Community Partnership and Education Leads to Living Kidney Transplant Carl Higgins recently set the living donor process in motion when he asked his REACH Kidney Care transplant coordinator, Christa Lawson, if she would display kidney transplant information at Grace Church of the Nazarene to educate the congregation. “I was thrilled that Carl wanted me to attend his church and offer transplant education. He put me in touch with Pastor Jonathan Left to Right: Diane and Carl Higgins, Trees who welcomed me. I found Pastor Jonathan and Cara Trees the congregation to be curious about organ donation, kidney failure, and what they could do to help,” said Lawson. “As a society, we struggle to openly discuss kidney failure and the need for help. Most people don’t know that living kidney donation is an option. That’s why community education is so enlightening.” Pastor Jonathan Trees was knowledgeable about dialysis, but he admits that he didn’t really understand the toll it takes on a person until you know someone on dialysis. Story continued on next page.
in this issue... Living Kidney Transplant
Purpose Project Recap
SO Why Exercise?
Kidney disease bill and more!
Community Partnership, continued “It wasn’t until my wife and I sat around with friends that we realized how kidney disease and dialysis was impacting their life. That’s how it became personal for us. At that point, we had to take action. We had the knowledge of what can happen, what a solution might be for them, and to walk away from it would have been wrong,” said Trees. Three members of the Grace Church of the Nazarene congregation are battling kidney failure. Each is hoping for a kidney transplant. 21 parishioners who heard the final segment of the Live Generously series on Sunday morning took the next step to sign up for screening to see if they could become a donor. Pastor Trees led by example. He was one of the 21 potential donors who turned out to be a match for Carl Higgins. “Kidney donation became a way for me to not just talk and pray about healing but literally a way to become a part of the solution,” said Trees. “I was surprised at how easy it was. I felt like the team that evaluated me as a potential donor had my best interests in mind each step of the way. I feel educated about the entire process. I hope that more people have the opportunity to learn about kidney failure and how easy it is to become a donor.” Carl was diagnosed with Wegener’s disease in March of 2010. Under the care of nephrologist, Dr. William Pettus of Nephrology Associates, he was referred to REACH Kidney Care to learn more about managing kidney disease. The goal was to delay kidney failure as long as possible, but make an informed choice among available options should kidney failure become imminent. “REACH Kidney Care helped me make sense of what kidney disease is. Through education and care coordination, the team at REACH became my support system,” said Higgins. “They were with me
Through education and care coordination, the team at REACH became my support system.
A living donor is the most powerful way to offer an extension of life. every step of the way. Christa is the one who encouraged me to learn about living kidney donation. It is with her help that I’m scheduled for a kidney transplant now.” Days after Pastor Trees was found to be a match for Carl, the transplant procedure took place. Pastor Trees went into surgery in the early morning hours, with Carl following behind him a short time later. Both families, including their friends, gathered in the waiting area, eagerly waiting on news from the surgery. The transplant surgery was a success. Carl’s new kidney began functioning right away. Pastor Trees was discharged 48 hours later, while Carl stayed a few days longer. “A living donor is the most powerful way to offer an extension of life and a life that is more fulfilling for those going through dialysis or those who are waiting for a kidney,” explained Trees. One member of the congregation has received a deceased donor kidney transplant since the REACH donor sign ups took place. A third parishioner is still waiting to see if there will be a match from the list of potential donors. There is hope that a second living kidney donor transplant will occur. According to the Organ Procurement and Transplant Network 2,973 Tennesseans are waiting for a life-saving organ, of which 2,628 need a kidney. Diabetes and high blood pressure are the leading causes of kidney disease which can lead to irreversible kidney failure. Early detection and lifestyle changes can help to prevent or delay kidney failure. Once kidneys fail, dialysis or a transplant is needed to live. To learn more about kidney disease, visit http://www.reachkidneycare.org/kidney-disease/. To register to be an organ donor, visit https://www.donatelife.net/register/.
Purpose Projects raise awareness of kidney disease in communities From January to August 2017, DCI, REACH Kidney Care and DCI Pharmacy teams participated in Purpose Projects across the United States. Purpose Projects are community service events where DCI employees team up to meet a community need while providing kidney disease and organ donation education. 34 Purpose Projects provided education and resources to more than 47 communities. The Projects varied in nature and c r e a t i v i t y. Three educational videos and two coloring books were designed to provide insight to kidney disease. A car show and a kidney disease flea market brought the community together in unique ways. Projects were held on a golf course, in a hockey stadium, at a baseball park and at a state fair. Many Projects directly impacted patient health. Kidney screenings offered blood pressure checks and urine tests; cooking demonstrations showed how to use fresh food to prepare a kidney friendly meal; and support group sessions allowed individuals to share concerns about kidney disease.
