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Clinical Key Performance Indicators (KPIs) are crucial for evaluating the quality and effectiveness of hemodialysis treatment. These metrics offer valuable insights into patient care, aiding providers in monitoring and enhancing patient outcomes. This study examines the use and analysis of vital KPI parameters in hemodialysis patients. The research focuses on three hemodialysis centers of Africa Healthcare Network (AHN) in Rwanda: Kimihurura (Kigali), Gisenyi, and Gihundwe, providing examples of potential care improvements in Low-Income Countries.
We analyzed validated KPI variables which included hemoglobin, calcium, phosphorus, calcium-phosphorus product, KT/V, vascular access, infection rates, hospital admissions, and mortality using recorded data from Clinicea, the electronic medical record of AHN, between February and November 2022. Additionally, operational KPIs, such as nurse-to-patient ratio and bed occupancy, were assessed.
The analysis included KPI data from three AHN centers in Rwanda, comprising 67 patients in total. From May to November 2022, there was an improvement in the percentage of patients tested for Kt/V urea, serum albumin, and ferritin. Hemoglobin levels met the target (Hb 11-12g/dl) in 40% of patients, with the Gihundwe center having the highest number of patients with anemia (Hb <8g/dl). Vascular access showed an increase in patients with AVF and a decrease in those with tunneled catheters. Infection rates, admissions, and mortality were relatively low. The nurse-to-patient ratio was around 2.3 per nurse per day, with higher ratios at Kimihurura standalone. Bed occupancy saw an increase in November 2022. The Gihundwe dialysis center recorded 100% Kt/V urea in both October and November 2022.
Overall, KPIs can optimize monitoring of hemodialysis center activity, enabling targeted clinical improvement of patient outcomes and quality of care, particularly has potential in Low-Income Countries.