A Quality Improvement Initiative Targeting Chronic Kidney Disease Metrics Through Increased Urinary Albumin Testing
| Autor: | Micah L. Thorp, Robert Unitan, Ken J Park |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Urinary albumin Quality management business.industry Angiotensin-Converting Enzyme Inhibitors General Medicine Urine urologic and male genital diseases medicine.disease Quality Improvement female genital diseases and pregnancy complications Angiotensin Receptor Antagonists Benchmarking Electronic health record Albumins Internal medicine Informatics medicine Humans In patient Original Research Article Renal Insufficiency Chronic Stage (cooking) business Kidney disease |
| Zdroj: | Perm J |
| ISSN: | 1552-5775 |
| Popis: | INTRODUCTION: Achievement of quality metrics in chronic kidney disease (CKD), specifically urinary albumin testing and angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) use, remained lower in Kaiser Permanente Northwest compared with other Kaiser Permanente regions. We were interested if more frequent testing of urine albumin (ACR) improved CKD quality metrics. METHODS: We implemented a quality improvement project automating ACR testing using an informatics tool in patients with stage 3 CKD linked to an electronic health record (EHR) alert recommending ACEi or ARB initiation in patients with renal indication. RESULTS: At 1 and 2 years after implementation of ACR testing, ACR testing increased from 26.9% prior to implementation to 83% at 1 year and 77% at 2 year after implementation (p < 0.001). However, ACEi or ARB use did not increase significantly (65.8% vs 65.7% vs 66.4%, p = 0.54). There was also no significant change in other quality metrics, including diabetes control, hypertension control, and comanagement of higher-risk CKD patients. DISCUSSION AND CONCLUSION: In patients with stage 3 CKD, increased ACR testing via automated testing linked with EHR alert did not result in an improvement in CKD quality metrics. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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