Thursday, August 11, 2011

Self-dialysis in Sweden

Ryhov Hospital in Jönköping, Sweden, had a traditional hemodialysis and peritoneal dialysis center. Now they aim to have 75% of patients be on self-dialysis.

Read that again.

When Maureen Bisognano, CEO of the Institute for Healthcare Improvement, told me this story, I was blown away.  How could this happen?  Here are some of her slides from a recent presentation.

In 2005, a patient named Christian asked about doing it himself.  The nurse in charge thought about it and thought that he could pull it off.  She had trained many other nurses in the procedure, so she just trained him in the same sequence.  Then it went viral. 

They currently have 60% of their patients on self-dialysis and hope to reach 75%.  Christian reports:

The nurse leader says:

Did you notice that?  1/2 to 1/3 less cost per patient.  Better outcomes, far fewer complications and infections.

A staff nurse says:

Did you notice that?  Instead of engaging in vulnerable and helpless behavior during treatment, the patients were energized and would exercise.

What does all this mean?

I can already hear the objections.  "Our patients are sicker."  "The Swedes are all the same ethnicity."  "It would never work here."



Beverly said...

From Facebook:

This is kind of amazing; in America they would have fired the nurse for not following protocol, or something. Thus is innovation born.

@drpippa said...

From Twitter:

How can we get more patients empowered to self care? We can change our systems!

@medicallessons said...

From Twitter:

Self-dialysis in Sweden: Ryhov Hospital lets patients take care of themselves (neat idea! and why not?)

@baerbelsmile said...

From Twitter:

Would be great to have this here in the US,too. Would cut cost.

@fvguima said...

From Twitter:


@CloseToHomeMD said...

From Twitter:

Because we have regulated ourselves into a deep dark hole.

Anonymous said...

Wow, empowering the patient/person with a chronic disease. How novel :-).

KidneyDoc36 said...

I have long believed that our targets for independent dialysis (around 35%) are far too conservative and underestimate the capability and will of people with chronic illness to look after themselves. I would like to connect with Ryhov Hospital dialysis unit to learn more about how they have overcome barriers to self-care, including but not limited to learned dependence, fear of technology, lack of self-confidence and the archaic attitude of doctors and nurses who are fixated on control and overblown concerns about professional liability, and can find a million reasons why each patient is "not suited" to self care.

Who can I contact at at Ryhov to learn about their strategy?

R. Scott Lake said...

From Google+:


Anonymous said...

I recently studied nursing in Sweden, and had the opportunity to visit this unit and to talk with the staff, and see the patients. It is quite amazing and was great to see!

Anonymous said...

We are all so thrilled about the postive comments about our selfcare-unit in Jönköping, Sweden.

we are so proud of our patients. They are the best and motivate us to continue this way.

If you have questions you are more than welcome to contact us.

Eskil said...

I´m really proud to be married to one of the nurses!

This is really amazing and I think that this mindness is something for other to copy.