DCI Purpose Projects raised over $18,000 for local charities in their respective communities. 4
Over 450 people were screened for kidney disease through health fairs and community programs.
Over 20,000 people were impacted by DCI Purpose Projects
Celebrating the Specialties within kidney care Nephrology Nurses Week took place during the week of September 10-16. The American Nephrology Nurses Association (ANNA) designates the second full week in September to celebrate all nephrology nurses that care for patients with kidney disease. DCI had a great time interacting with nephrology nurses, and others who wanted to celebrate, through social media. We also recognized several nephrology nurses that go above and beyond their job title, such as nurses who helped displaced dialysis patients during the 2017 hurricane season.
The National Association of Nephrology Technicians recognizes the second full week in October as National Hemodialysis Technicians Week. During this recognition week, DCI had two spotlight hemodialysis technicians that were recognized for their outstanding performance inside and out of the clinic. DCI social media followers were encouraged to share graphics with and tag hemodialysis technicians to show support and celebrate the amazing things they do!
The entire month of October has been coined as American Pharmacists Month by the American Pharmacists Association. Through social media, the APhA put together two events, American Pharmacists Selfie Day and Pharmacy Technician Day! For both of these events, DCI celebrated our pharmacy teams by showcasing their selfies and thanking our technicians for the great work they do for patients!
So Why Exercise? Did you know that 80% of American adults do not meet the governmentâ€™s national physical activity recommendations for aerobic activity and muscle strengthening? According to the State of Obesity 2017 report approximately 45% of adults are not active enough to achieve health benefits. Is exercise really that important? Yes, especially for people at risk for chronic kidney disease. (CKD). Regular exercise may help to manage the risk factors for CKD. Studies show older age, diabetes, high blood pressure, cardiovascular disease, and higher body mass index are associated with CKD.Â With regular exercise you may lessen the possibility of developing CKD or progressing into end stage renal disease. Exercise is one prevention method you must practice in order to avoid dialysis or the need for a kidney transplant. There are several recommendations to prevent this, such as smoking cessation and dietary improvements to name a few, but let us focus on exercise.
Studies show older age, diabetes, high blood pressure, cardiovascular disease, and higher body mass index are associated with Chronic Kidney Disease. 6
Continuous exercise, such as walking, swimming, or biking is a great place to start. Every person is different, so you should work within your recommended limits and set a goal to improve over time. Consider taking a ten minute walk outside to enjoy the fresh air. Make sure you walk fast enough to get your heart pumping, but not so fast that you feel faint or overheated. As you move forward with your exercise routine, increase your time until you reach 30 minutes most days of the week. After adopting exercise into your day-today routine, you should notice positive changes. These changes may include increased energy, awareness of the foods you are consuming, improved blood pressure, better sleep, lowered cholesterol, and weight loss. All of these changes may improve your chances of delaying end stage renal disease. Of course people want to delay end stage renal disease, but getting motivated to exercise is sometimes a problem. It may help to exercise with other people. The National Kidney Foundation holds kidney walks in cities around the US throughout the year. Maybe you need a plan to get started. There are simple work out plans designed for people of all ages and fitness levels. Remember, today is always a good day to invest in your health. When you feel like giving up on exercising, remember why you started. Exercise really can help delay or prevent CKD.
The State of Obesity 2017 report discovered that approximately 45% of adults are not active enough to achieve health benefits. 7
REACH Kidney Care Takes the Fright Out of Dialysis Yvonne Pearson has been a part of REACH Kidney Care since 2013. She has stage 4 kidney disease and she has worked with the REACH team to manage her condition, delaying the start of dialysis for years. Yvonne was attending St. Luke’s Free Medical Clinic in Spartanburg, SC, while working through a diabetes diagnosis. Her doctor knew that chronic kidney disease was becoming an issue, so he referred Yvonne to REACH to talk about kidney disease and what her options would be. When her doctor mentioned that dialysis may be in her future, she had no idea what to expect. Yvonne made an appointment with REACH where she met a team dedicated to helping her, including Caterrace Moore, a REACH Spartanburg Care Coordinator. Caterrace impacted Yvonne’s life by educating her on four things: •Telling her what she could do to slow the progression of kidney disease •Treatment options for kidney failure •Different accesses for dialysis •What to expect on dialysis
She takes time to explain things to me and goes over my blood work and all other tests. 8
Caterrace was even able to help her find cost-effective options for her medications. “Caterrace is the best nurse I’ve ever had,” Yvonne said. “She takes time to explain things to me and goes over my blood work and all other tests.” Yvonne says that she is more prepared for dialysis because of REACH. They provided books and a DVD that explained strategies for prolonging kidney function. She was even able to visit a dialysis clinic to see what it was like, which made her comfortable with the dialysis process. “The most helpful thing about the REACH program is that if I ever have to go on dialysis I know that I will have a trusting and helpful staff to support me,” Yvonne says. She adds, “If I can tell people one thing it’s this: If God can bring me to it, He can see me through it!”
