{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:07:41Z","timestamp":1788826061419,"version":"build-2803163510"},"reference-count":24,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Timely arteriovenous (AV) access creation to reduce catheter burden in patients with End-Stage Kidney Disease (ESKD) is essential, but delays remain common. We implemented a Clinical Practice Improvement Programme (CPIP) to reduce delays to AV access creation in patients with incident ESKD, who initiated haemodialysis via tunnelled dialysis catheters and underwent first-time AV access creation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a quality improvement study in a single-centre, tertiary institution in Singapore. Interventions implemented used root cause analysis and Plan\u2013Do\u2013Study\u2013Act cycles to streamline workflows, desynchronised the need for vessel mapping prior to surgical consultation, and introduced a prioritised inpatient referral pathway. Primary outcome was time from nephrology referral to surgical AV access creation. Secondary outcomes included time intervals between referral, vessel mapping, surgical listing and surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 227 patients were included (75 pre-CPIP, 152 post-CPIP). Following CPIP implementation, the median time from referral to AV access creation decreased from 142\u2009days pre-intervention to 105\u2009days at 6\u2009months and 86\u2009days at 12\u2009months post-intervention (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), representing a reduction of 40.9%. The median time from vessel mapping to surgical listing was significantly reduced from 41\u2009days pre-CPIP to 11 and 9\u2009days at 6 and 12\u2009months post-CPIP, respectively (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.002). Time from surgical evaluation and listing to surgery remained unchanged.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The CPIP significantly reduced delays from nephrology referral to surgical AV access creation. Earlier surgical evaluation and streamlined workflows may improve time to fistula use and reduce catheter-related complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11297298261446393","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T05:30:06Z","timestamp":1778563806000},"page":"2254-2262","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Reducing time to arteriovenous access creation in incident end stage kidney disease: A single-centre quality improvement study"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3711-0946","authenticated-orcid":false,"given":"Malcolm H W","family":"Mak","sequence":"first","affiliation":[{"name":"Department of General Surgery, Vascular Surgery Service, Tan Tock Seng Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy J K","family":"Koh","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine, Tan Tock Seng Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Vascular Surgery Service, Tan Tock Seng Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine M","family":"Leynes","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Vascular Surgery Service, Tan Tock Seng Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Vascular Surgery Service, Tan Tock Seng Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashura B","family":"Mumazat","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine, Tan Tock Seng Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine, Tan Tock Seng Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prajwala","family":"Prakash","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Vascular Surgery Service, Tan Tock Seng Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiantai","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Vascular Surgery Service, Tan Tock Seng Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enming","family":"Yong","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Vascular Surgery Service, Tan Tock Seng Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lester","family":"Chong","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Vascular Surgery Service, Tan Tock Seng Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Vascular Surgery Service, Tan Tock Seng Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glenn","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Vascular Surgery Service, Tan Tock Seng Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"See Cheng","family":"Yeo","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine, Tan Tock Seng Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ee Ling","family":"Ong","sequence":"additional","affiliation":[{"name":"Office of Quality and Clinical Governance, Tan Tock Seng Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.47102\/annals-acadmedsg.2024291"},{"key":"e_1_3_2_3_2","volume-title":"2022 USRDS annual data report: epidemiology of kidney disease in the United States","author":"United States Renal Data System","year":"2022","unstructured":"United States Renal Data System. 2022 USRDS annual data report: epidemiology of kidney disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 2022."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.34067\/KID.0004382020"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/1129729819878595"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2019.12.001"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/nep.12788"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfn261"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298241244509"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/1129729818765055"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2261-13-86"},{"key":"e_1_3_2_12_2","article-title":"Clinical practice guidelines for vascular access","volume":"48","author":"Vascular Access 2006 Work Group","year":"2006","unstructured":"Vascular Access 2006 Work Group. Clinical practice guidelines for vascular access. Am J Kidney Dis 2006; 48: S176\u2013S247.","journal-title":"Am J Kidney Dis"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1159\/000514550"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.5301\/jva.5000591"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.xkme.2020.04.004"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.08961209"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2005.11.023"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/hdi.12831"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/20543581211032846"},{"key":"e_1_3_2_20_2","article-title":"Preoperative vein mapping is not associated with arteriovenous access type created but is associated with improved patency","volume":"74","author":"Levin SR","year":"2021","unstructured":"Levin SR, Farber A, King EG, et al. Preoperative vein mapping is not associated with arteriovenous access type created but is associated with improved patency. J Vasc Surg 2021; 74: e332\u2013e333.","journal-title":"J Vasc Surg"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/JMQ.0000000000000033"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298241240169"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2024.01.069"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-020-01136-1"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2020.12.019"}],"container-title":["The Journal of Vascular Access"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298261446393","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11297298261446393","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298261446393","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T23:19:23Z","timestamp":1788823163000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11297298261446393"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,11]]},"references-count":24,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1177\/11297298261446393"],"URL":"https:\/\/doi.org\/10.1177\/11297298261446393","relation":{},"ISSN":["1129-7298","1724-6032"],"issn-type":[{"value":"1129-7298","type":"print"},{"value":"1724-6032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,11]]}}}