Ontario Renal Network | Reseau Renal de L'Ontario
 

Vascular Access-Archived


ORN | Ontario Renal Network » Ontario Renal Plan » Vascular Access-Archived
 
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2012/13 Achievements
  • Launched a Body Access and Independent Dialysis Collaborative
  • Collected vascular access surgery wait times data for the Wait Times Information System
  • Read More
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Patients on dialysis consider their access a lifeline, necessary for them to continue dialysis. The Ontario Renal Network has heard this message and has made access a priority program with the commitment to ensure each patient on dialysis in Ontario is achieving appropriate access. Our goal is to increase functioning, complication-free access. Our patients expect and deserve this level of care — we will deliver it.
Dr Louise Moist,
ORN's Provincial Lead For Vascular Access

Meet Ian MacFarlane ...with the support of my medical team ... I'm getting prepared to do home dialysis.  Ian MacFarlane with wife, Joyce Read His Story

Strategic Priorities

Triple aim triangle

By 2015, we will

  • Provide standardized, easy-to-understand education for patients about access options for hemodialysis
  • Decrease the use of catheters for patients on hemodialysis
  • Decrease the wait time between a patient’s decision around access surgery and its completion

Targets

  • 100% of patients seen in a pre-dialysis clinic for at least one year will have been assessed for appropriate body access before starting dialysis
  • 2% absolute decrease per year in prevalent hemodialysis catheter use
  • Establish a target for improvement in access wait times once baseline data become available

A vascular access is a literal lifeline for hemodialysis — it provides an access for blood to pass through the dialysis filter and deliver back “cleaned” blood. For peritoneal dialysis, which uses the peritoneum that lines the abdominal cavity as the filter, the "lifeline" is a catheter that is placed in the lower abdomen.

The arteriovenous (AV) fistula is often considered the optimal long-term vascular access for hemodialysis for these reasons:
  • Provides adequate blood flow
  • Lasts a long time
  • Has a lower complication rate than other types of access

If an AV fistula cannot be created, an AV graft or central venous catheter may be required.

The Opportunity

To achieve appropriate access for each patient on dialysis in Ontario.

Key Initiatives

  • Implement a standardized process and checklist for peritoneal and vascular access to improve coordination of care in the multiple steps
  • Deploy Vascular Access Care Coordinators in every CKD program
  • Enhance education and skill training around vascular access
  • Develop and implement a surgical wait time strategy for vascular access surgery and radiological services 
  • Develop guidelines to improve access for the insertion and maintenance of peritoneal dialysis catheters