The Dialysis PATIENTS Demonstration Act Could Harm the Future of Care for Patients with Kidney Disease Dialysis Clinic, Inc., the nation’s largest non-profit dialysis provider, opposes the Dialysis PATIENTS Demonstration Act of 2017. The Act, H.R. 4143/ S. 2065, was introduced into the U.S. House on October 26, 2017 and Senate on November 2, 2017 and proposes “to establish a demonstration program to provide integrated care for Medicare beneficiaries with end-stage renal disease, and for other purposes.” “Dialysis Clinic, Inc. is wholly supportive of integrated care and finding new methods to improve the care for people with kidney disease,” said Doug Johnson, MD, vice-chairman of Dialysis Clinic, Inc. “Yet, there are significant flaws in the proposed legislation which we’ve conveyed to our representatives so that they and the broader public understand why we can’t support something that we believe could harm the future of care for patients with kidney disease.” Concerns were detailed in letters to the House of Representatives and the Senate on November 2 and November 8, respectively. The letters, posted on DCI’s website, outline several reasons for DCI’s opposition. “At first glance, it appears that the proposed legislation is designed to improve care coordination for patients.
However, on closer review, it becomes clear that the bill doesn’t improve patient care, rather it creates a new payment method that would only benefit the largest providers in the industry,” said Johnson. DCI asks individuals to evaluate the impact of the Dialysis PATIENTS Demonstration Act by considering the following questions: Will patients really have a choice? If the model were to go into effect, patients of participating dialysis providers would be involuntarily enrolled in a plan and then required to opt-out if they chose not to participate in the plan. However, if a patient missed the 75-day opt-out window, he/she could not leave the plan later in the year, even if he/she had concerns about the quality of care. Don’t patients deserve to choose among a variety of dialysis providers? The legislation could further increase consolidation in a sector that is already highly consolidated. Only large corporations could easily re-structure themselves from a provider organization into an entity that could also administer an insurance plan, with complete risk of all of the patient cost, which averages over $80,000 per year, as envisioned in the bill. If the legislation were to pass, the largest dialysis providers could have a competitive
advantage over smaller providers, many of which are not-for-profit, and there could be a risk of Send a letter to your Senator and further increasing consolidation in care of patients U.S. representative! on dialysis. “One important way to encourage… Go to www.dciinc.org/dpda. innovation is to roll back over-consolidation in the dialysis industry. While nonprofit and smaller dialysis If you are on a computer, you will be providers still exist, their numbers are dwindling,” able to read more about the Act. You will reported Anne Kim in her recent article, The Dialysis find information explaining how this bill Machine. impacts people with kidney disease. Why create a new demonstration model when there is a Comprehensive ESRD Care model Under the column “Start Here to Take that exists and works? The Center for Medicare Action” you will find a letter that you can & Medicaid Innovation launched the CEC model send to your representatives. in October 2015. Providers are encouraged to find innovative ways to improve patient care while If you are on a tablet or smartphone, you reducing cost to CMS. Many providers, including will be directed straight to the letter. DCI, have focused on care coordination, medication therapy management, and chronic kidney disease A form letter is already written. However, (CKD) education and have seen positive results. it will be more impactful if you customize The financial results for the first year of operations the content of your letter based on your of the ESCO show that every ESCO decreased the personal experience with kidney disease. cost of care. Claims have been made that the proposed Once you have completed the letter, enter legislation is good for patients, good for taxpayers your email and address. The email will be and good for the health care system. Is it really? sent to the Senator and U.S. Representative Patients are already seeing the benefits of improved that match your area. care coordination in the ESCOs. Avoiding new legislation and instead recommending that the Then, share “I oppose the #Dialysis ESCO be revised to add a third track with capitated PATIENTSAct” on social media. payment could save taxpayer money and legislative time. If this is really about patient care, then why would it be possible to exclude patients from the model during their most vulnerable times? An integrated kidney model should include CKD care, palliative care, transplantation, medical management, and hospice. Unfortunately, the Dialysis PATIENTS Demonstration Act covers none of those critical services and requires a patient to leave the organization if that care is needed. Creating silos of care is not integrated care and is not in the best interest of the patient. Any model addressing integrated care for patients on dialysis should keep all patients in the model, regardless of the needed care, so that these patients will not risk being abandoned by their expanded care team at these critical times. “We feel strongly that the Dialysis PATIENTS Demonstration Act is not in the best interest of all dialysis patients and may, in fact, harm the future of care for patients with kidney disease.” The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.
Learn how community partnership and education led to a living kidney transplant. Celebrate the success of Purpose Projects that brought kidn...
Published on Nov 10, 2017
Learn how community partnership and education led to a living kidney transplant. Celebrate the success of Purpose Projects that brought kidn...