The Local Renal Health Centre (LRHC) program’s annual general meeting took place April 21. Over 65 people with representatives from 13 of the 16 LRHCs were present as well as members of the LRHC community support team based at Health Sciences Centre.
The LRHC program operates as part of Manitoba Renal Program – Winnipeg Regional Health Authority (WRHA) but also partners with regional health authorities, First Nations, the Northern Medical unit and First Nations Inuit Health Branch (FNIHB) throughout the province to deliver kidney health care.
The day began with LRHC Medical Director, Dr. James Zacharias, providing an overview of the program and updates on some program statistics. The oldest LRHCs are 30 years old and located in Flin Flon, Dauphin and Boundary Trails (formerly Morden). The newest LRHCs opened in 2012 and are in Hodgson and Berens River. The LRHC program serves over 270 patients in 16 locations and continues to grow.
Over the past several years, an average of 7 per cent of LRHC patient dialysis treatments have taken place in a Winnipeg unit for reasons such as doctors’ appointments or being an inpatient. Zacharias acknowledged the reason behind 30 per cent of those transient treatments was unknown and that the program would seek to identify and document this information in the future. Additionally, when LRHC patients are in Winnipeg, approximately 30 per cent of vacant LRHC spots are utilized by Winnipeg patients.
When it comes to wait lists, the largest lists are in the northern and eastern regions of the province. As of April 1, 2016 there were 21 LRHC spots available and 16 people on the waiting list but only six people on the wait list were ready to go to units where vacant permanent spots exist. Last year (ending April 2016) 79 LRHC assessments were done prior to permanent patient transfer.
Some available spots are located in limited demand areas such as northern or remote locations. Also there are many factors taken into account when considering a patient for a LRHC dialysis spot such as patient medical status, access to housing, transportation, place on a waiting list and whether or not they are training for home dialysis.
Many LRHC patients are facing less travel time and being able to stay closer to home for follow up appointments with the program. About 50 per cent of LRHC patients had visits closer to home due to LRHC on-site visits and telehealth.
MRP Program Director Betty Lou Burke and Administrative Director Alan Weber participated in an ‘Ask the Expert’ panel to face questions from LRHC staff including questions on improving staff access to education and medication cost coverage for patients.
Staff also listened to presentations on types of modalities, adherence, malnutrition and wound care from MRP educator Julie Lorenz, Dr. Andrea Mazurrat, WRHA’s Brenda Hotson and Health Sciences Centre renal manager Lesley Cotsianis respectively.
Each LRHC in attendance then presented an overview of their regions or units. For some of rural and remote dialysis centres, staffing and jurisdictional issues were mentioned as being consistent challenges. Local physician support is also a challenge for some rural units in hospitals facing doctor shortages. For communities closer to Winnipeg, many talked about being at or close to capacity. One unit is exploring supporting a home hemodialysis space in two local First Nations community nursing stations.
The day closed with MRP medical director Mauro Verrelli providing an update on the program’s overall strategic plan, accomplishments and next steps.