1. A Comprehensive Quality Assurance Platform in Canada for National Point-of-Care Chronic Kidney Disease Screening: The Kidney Check Program
- Author
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Michelle Di Nella, Caroline Chartrand, Adeera Levin, Sarah Curtis, Lorraine McLeod, Heather Martin, Paul Komenda, Cathy Woods, AbdulRazaq Sokoro, and Barry Lavallee
- Subjects
030232 urology & nephrology ,chronic kidney disease (CKD) ,030204 cardiovascular system & hematology ,patient-centered care ,lcsh:RC870-923 ,Indigenous ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Knowledge translation ,Health care ,medicine ,Research Letter ,patient-oriented research ,Community engagement ,business.industry ,screening ,lcsh:Diseases of the genitourinary system. Urology ,medicine.disease ,Health equity ,patient-engagement ,point-of-care testing ,Quality management system ,Nephrology ,Organizational structure ,business ,Kidney disease - Abstract
Indigenous peoples often endure significant health disparities fueled by historic and ongoing marginalizing policies and practices. In many cases, Indigenous groups are isolated from mainstream health care services (geographically, economically, or culturally) and lack the preventive health benefits associated with continuity of care.1 In Canada, this manifests in disproportionately high rates of chronic disease, often diagnosed at a younger age and greater severity than non-Indigenous groups. Of these, chronic kidney disease (CKD), diabetes, and hypertension are highly prevalent, reaching epidemic levels in many communities.2 Kidney Check is a comprehensive screen, triage, and treat initiative working to bring preventive kidney care to rural and remote Indigenous communities across Manitoba, Ontario, British Columbia, Alberta, and Saskatchewan. Modeled after the 2015 FINISHED initiative in Manitoba,3 and working within the CanSOLVE CKD network (www.cansolveckd.ca/), Kidney Check employs point-of-care testing (POCT) to identify CKD, diabetes, and hypertension in individuals aged 10 and up regardless of preexisting risk factors. To ensure the efficacy and sustainability of the program, Kidney Check relies on a strategic quality management system that addresses all aspects of the screening process. The intent of this manuscript is to describe the development process of all procedures and components related to the deployment of the Kidney Check program with specific focus on organizational structure, point-of-care testing devices, and data management. The Kidney Check Team Kidney Check’s management structure consists of the leadership team, advisory committee, patient partner committee, and mobile screening teams. Leadership provides guidance to the provincial teams to ensure the appropriate objectives, processes, and tools are in place to support high-functioning groups. This includes working closely with the advisory committee to preemptively identify potential barriers and risk issues in order to develop efficient mitigation strategies. Largely composed of Indigenous stakeholders and closely affiliated with the CanSOLVE CKD Indigenous People’s Engagement Council (IPERC), the advisory committee provides valuable insight on how to best use engagement strategies to maximize participation in the screening event. They are supported by the patient partner committee that oversees the execution of knowledge translation activities including but not limited to community selection criteria, community engagement procedures, and review of communication materials and strategies. Screening teams operate under the auspices of the Diabetes Integration Project and First Nations Health and Social Secretariat of Manitoba (FNHSSM). Stationed in various communities across the country, the team’s primary aim is to accommodate high throughput while maintaining quality control (QC) standards. As an affiliate of the CanSOLVE CKD network, members of all committees within Kidney Check have linkages to the broader network.
- Published
- 2020