WIHI: Greater Satisfaction, Outcomes, and Savings with Self-Administered Care

Date: July 13, 2017


  • Kedar Mate, MD, Chief Innovation and Education Officer, Institute for Healthcare Improvement (IHI)
  • ​Kavita Bhavan, MD, MHS, Director of Infectious Diseases/OPAT Clinic, Parkland Center for High Impact Clinical Outcomes Studies, Associate Professor Internal Medicine, UT Southwestern Medical Center​
  • Alex Anderson, Research Associate, IHI

Patients undergoing dialysis typically do so in a hospital or health care facility. Most people don't question the need to have experienced health care staff on hand or what's considered a safe environment for the treatments. But that might be changing.

A growing number of patients in Sweden have 24/7 access to special units at health systems where they schedule and conduct their hemodialysis themselves. And, inspired by Sweden, a small number of US nephrology centers are trying something similar. Even more ambitious: One of the largest safety net hospitals in the US has been teaching a few thousand patients how to administer their own IV antibiotics at home.

A team at Parkland Health and Hosptial System in Dallas, led by WIHI guest Dr. Kavita Bhavan, wanted to see if a population of patients without health insurance, whose multiple hospital days on an antibiotic drip weren't being reimbursed by anyone, might do as well and maybe even better than patients with insurance, receiving nurse-assisted IV antibiotic therapy at home, at an infusion center, or skilled nursing facility. The answer seems to be, "Yes."

This is patient engagement at a whole new level. Listen to this episode of WIHI to hear more about this groundbreaking quality improvement work.


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