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Our Practice Wide Initiatives

Vascular Access Improvement

Our Dialysis Access Center is dedicated to improving dialysis access care and patient's quality of life by rapid delivery of dialysis access care through maximizing access life and minimizing complications as an alternative to hospitalization. Our nephrologists and dialysis access coordinators are focused on educating patients about benefits of a fistula for dialysis access and encourage early creation of AV Fistulas instead of relying on grafts and catheters. We have programs and protocols in place for catheter reduction at the dialysis units. Our goal is to have more than 70% of our patients with fistulas and less than 5 percent of our patients using catheters.

Kidney Disease Education

We help people cope with their kidney disease and learn about what kidneys do and what treatment options are available. We routinely refer them to Master Kidneys classes offered by our staff or kidney school website or another site, FreseniusKidneyCare, so they can learn things at their own pace. We are believers in pre-emptive kidney transplant and work with our patients to get a donor or on a waiting list when their kidney function is below 20 percent. For those that need to start dialysis we make sure they begin treatments at the optimal time and have an easy transition. Our goal is to have all patients with CKD Stage 4 and CKD stage 5 attend Master Kidneys class offered by East Bay Nephrology or either KidneyCare365 education classes offered by Fresenius or Kidney Smart Classes offered by Davita. These classes discuss not only preventative measures but also treatment options including home dialysis, in-center dialysis and transplant.

Infection Prevention

We’ve created policies and protocols to prevent infections among kidney patients at the access center, the dialysis unit and in the office. In addition, we're working to ensure 100 percent of our staff and patients are vaccinated. We provide vaccinations against influe nza, pneumonia and hepatitis.

Promote more Kidney Transplants

We work with patients to keep them healthy while waiting for a kidney transplant and after they have received one with frequent timely office visits. We guide the patients through their transplant journey, from initial evaluation to post transplant care. Patients can refer to THE BIG ASK, THE BIG GIVE by NKF for inspirational videos on how to start a conversation about donation with family and friends. Non-profit national registries like National Kidney Registry and Alliance for Paired Kidney Donation can help promote paired donations for donors that don't match their recipients. Protocols are in place to expedite pre-transplant workup as requested by our transplant centers in the Bay Area. Our goal is to achieve double the national transplant rate and keep the transplant patients healthy as long as possible.

Increase Home Dialysis

We educate patients on benefits of home dialysis. Home dialysis offers patients more freedom, greater flexibility and independence. Many patients feel the best and enjoy optimal quality of life on home dialysis. We work with our educators and local home programs to ease transition to home therapies. We work with our expert surgeons for timely placement of peritoneal dialysis access. We have urgent start programs at our local hospitals and local home programs. We aim to have 50 percent or more of our patients choosing to dialyze at home.

Hospital Follow-ups

Each hospitalized patient has a follow-up plan. We want to make sure all is well after each hospital we can make sure patients get the care they need wherever they are. Through use of technology the primary patient Nephrologist and care coordinator receive alerts for every hospital admission and discharge. Discharge summaries are obtained and medication reconciliations are performed and patients are contacted regarding their follow-up plans. The aim is easy access to the right information for optimal care coordination.

Medication Reconciliation

Our physicians and expert staff members review patients’ medications to ensure they have obtained the medications they need and work with insurance companies to obtain appropriate authorizations electronically. They make sure the patient understands the proper amount of medicine and schedule, especially following a hospital stay. Our care coordinators facilitate information flow to the patient, either in person, on the phone or via secure video chat. The aim is to make sure the patient can obtain the medicines they need and have medication reconciliation after every hospital discharge.

Avoid Frequent Hospital Care

For select individuals with frequent emergency room and hospital visits every effort is made to use the community health resources and appropriate follow-ups, speak with the patient by phone and work with the care team to keep the patient out of the hospital if a visit there is not necessary and alternate paths of appropriate care are available.

Facilitate a Healthy Dietary Pattern

In Chronic Kidney Disease, low protein diets have been shown to delay the progression of chronic kidney disease but are not widely adopted. To delay progression of CKD we have adopted MedChefs to make making a low protein plant-based diet in CKD, simple, sustainable, and enjoyable. By use of the MedChefs app and website, along with weekly group meetings, patients experience a transformation of their diet and lifestyle. The resulting long-term adherence to this healthy dietary pattern extends life, delays kidney disease progression by 2-3 years, improves the quality of life and reduces the economic burden of chronic disease for our patients.