Before a patient can be referred for a kidney transplant in British Columbia, there are numerous steps for both the individual and for multiple health-care providers to complete. A survey of kidney care providers and patients from across the province shows while a substantial portion of respondents understand many aspects of the process, there are opportunities to further improve communication, education and coordination.
Transplantation is an ideal form of treatment for people with kidney failure who meet the requirements. However, the referral process is complex and can be difficult to understand, requiring coordination among many different kinds of health-care providers, as well as education for patients.
BC Renal has been working on province-wide strategies to boost peoples’ understanding of the process, and recently conducted a survey to explore the levels of knowledge of staff and patients.
“We wanted to look at it from both sides, to see if there were any areas we could further improve, all with the goal of giving our patients the best chance of getting a transplant,” explains Dr. Micheli (Mike) Bevilacqua who was involved in the study and is a nephrologist with Fraser Health and chair of the BC Renal provincial Kidney Care Committee.
In total, the researchers surveyed 100 health-care providers and 146 patients eligible for kidney transplantation from across BC.
The results show a significant portion of care providers self-reported understanding their own role within the transplant referral process, at 76 percent. However, only 47 percent understood others’ roles.
“The majority of people didn’t know the roles of others, which is a problem when you have multiple people involved and you don’t know who is doing what,” Bevilacqua explains.
As well, while 92 percent of care providers reported feeling confident about their knowledge of transplant eligibility, only 68 percent of nurses and 77 percent of nephrologists reported having enough knowledge to discuss living donation with patients. These findings suggest it could be beneficial to further support staff in discussing the transplant process with patients and in understanding each other’s roles.
“I think part of the solution is having a more structured way for each team to have updates from one another,” Bevilacqua says.
Among the patients surveyed who had taken part in an education session about transplantation, only 60 percent reported having a good grasp of the pre-transplant clinical processes. Bevilacqua says this finding may indicate that some patients would benefit from multiple educational sessions at different stages.
“It’s a very complicated process to complete all of the necessary testing of a patient in preparation for a transplant, so doing a one-time education session about the various steps might not be enough,” he says. “We may need to revisit it from time to time and check in with people on where they are at in the process.”
The results of this study, led by Dr. Oshorenua Aiyegbusi and published in the Canadian Journal of Kidney Health and Disease, will be used by the researchers to guide improvements in communication, education and coordination strategies moving forward.
