Roaming Renal Clinics: Overcoming Challenges in Delivering Renal Supportive Care to a Large Regional Population

Miss Miriam Hellyer1, Mrs Catherine Stockil1, Ms Patrina Marsden1, Mrs Kelly-Anne Marchioni1

1Murrumbidgee Local Health District, Wagga Wagga, Australia

Existing Issue

The Murrumbidgee Local Health District within New South Wales covers a large geographical area (>125,000 sq.km.) and serves a population of some 250,000 people whose socioeconomic status (SES) is lower than state average. Lower SES is associated with poorer health outcomes and rates of CKD are 1.9 times higher compared with those living in higher SES areas. Renal supportive care (RSC) services provide a pathway of care for patients who have chosen not to receive dialysis. A key principle of the RSC model is that patients do not travel to receive expert care and are seen in their own homes. However, with the challenges of increasing patient numbers, a lack of additional staffing and having a vast geographic region to cover, current practices were no longer sustainable.

Planning and Implementation

Peripheral RSC clinics around the region incorporating telehealth were proposed as a solution. These clinics involved patients local to the area travelling to their local community health centre (CHC) to see the RSC team. Telehealth could be facilitated with one member of the RSC team on site while the others connected remotely. Discussions with patients were first initiated to identify whether travel of 30 minutes to their local health facility would be acceptable. Clusters of RSC patients around MLHD were identified to utilise appropriate CHC’s.

Outcomes

Following implementation an increase of 18.4% patient contacts was recorded over 12 months. Ongoing patient reported experience measures demonstrate a high level of satisfaction.

Key take home message

Clustering patients by location, utilising telehealth and booking patients into local CHC’s improves sustainability of the RSC service.


Biography:

Catherine is a Renal Supportive Care Social Worker with 12 years’ experience working in health. She obtained her BSW from Charles Sturt University and is a Riverina local. Advance Care Planning and end of life care are areas of interest. She enjoys the challenges and rewards of working in regional NSW.

Miriam is a Renal Supportive Care Dietitian with over 9 years’ experience in healthcare. She obtained her BSc (hons) in Dietetics from the Coventry University, UK. In 2019, she moved to Australia and obtained full APD status. Miriam has a master’s degree in public health and an interest in population-health.

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