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Offering Patients Therapy Options in Unplanned Start: Development and Implementation of an Education Program for Unplanned-Start Patients.

Unplanned start of dialysis is still a common and important problem for dialysis units in Europe and across the world: 30%-50% of patients can commence therapy in that way. Such patients are known to experience increased morbidity and mortality, to make greater demands on health care resources, and to be less likely to receive their dialysis modality choice. We therefore aimed to meet the specific needs of unplanned-start patients by developing and implementing an Unplanned Start Educational Programme in dialysis units. The new program--which is intended to effectively influence the clinical pathway for patients and to equip health care professionals with the tools necessary to support and optimize the process of unplanned dialysis start--was created with the support of 5 dialysis units and academic experts in patient education. It involves process mapping of patient flows so as to recognize the key steps in the management of unplanned dialysis. Following its successful development, the Unplanned Start Educational Programme was delivered to patients. To evaluate the effectiveness of the program, an observational study, Offering Patients Therapy Options in Unplanned Start, had the primary outcome of measuring the impact of the education program on dialysis modality choice (peritoneal dialysis or hemodialysis).