The benefits of offering extended-hour dialysis shifts

The non-profit Hortense and Louis Rubin Dialysis Centers in New York already had an in-center nocturnal hemodialysis program, where patients came in at 8:00 pm and stayed until 5:00 am to get longer, more gentle dialysis treatments. But that wasn't a good fit for all of the dialysis patients who could have benefitted from the extra treatment time. So now Rubin offers an after-work option so people can come in at 5:00 pm and stay until 11:30 pm or midnight, or any timeframe therein. The shift is available at all three Rubin locations: Troy, Clifton Park, and Saratoga Springs, NY.

Dori Schatell, executive director of Medical Education Institute, is the author of "Rubin thinks outside the shift with new extended-hours dialysis" in NN&I's March 2013 issue. Shari Meola, RN, CNN, is the clinical services coordinator at the H&L Rubin Dialysis Center Inc., which is featured in the article. -by Rebecca Zumoff

Question: What do you think is the biggest barrier keeping more dialysis clinics from offering these kinds of hours?

Meola: I believe the biggest barrier may be staffing the overnights and the extended therapies and in rural settings transportation plays a role. It is difficult for some of the patients who are very interested to get a ride back and forth to their treatments in the "off" hours.

Q: Give us a current status on the number of patients who have signed up for this shift at your two clinics. Do you anticipate"staying power" for this program?

Meola: Our overnight in-center program is a bit more popular than our extended after work therapy is. We seem to have a continual wait list for the overnights. The extended therapy is appealing for the person who works and just comes after work for an extended treatment, but can go home to their own bed to sleep. I do believe there is staying power for both of these therapies as they both appeal to people looking for "more" therapy to fit into their lifestyle. I also believe that these are both very good options for the vacationing patient. Coming in to a center on later hours, allows the vacationing patient and family the ability to be free during the day to enjoy vacation activities.

Q: Do you think offering these types of shifts can have an impact on patient rehabilitation?

Schattel: Absolutely! Patients know their lives best, and know what fits into their lives best. If clinics can offer treatment that are twice as long as standard ones without negatively impacting family life, new possibilities open up for patients. What Rubin is doing is the very definition of "patient-centered care."

Q: What can be done to increase these kinds of treatment options in dialysis clinics?

Schattel: The first step is to get the word out about options like these! What we hope to do with this article is plant seeds in the minds of others who will think creatively about how to deliver dialysis that will help patients to have the best possible lives.

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