A Dedicated Nephrology Daycare Unit: A Step Toward a Patient-Centered Approach

TL;DR

A dedicated nephrology daycare unit improves patient care by reducing delays in treatment and enabling efficient delivery of procedures.

Contribution

The study demonstrates the effectiveness of a dedicated nephrology daycare unit in streamlining care and minimizing treatment delays.

Findings

The unit served 157 patients with 233 admissions, handling various procedures like immunosuppressive therapy and renal biopsies.

86% of cyclophosphamide therapy was completed on time, and 85% of rituximab therapy was administered without delay.

No complications were reported from admissions to the unit.

Abstract

Background

Nephrology services encompass a wide range of day-care procedures. Securing beds for day admissions can be challenging and may lead to significant delays in patient management.

Objective

This study aims to describe the impact of establishing a dedicated nephrology daycare unit at a tertiary care center.

Methods

Since January 2021, a dedicated nephrology daycare unit has been operational at King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia. This observational study retrospectively reviewed the admission records to the KAUH nephrology daycare unit from January 2021 to December 2023. Admissions with missing data were excluded from the analysis. The study outcomes included: 1. the number of patients served in the unit, 2. the scope of services provided, 3. the “time to completion” of immunosuppressive therapy administered in the unit, and 4. the rate of complications related to admission to the unit.

Results

There were 233 admissions for 157 patients. The scope of procedures included: 1. administration of immunosuppressive therapy (42 doses of cyclophosphamide, 70 doses of rituximab, three doses of methylprednisolone), 2. renal biopsies (25 procedures), 3. tunneled dialysis catheter procedures (40 procedures, both insertion and removal), 4. dialysis access angioplasty (three procedures), 5. IV iron therapy (45 admissions), and 6. other miscellaneous causes (five admissions). Ideal time to completion of cyclophosphamide therapy was achieved in 86% of patients, with the remaining 14% experiencing delays due to reasons other than bed availability. Time to completion of rituximab therapy was achieved without delay in 85% of patients, with a time interval of less than 21 days. There were no reported complications associated with admission to the unit.

Conclusions

Establishing a dedicated nephrology daycare unit facilitates the delivery of nephrology day-procedures and reduces delays in therapy.

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