Dialysis clinics in the United States showed a 13% drop in first-year mortality during Kidney Care Partners' Performance Excellence and Accountability in Kidney Care quality improvement initiative, along with a 25% reduction in mortality for the first 90 days of dialysis treatment, according to an analysis of the PEAK program prepared by Brown University.
Launched in 2009, the PEAK initiative was designed to highlight proven practices with the goal of improving the rate of survival of kidney failure patients new to dialysis. As part of the campaign, KCP worked with Quality Partners of Rhode Island (now Heathcentric Advisors) to convene a series of expert panels to focus on clinical as well as patient and family engagement "best practices" that, if implemented consistently, could help improve survival rates. Areas of focus included reducing catheter use in favor of arteriovenous fistulas, improving cardiovascular outcomes, managing nutrition and inflammation, handling anemia, and optimizing dialysis, along with screening for depression, educating patients, and providing social support.
To monitor the kidney care community's efforts to improve first-year survival rates, KCP partnered with researchers at Brown University who analyzed government data sets that include information on patient deaths. Researchers from within the kidney care community worked with Brown researchers on a technical advisory panel to help interpret the data. “The reduction in first-year mortality represents a significant quality achievement," said Brown University’s Vincent Mor, MD. “A reduction of 13.6% in first-year mortality and 25% in 90-day mortality is quite substantial.” KCP had originally set a goal of a 20% reduction in first year mortality.
Incoming KCP chairman Edward Jones, MD, acknowledged that KCP could not link specific best practices to the lowered mortality, noting that results varied across the country. “More aggressive adoption of the strategies by different Networks might have lead to improvement in outcomes,” said Jones.