Enhancing primary care capacity in chronic kidney disease management: a quality improvement educational initiative

Abstract

Background: Gaps in identification, medical management and appropriate referral for patients with chronic kidney disease (CKD) are evident.

Objective: We designed and implemented an interactive educational intervention (accredited workshop) to improve primary care providers' awareness of tools to support guideline-concordant CKD management.

Design: We used the Kern method to design the educational intervention and targeted the accredited workshops to primary care team members (physicians, nurses and allied health) in Alberta, Canada. We conducted anonymous pre-workshop and post-workshop surveys to identify practice-specific barriers to care, identify potential solutions, and evaluate provider confidence pre-intervention and post-intervention. We used non-parametric statistics to analyse Likert-type survey data and descriptive content analysis to categorise responses to open-ended survey questions.

Results: We delivered 12 workshops to 114 providers from September 2017 through March 2019. Significant improvements (p<0.001) in confidence to appropriately identify, manage and refer patients with CKD were observed. Participants identified several patient-level, provider-level, and system-level barriers and potential solutions to care for patients with CKD; the majority of these barriers were addressed in the interactive workshop.

Conclusions: The Kern model was an effective methodology to design and implement an educational intervention to improve providers' confidence in managing patients with CKD in primary care. Future research is needed to determine if these perceived knowledge and confidence improvements affect patient outcomes and whether improvements are sustained long term.

Keywords: chronic renal failure; medical education & training; primary care; quality in healthcare.