The following is a summary of “Creating KidneyPal: A Specialty-Aligned Palliative Care Service for People with Kidney Disease” published in the December 2022 issue of Pain and Symptom Management by Lakin et al.
Kidney disease patients have significant unmet palliative care requirements and are neglected by specialized palliative care teams.
Through focus groups and iterative improvement cycles, researchers developed KidneyPal, a specialty-aligned interprofessional palliative care service, to enhance the provision of palliative care to patients with kidney illness. Through clinical process indicators, such as the percentage of inpatient nephrology census that used KidneyPal, patient demographics, the source of the consult, physician comments, and self-reported team interventions, they iteratively assessed the development of KidneyPal.
Over 314 different patients visited KidneyPal between January 2019 and January 2021. Although the source of consultations changed with time, nephrology services accounted for the bulk of consultations. With the largest participation with patients on the inpatient nephrology hemodialysis service (mean of 29.9%), they consulted on an average of 13.5% of the inpatient nephrology patient hospital census. Nephrology doctors who participated in a survey gave KidneyPal good marks for its high rates of psychological support and goal-of-care treatments.
They were able to provide specialized palliative care for a new cohort of patients as a result of the development of KidneyPal. With time, they expanded to provide care for the whole spectrum of kidney disease patients as indicated by our nephrology service lines. They were able to achieve, it by being embedded in nephrology, forming bonds with individuals who care for kidney disease patients, and gradually customizing their service and interventions.