Ontario Renal Plan 2015 – 2019
In 2015, we launched our second Ontario Renal Plan, a comprehensive strategy to guide the delivery of kidney care services in Ontario.
The Ontario Renal Plan 2015 - 2019 emphasized partnerships between patients and their healthcare teams, among healthcare professionals and between agencies. In creating the plan, we collaborated and consulted extensively with more than 260 participants, including people with chronic kidney disease and their families. These consultations outlined several key themes that became the basis of the 3 goals identified in the second plan:
- Person-Centred Care: Empower and support patients and family members to be active in their care
- Integrated Care: Integrate patient care throughout the kidney care journey
- Access to Care: Improve patients’ access to care
Here are some examples of progress made towards each goal of the plan.
Work in this area focused on patient engagement methods, as well as on tools, resources and supports for patients, families and healthcare professionals. This helps with shared decision-making and supports patients and families in self-management and self-reporting of their experiences.
- In 2015, we created a provincial Patient and Family Advisory Council. The council grew to 15 members by September 2018. This group of dedicated patients, family members and caregivers share their experiences and perspectives to help guide and inform the development of policies and initiatives that directly affect the way kidney care is provided in Ontario.
In addition, as of September 2018, there were more than 20 Patient and Family Advisory Councils across the province, who are partnering in the design and development of regional kidney care initiatives.
- In 2017/18, the Ontario Renal Network began collecting information directly from patients across the province related to their experience with, and outcomes of, kidney care. The responses from 3,800 patients to experience surveys helped us understand what proportion of patients are informed about their treatment options. More than 1,400 patients completed a symptom screening tool and provided results to their care team.
Better integration of care means that patients will experience well-organized care from a multidisciplinary team, with easy-to-navigate transitions at every stage of their kidney care journey.
Our work in this area focused on early detection and prevention of progression of kidney disease, palliative care for renal patients, and kidney transplant.
- We assessed the state of multi-care kidney clinics in the province to make sure patients have access to consistent, high-quality multidisciplinary care across Ontario. The results contributed to the development of the Multi-Care Kidney Clinics Best Practice Guidelines.
- Learning Essential Approaches to Palliative (LEAP) Care is an interdisciplinary education program that introduces the essential practical knowledge, attitudes and skills to provide a palliative care approach to kidney care. All 14 regions have implemented the program. As of November 2018, more than 320 providers have been trained in LEAP. In addition, 14 participants from the Regional Renal Programs have taken the LEAP Facilitator program. This will provide them with the tools and skills to offer LEAP training within their programs and regions.
- Patient-Centred Decision-Making focuses on ensuring that patients have meaningful conversations around their goals of care and treatment decisions early and regularly though their care. We developed resources for healthcare professionals and patients to help with these discussions.
- In partnership with the Trillium Gift of Life Network, we developed the Access to Kidney Transplantation and Living Donation Strategy. As a randomized control trial, 13 of the Regional Renal Programs are participating in this strategy to increase access to kidney transplantation, with a focus on living kidney donor transplants.
Access to Care
Some Ontarians with chronic kidney disease face barriers (e.g., geographic, sociodemographic) in accessing kidney care. Our work under this goal took a person-centred, community-first approach. Many barriers can be reduced when care is offered and supported in the patient’s home (including long-term care facilities) or community.
- Several projects addressed the unique challenges that First Nations, Inuit and Métis populations may face in accessing care.
- We partnered with First Nations communities and Thunder Bay Regional Health Sciences Centre to support patients to transition to home hemodialysis in remote fly-in communities in the North West.
- A new screening model helps capture risk factors for kidney disease and connects people in First Nations communities with measures and healthcare to prevent the disease from getting worse. In 2016/17, more than 500 community members were screened as part of the Wikwemikong Chronic Kidney Disease Screening initiative. Of these members, 323 were referred for diabetes or high blood pressure management, and 28 were referred for primary care management of early-stage chronic kidney disease. Community screening initiatives are expanding to the Mushkegowuk Tribal Council and North Shore Tribal Council regions of the North East Local Health Integration Network.
- In 2016/17, we introduced the Home Hemodialysis Utility Grant to help reduce financial barriers to home hemodialysis and support patients to dialyze at home. In 2017/18, 623 people received grants to help offset electricity and water costs associated with their home hemodialysis treatments.
- We established 6 Glomerulonephritis Specialty Clinics across Ontario to provide expert care to people living with glomerulonephritis and to act as partners to the remaining Regional Renal Programs in a shared care model. In addition, a funding policy was implemented to ensure patients have access to multidisciplinary and specialized care.
- To improve access to appropriate medications for people living with glomerulonephritis, we developed tools to help healthcare providers navigate the complex funding application process. We also created patient-friendly factsheets on 7 commonly prescribed immunosuppressive medications.
- We implemented Regional Renal Models of Care, which define roles and accountabilities of Regional Renal Program hubs, satellites and acute kidney injury affiliates for the organization and delivery of kidney care.