The development and design of a tool for continuous quality improvement in peritoneal dialysis

Kidkom Salelanont¹,, Suwannee Sriprach², Tanapon Meeudon³, Montri Phathong², Siribha Changsirikulchai ¹

Renal Division, Department of Medicine, Faculty of Medicine, SrinakharinwirotUniversity, Thailand ¹ ,The National Health Security Office Region 4 (Saraburi), Thailand ², The National Health Security Office Region 1(Chiang Mai), Thailand³

Purpose: Continuous quality improvement (CQI) is mandatory to improve clinical care. The monitoring and evaluation of outcomes are important steps in CQI. We develop the Database of Peritoneal dialysis in EXcel (DPEX) being a tool for individual PD units to monitor and evaluate peritoneal dialysis (PD) outcomes.

Method: DPEX has been started since 2012. It is permitted freely usage by PD centers throughout Thailand. Initially, it has been designed in web application and evaluated 3 clinical outcomes. At the end of 2018, it has been redesigned into web-application and window-application. The variables has been expanded, categorized and divided into 17 modules according to requirements from users. Data in each modules has been voluntarily registered depend on each PD units.

Result: The modules in DPEX are composed of 1.basic information, 2.infection both PD and non-PD related infection, 3.hospitalization, 4.comorbidity, 5.physical examination, 6.general laboratory, 7.special laboratory, 8.PD prescription, 9.chest x-ray and electrocardiography, 10.peritoneal equilibration test, 11.adequacy,
12.nPNA, 13.Tenchkhoff catheter insertion, 14.activity daily life, 15.depression screening, 16.referral system, and 17.hospital profile. There are 97 from 253 PD units (38.3%) registered in DPEX. Total number of PD cases registered were 22,248 cases since 2012 to December 2018 (average 3,708 cases/year). The number of data recorded were 367,135 records. DPEX program can be automatically reported to 24 clinical and process outcomes immediately after input data. The users can export their own data for further analysis and design CQI.

Conclusion: DPEX has been used in many PD units probably from easy program, and benefit to CQI.