{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:58:45Z","timestamp":1777503525183,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:00:00Z","timestamp":1747872000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:00:00Z","timestamp":1747872000000},"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":["Can J Kidney Health Dis"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose of Review:<\/jats:title>\n                    <jats:p>Quality improvement (QI) initiatives use a team-based approach to problem-solving clinical and health system issues. All QI initiatives require the coordinated efforts of health care professionals and other stakeholders to encourage the provision of evidence-based clinical care. Most clinicians understand the principles of QI but may lack the training necessary to undertake individual projects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>An educational, nephrology-oriented clinical case was created based on the IDEAL study on timing of dialysis initiation, a prioritized quality indicator in several provinces. The case illustrates how to utilize commonly employed QI methodology and to provide a pragmatic framework for both developing and running a QI project. Core concepts addressed in this review include how to perform a QI chart audit, identification of a quality-of-care problem, engaging stakeholders, and how to conduct a root cause analysis that leads to selection of QI measures and change solutions. Last, plan-do-study-act (PDSA) cycles and interpretation of data using run charts are highlighted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Sources of Information:<\/jats:title>\n                    <jats:p>PubMed and Google scholar were used as sources of published QI methodology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Findings:<\/jats:title>\n                    <jats:p>This nephrology-oriented QI case highlights how a core set of QI principles and tools can be used to improve clinical care. This review demonstrates that determining clear goals, utilizing evidence-based guidance to improve timing of dialysis initiation, engaging the appropriate stakeholders, identifying a feasible and measurable change, and tracking if that change leads to improvement are essential components of all QI initiatives. The above framework can be utilized in a variety of clinical areas both within and beyond nephrology-specific care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Limitations:<\/jats:title>\n                    <jats:p>Considerations regarding QI-specific data analysis were not addressed as they were beyond the scope of this review.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20543581251323947","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T07:56:22Z","timestamp":1747900582000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["How Can We Decrease Early Dialysis Initiation? An Interactive Quality Improvement Teaching Case for Health Care Providers and Narrative Review of Quality Improvement Methodology"],"prefix":"10.1177","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7604-8877","authenticated-orcid":false,"given":"Khaled","family":"Lotfy","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine, London Health Sciences Center, Western University, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4278-6074","authenticated-orcid":false,"given":"Epsita","family":"Shome-Vasanthan","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Alberta, Edmonton, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1843-6131","authenticated-orcid":false,"given":"Samuel A.","family":"Silver","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Kingston Health Sciences Centre, Queen\u2019s University, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6462-8858","authenticated-orcid":false,"given":"Tamara","family":"Glavinovic","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, The Ottawa Hospital, University of Ottawa, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,5,22]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/2054358117725295"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1000552"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfs125"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.130363"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gft238"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01650216"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2016.11.029"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.100349"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.4135\/9781446217153"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1080\/14719030410001675722"},{"key":"e_1_3_3_12_2","unstructured":"Ontario HQ. Engaging with patients and caregivers about quality improvement: a guide for health care providers. Published 2016. Accessed December 12 2024. http:\/\/www.hqontario.ca\/portals\/0\/documents\/qi\/qip\/patient-engagement-guide-1611-en.pdf"},{"key":"e_1_3_3_13_2","unstructured":"Patient Safety Essentials Toolkit. Published 2023. Accessed November 29 2023. https:\/\/www.ihi.org\/resources\/tools"},{"key":"e_1_3_3_14_2","volume-title":"Canadian Incident Analysis Framework","author":"Parties I.","year":"2012","unstructured":"Parties I. Canadian Incident Analysis Framework. Edmonton: Canada Patient Safety Institute; 2012."},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.4324\/9780429271991"},{"key":"e_1_3_3_16_2","volume-title":"Fundamentals of Health Care Improvement: A Guide to Improving Your Patient\u2019s Care","author":"Ogrinc GS.","year":"2012","unstructured":"Ogrinc GS. Fundamentals of Health Care Improvement: A Guide to Improving Your Patient\u2019s Care. 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