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Vol. 29. Issue. 1.February 2009
Pages 1-94
Vol. 29. Issue. 1.February 2009
Pages 1-94
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A discussion on quality
Una reflexión sobre la calidad
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Ramón Pons Pradesa
a Hospital General de Castellón Castellón Castellón España,
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Dear Editor,

There is a current trend towards the implementation of quality systems in haemodialysis, which is without doubt beneficial for all, both patients and health professionals. The interest of nephrologists is shown in the recent abundance of publications on this issue.1,2 However, I would like to discuss3 this new aspect of our study both verbally and physically. In order to demonstrate the virtues of the quality indicators, some of the articles4,5 use very weak basal data and therefore the “improvement margin” is very wide. This should lead us to ask why we are neglecting these patients.

In my opinion, there must be a sufficient “quality and quantity” of health professionals to provide proper treatment for chronically ill haemodialysis patients. I also believe that the Scientific Organisations involved should, as far as possible, place pressure on the corresponding administrations, so that all haemodialysis patients are treated by qualified nephrologists that the ratio of patients per nephrologists and nurses is acceptable and that paperwork is reduced to ensure greater contact between the nephrologist and patient.

Bibliography
[1]
Rocco M, Frankenfield D, Hopson S, McClellan W. Relationship between Clinical Performance Measures and Outcomes among Patients Receiving Long-Term Hemodialysis. Annals Int Med 2006;145:512-20.
[2]
Plantinga L, Fink N, Jaar B, Sadler J, Levin N, Coresh J, Klag M, Powe N. Attainment of clinical performance targets and improvement in clinical outcomes and resource use in hemodialysis care: a prospective cohort study. http://biomedcentral.com/1472-6963/7/5.
[3]
http://www.rae.es/.
[4]
Parra E, Ramos R, Betriu A, Paniagua J, Belart M, Martínez T. Effect of a quality improvement strategy on several haemodialysis outcomes. Nephrol Dial Transplant 2008;23:2943-7. cartas al director [Pubmed]
[5]
82 Nefrología 2009;29(1):81-94 5. Plantinga L, Jaar B, Fink N, Sadler J, Levin N, Coresh J, Klag M, Powe N. Frequency of patient-physician contact in chronic kidney disease care and achievement of clinical performance targets. Int J Qual Health Care 2005;17:115-21.
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