Chronic Kidney Disease Learning Collaborative

Table of Contents

Overview

The NKF has developed a Chronic Kidney Disease (CKD) Learning Collaborative model to improve clinician awareness of CKD, improve routine testing for CKD, and ensure that people with laboratory evidence of CKD are appropriately risk stratified and receiving guideline concordant care. Learning Collaboratives are quality improvement initiatives in which clinical staff work together to redesign their systems to become more patient-focused and efficient. Through individual clinic meetings and peer to peer engagement, this model provides education and implements clinical decision support and workflow changes.

Strategies

Adapted from the CKD Change Package, the NKF offers an evidence-based CKD Learning Collaborative model that brings together teams from different practices to collaborate to improve CKD care.  This program follows the Institute for Healthcare Improvement Breakthrough model and employs the following strategies:

CKD Data Analysis

  • Conducted at the practice level to identify and illuminate CKD-related care gaps and identify specific measures targeted for improvement

CKD Workflow Review and Practice Onboarding

  • Review CKD data with practice staff, identifying CKD care gaps
  • Develop practice-specific CKD strategy with care team, evaluating existing workflows for diabetes, hypertension, and CKD
  • Provide practice-specific technical assistance to address any questions and build engagement

Monthly Meetings and Action Periods

  • Provide individual coaching and facilitation

Quarterly All Teams Meetings

  • Provide CKD technical assistance, discuss successes/challenges and how they were overcome, benchmark performance against other participating teams, and share progress, etc.

Program Outcomes Reporting

  • Assess increases in CKD testing, diagnosis, and risk stratification for people living with CKD as well as evaluate changes in people with CKD receiving guideline concordant care
In participating practices, CKD testing rates have demonstrated as much as a 28-55% improvement in CKD testing and diagnosis during the past year. Previous work by NKF has proved that even small increases in uACR testing can have impacts in reducing hospital admissions and readmissions, as well as drive net savings in medical costs.1

Outcomes

The NKF has partnered with FQHCs, ACOs, and other health systems to execute learning collaboratives in Missouri and Virginia. The partnerships have resulted in: 

  • Successful data analysis and population health strategy development
  • Implementation of CKD clinical decision support, identification of care coordination strategies
  • Increased patient engagement for CKD testing

Contact

For more information on the learning collaborative or to explore a partnership contact Katelyn Laue


1 Vassalotti, J et al. CKD Quality Improvement Intervention with PCMH Integration: Health Plan Results. Am J Manag Care. 2019;25(11):294-e301

CKDIntercept

CKDIntercept is a groundbreaking initiative from the National Kidney Foundation to improve chronic kidney disease testing, recognition and management in primary care.

For more information on the initiatives and programs within CKDIntercept: