Assessing the efficacy of coproduction to better understand the barriers to achieving sustainability in NHS chronic kidney services and create alternate pathways

Health Expectations

Sarah Hirst Williams¹  Gareth Roberts²  Joanna Charles³  Linzi Isaac⁴  Judith Stone⁵  Teri Howells⁶  David Fellowes⁶  Joanne Popham⁷  David Dallimore⁸  Jane Noyes⁸  Leah Mc Laughlin⁸  James Chess⁹  Jonathan Mathews^1,10  Gail Williams^1,10 

[1] Betsi Cadwaladr University Health Board Bangor Wales UK;Cardiff and Vale University Health Board Cardiff Wales UK;Centre for Health Economics and Medicines Evaluation Bangor University, School of Medical and Health Sciences Bangor Wales UK;Kidney Care UK Alton UK;Kidney Wales Foundation Cardiff Wales UK;Patient Representative Swansea Wales UK;Paul Popham Fund Renal Support Wales Swansea Wales UK;School of Medical and Health Sciences Bangor University Bangor Wales UK;Swansea Bay University Health Board Swansea Wales UK;Welsh Renal Clinical Network Welsh Health Specialised Services Committee Pontypridd Wales UK;

关键词: coproduction;    dialysis;    family;    kidney disease;    patient;    service improvement study;   

DOI  :  10.1111/hex.13391

来源: DOAJ

【 摘 要 】

Abstract Context Too many people living with chronic kidney disease are opting for and starting on hospital‐based dialysis compared to a home‐based kidney replacement therapy. Dialysis services are becoming financially unsustainable. Objective This study aimed to assess the efficacy of coproductive research in chronic kidney disease service improvement to achieve greater sustainability. Design A 2‐year coproductive service improvement study was conducted with multiple stakeholders with the specific intention of maximizing engagement with the national health kidney services, patients and public. Setting and Participants A national health kidney service (3 health boards, 18 dialysis units), patients and families (n = 50), multidisciplinary teams including doctors, nurses, psychologists, social workers, and so forth (n = 68), kidney charities, independent dialysis service providers and wider social services were part of this study. Findings Coproductive research identified underutilized resources (e.g., patients on home dialysis and social services) and their potential, highlighted unmet social care needs for patients and families and informed service redesign. Education packages were reimagined to support the home dialysis agenda including opportunities for wider service input. The impacts of one size fits all approaches to dialysis on specialist workforce skills were made clearer and also professional, patient and public perceptions of key sustainability policies. Discussion and Conclusions Patient and key stakeholders mapped out new ways to link services to create more sustainable models of kidney health and social care. Maintaining principles of knowledge coproduction could help achieve financial sustainability and move towards more prudent adult chronic kidney disease services. Patient or Public Contribution Involved in developing research questions, study design, management and conduct, interpretation of evidence and dissemination.

【 授权许可】

Unknown