The investigators hypothesize that the post-hospitalized patient status is characterized by subacute and reversible metabolic and hematological changes that, if addressed and treated in a timely manner, would result in a reduced risk for repeat hospitalization. Consequently, a structured quality improvement program, focused on increasing adherence to company wide anemia management policies (ie hemoglobin monitoring within the first 3-5 days post-hospitalization, followed by an appropriate EPO dose modification within the 7 days post-hospitalization), will significantly decrease the risk of hospital re-admission in the 30 days after discharge.
The post-hospitalization quality improvement project will be piloted across 30 Fresenius clinics. Targeted enrollment of 1500 episodes of hospitalization in which the patient returns after discharge to resume outpatient dialysis. Patient outcomes will be followed for up to 30 days from the time of discharge from hospital.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
1,500
Patients returning to the unit are immediately assessed and treated for anemia
Normal unit policy for labs and anemia treatment
Denver Central
Denver, Colorado, United States
St. John's
Jacksonville, Florida, United States
JAX Beach
Jacksonville, Florida, United States
Prairie
Chicago, Illinois, United States
Tri Counties
Decatur, Indiana, United States
Huntington
composite of death or repeat hospitalization within the 30 days after discharge from a previous hospitalization
Time frame: one year to accumulate 1500 hospitalizations
hemoglobin, transferrin saturation, albumin, white blood cell count, and C-reactive protein* levels measured in the period following hospitalization and change relative to values measured prior to hospitalization (where available).
Time frame: one year to accumulate 1500 hospitalizations
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Floyd County
New Albany, Indiana, United States
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Delta, Louisiana, United States
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