WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

Dr. Emilia Addo*

ABSTRACT

Background and Purpose: The management and treatment of chronic diseases, such as end-stage renal disease, is often unproductive because of patients’ poor adherence to treatment. The chronic care model toolkit is an Agency for Healthcare Research and Quality supported framework, associated with improved outcomes in patients living with chronic disease. This project was to develop and plan an educational program using the chronic care model toolkit for the interdisciplinary clinical staff of a renal hemodialysis center. AHRQ chronic care model educational program is an innovative quality initiative that leads to evidence-based practice. It addresses key aspects of developing and building a multidisciplinary team to deliver and achieve best practices for patient care, underutilized among End Stage Renal Disease patients. Method: Educational program materials were developed, including a plan for future implementation over 6 weeks in 2-hour twice-weekly sessions. Program planning accounted for the mixed roles and responsibilities of the interdisciplinary clinical team members. The pretest and posttest materials were developed from the toolkit. Results: It is recommended that clinical metrics be tracked through a Quality Assessment Performance Improvement measure to evaluate potential long-term influences of the program on patient adherence and outcomes. Conclusions: The project may enhance teamwork and improve clinical outcomes by using the AHRQ toolkit. This evidence-based initiative has implications for advanced nurse practitioners as leaders building a multidisciplinary team through workforce coordination and practice structuring and redesign to deliver and achieve best practices for patient. The processes are conducive for cost-effective, efficient, timely and safe management.