{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T02:41:28Z","timestamp":1755225688480,"version":"3.43.0"},"reference-count":20,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:00:00Z","timestamp":1745884800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We review the impact of a nephrology key performance indicator (KPI) program implemented over a ten\u2010year period in Victoria, Australia. The program enabled transparent comparison of performance across nephrology units, however improvement against performance targets was not consistent and better understanding of KPIs is required to promote quality improvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>We aimed to review the impact of the Victorian nephrology KPI programme over a 10\u2010year period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">KPI<\/jats:styled-content> programme involved six <jats:styled-content style=\"fixed-case\">KPIs<\/jats:styled-content> related to the continuum of care for kidney replacement therapy: pre\u2010dialysis education, vascular access at first haemodialysis, home dialysis rates, peritonitis rates, pre\u2010emptive kidney transplantation and rates of transplantation\/waitlisting. Data were collected monthly from the 10 Victorian nephrology services using a purpose\u2010designed website portal. Results were analysed and reported every 3\u2009months. We present a summary of each <jats:styled-content style=\"fixed-case\">KPI<\/jats:styled-content> and discuss changes over the 10\u2010year period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">KPI<\/jats:styled-content> data demonstrated significant differences in performance across <jats:styled-content style=\"fixed-case\">KPIs<\/jats:styled-content> after implementation, particularly in rates of home dialysis and transplant waitlisting. Changes within units were sometimes significant, but across Victoria, performance was relatively static. Over 10\u2009years, there was a lack of significant improvement in clinical performance in several indicators and multiple changes to <jats:styled-content style=\"fixed-case\">KPI<\/jats:styled-content> targets were made.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">KPI<\/jats:styled-content> programme enabled comparison of performance across nephrology units, but improvement in performance targets was not consistent over the 10\u2010year period and the programme served as a means for benchmarking perhaps, rather than a quality improvement tool. Better understanding of each <jats:styled-content style=\"fixed-case\">KPI<\/jats:styled-content> and resources available for quality improvement is crucial for the success of a <jats:styled-content style=\"fixed-case\">KPI<\/jats:styled-content> programme.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.70049","type":"journal-article","created":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T02:40:32Z","timestamp":1745980832000},"page":"1272-1280","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lessons from implementation of a nephrology key performance indicator programme"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5218-0424","authenticated-orcid":false,"given":"Adam G.","family":"Steinberg","sequence":"first","affiliation":[{"name":"Department of Nephrology The Royal Melbourne Hospital  Melbourne Victoria Australia"},{"name":"Department of General Medicine The Royal Melbourne Hospital  Melbourne Victoria Australia"},{"name":"Department of Medicine (RMH) University of Melbourne  Melbourne Victoria Australia"},{"name":"Safer Care Victoria  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7637-3661","authenticated-orcid":false,"given":"Peter F.","family":"Mount","sequence":"additional","affiliation":[{"name":"Department of Medicine (RMH) University of Melbourne  Melbourne Victoria Australia"},{"name":"Safer Care Victoria  Melbourne Victoria Australia"},{"name":"Department of Nephrology Austin Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maree","family":"Branagan","sequence":"additional","affiliation":[{"name":"Safer Care Victoria  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew A.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Eastern Health Clinical School Monash University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2853-5096","authenticated-orcid":false,"given":"Nigel D.","family":"Toussaint","sequence":"additional","affiliation":[{"name":"Department of Nephrology The Royal Melbourne Hospital  Melbourne Victoria Australia"},{"name":"Department of Medicine (RMH) University of Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4,29]]},"reference":[{"volume-title":"Crossing the Quality Chasm: A New Health System for the 21st Century","year":"2001","author":"Institure of Medicine","key":"e_1_2_7_2_1"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2019090869"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2020.09.028"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-024-00820-6"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2016.02.037"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2016101079"},{"key":"e_1_2_7_8_1","first-page":"184","article-title":"Implementation of renal key performance indicators: promoting improved clinical practice","volume":"20","author":"Toussaint ND","year":"2015","journal-title":"Nephrol Ther"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsb1002320"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.7326\/M17-0691"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1802595"},{"key":"e_1_2_7_12_1","unstructured":"Safer Care Victoria.Renal key performance indicators review;2019(cited 2024 Sept 8). 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