Chronic Kidney Disease Change Package 2023

Population Health Strategies for Cardiovascular and Kidney Disease Risk Reduction

Background

Chronic Kidney Disease (CKD) remains a largely under-recognized and growing public health issue. Despite current guidelines that recommend annual CKD testing for adults with diabetes and/or hypertension, less than 10% of those with hypertension and less than 40% of those with diabetes are completely assessed.

To address this problem, the National Kidney Foundation (NKF) developed Chronic Kidney Disease Change Package 2023 — Population Health Strategies for Cardiovascular and Kidney Disease Risk Reduction. The Change Package provides clinicians, public health practitioners, and quality improvement professionals a systematic approach for transforming CKD care, advancing health equity, and health care quality improvement.

The heart of this systematic approach is a dashboard of process improvement activities for CKD screening, recognition, and management. Selected activities can be adapted based on local practice or clinic needs, resources, and workflows.

The dashboard encompasses six Stages of Change which are generally needed for successful CKD care transformation. Each Stage below is associated with suggested, actionable Change Ideas that are supported by evidence-based, guideline-driven Tools and Resources. These Tools and Resources can be utilized to implement care improvement in priority populations.

CKD remains an under-recognized, growing public health issue.

Current guidelines recommend annual CKD testing in adults with diabetes and/or hypertension. Less than 40% with diabetes and less than 10% with hypertension receive guideline testing.

The Chronic Kidney Disease Change Package 2023 provides a systematic approach for care transformation, advancing health equity, and healthcare quality improvement.

At the center is a dashboard of process improvement activities that are adaptable according to local clinic needs, resources, and workflows.

Stages of CKD Change

The dashboard encompasses six Stages of Change for successful CKD care transformation, and each Stage provides actionable Change Ideas supported by evidence-based, guideline-driven Tools and Resources for care improvement activities.

1. Understand CKD and its Management in Primary Care

Review guideline testing and management for CKD and the consequences of unrecognized CKD as a disease multiplier.

Explore Stage of Change 1

2. Assess the Quality of CKD Care in Your Institution

Evaluate the effectiveness of your institution's CKD recognition and management.

Explore Stage of Change 2

3. Building the Business Case to Improve CKD Care

Demonstrate a strong case for change through a health equity lens and healthcare expenditures.

Explore Stage of Change 3

4. Convene a Multi-disciplinary Team

Gather input and participation from your institution's healthcare professionals who are ready for change.

Explore Stage of Change 4

5. Develop the Implementation Plan for Your CKD Intervention

Build a plan that aligns with practice or clinic workflows, patient panels, and available resources.

Explore Stage of Change 5

6. Execute and Measure Your Impact

Measure your CKD intervention to adjust as needed and help ensure it achieves the desired outcomes.

Explore Stage of Change 6

Chronic Kidney Disease Change Package 2023