TY - JOUR
T1 - Developing a CKD registry in primary care
T2 - Provider attitudes and input
AU - McBride, Dannielle
AU - Dohan, Daniel
AU - Handley, Margaret A.
AU - Powe, Neil R.
AU - Tuot, Delphine S.
N1 - Funding Information:
Support: Ms McBride was funded by the Johns Hopkins School of Medicine Dean's Summer Research Fund; Dr Handley is partially supported by University of California San Francisco (UCSF)–Clinical & Translational Science Institute (CTSI) grant UL1 RR024131 ; and Dr Tuot is supported by grant K23DK094850. This work is additionally supported by grant R34DK093992 from the National Institute of Diabetes and Digestive and Kidney Diseases , as well as the National Center for Advancing Translational Sciences, National Institutes of Health (NIH) , through UCSF-CTSI grant UL1 TR000004 . Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.
PY - 2014/4
Y1 - 2014/4
N2 - Background Chronic disease registries have been successful at promoting the delivery of guideline-concordant primary care for patients with diabetes and hypertension, but not for chronic kidney disease (CKD). To understand whether a registry could be designed to improve CKD management in primary care, we explored primary care provider attitudes about the benefits (or lack thereof) of a CKD registry compared with other chronic diseases and the key facilitators of successfully implementing a CKD registry in safety-net primary care. Study Design Qualitative, using semistructured interviews. Setting & Participants We conducted and recorded semistructured 1-hour interviews with medical directors and quality improvement champions from safety-net adult primary care clinics in San Francisco. Analytic Approach Recordings were transcribed and analyzed using a grounded theory approach until thematic saturation was achieved. Results 20 primary care providers were interviewed. 4 themes relevant to the development of a successful CKD registry for safety-net primary care were identified: (1) provider beliefs that a CKD registry could aid in the delivery of team-based high-quality CKD care; (2) clinic workflow redesign and staffing are key facilitators to successful implementation of a CKD registry; (3) unique complexities of CKD, such as varying etiologies, may limit the use of a CKD registry by nonphysicians; and (4) a CKD registry is aligned with current primary care priorities and health care delivery strategies. Limitations Small sample size and reliance on clinician leaders within one health care delivery system. Conclusions A CKD registry directed at the entire health care team, with the functionality to track, standardize, and enhance CKD care through decision support, has the potential to improve the management of CKD in safety-net primary care settings. These data directly informed the development of a CKD registry in these settings in San Francisco.
AB - Background Chronic disease registries have been successful at promoting the delivery of guideline-concordant primary care for patients with diabetes and hypertension, but not for chronic kidney disease (CKD). To understand whether a registry could be designed to improve CKD management in primary care, we explored primary care provider attitudes about the benefits (or lack thereof) of a CKD registry compared with other chronic diseases and the key facilitators of successfully implementing a CKD registry in safety-net primary care. Study Design Qualitative, using semistructured interviews. Setting & Participants We conducted and recorded semistructured 1-hour interviews with medical directors and quality improvement champions from safety-net adult primary care clinics in San Francisco. Analytic Approach Recordings were transcribed and analyzed using a grounded theory approach until thematic saturation was achieved. Results 20 primary care providers were interviewed. 4 themes relevant to the development of a successful CKD registry for safety-net primary care were identified: (1) provider beliefs that a CKD registry could aid in the delivery of team-based high-quality CKD care; (2) clinic workflow redesign and staffing are key facilitators to successful implementation of a CKD registry; (3) unique complexities of CKD, such as varying etiologies, may limit the use of a CKD registry by nonphysicians; and (4) a CKD registry is aligned with current primary care priorities and health care delivery strategies. Limitations Small sample size and reliance on clinician leaders within one health care delivery system. Conclusions A CKD registry directed at the entire health care team, with the functionality to track, standardize, and enhance CKD care through decision support, has the potential to improve the management of CKD in safety-net primary care settings. These data directly informed the development of a CKD registry in these settings in San Francisco.
KW - Chronic kidney disease (CKD) registry
KW - chronic disease management
KW - chronic kidney disease (CKD) awareness
KW - decision support
KW - guideline implementation
KW - health information technology (IT)
KW - primary care
KW - safety net
UR - http://www.scopus.com/inward/record.url?scp=84897116460&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84897116460&partnerID=8YFLogxK
U2 - 10.1053/j.ajkd.2013.10.012
DO - 10.1053/j.ajkd.2013.10.012
M3 - Article
C2 - 24295612
AN - SCOPUS:84897116460
SN - 0272-6386
VL - 63
SP - 577
EP - 583
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 4
ER -