships, we support patients with kidney disease in finding ways to overcome barriers that affect their health and ultimately improve social conditions and health outcomes.

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One special connection to note for the BC Renal Social Work Professional Practice Council has been with The Kidney Foundation of Canada - BC & Yukon Branch.

This resource has been invaluable to BC’s renal social workers and the patients with kidney disease we serve.

The Kidney Foundation not only provides services and programs to help support patients in BC living with kidney disease, but also provides strong advocacy to advance care and expand supports available across the province.

This year, the BC & Yukon Branch suffered the loss of Heather Johnson, who had been the Director of Programs over the last 15+ years. The BC Renal social work community wishes to acknowledge the impact Heather had on so many of us over the years. Though Heather will be greatly missed, we are confident we will continue to foster these connections with the new Director of Programs, Kate Chong, in the years to come.

“Our connection with the Kidney Foundation and Heather Johnson is an excellent example of the importance of community partnerships. I knew Heather in a professional capacity since joining the renal program 15 years ago. She did amazing work for The Kidney Foundation - BC & Yukon Branch as their Director of Programs, and was a great resource and advocate for both the provincial renal and transplant programs. I always appreciated the care and compassion she showed for our clients and her willingness to have conversations to improve the services for the renal population. She was so passionate about her work and will be greatly missed by all of us.”

Neelam Mann, Member, BC Renal Social Work Professional Practice Council

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GET IN TOUCH BC Renal Suite 260, 1770 West 7th Avenue Vancouver, BC V6J 4Y6, Canada Phone: 604-875-7340 Email: bcrenal@bcrenal.ca @BCRenal