Ontario Renal Network | Reseau Renal de L'Ontario

Local Achievements

ORN | Ontario Renal Network » Ontario Renal Plan » Local Achievements

Looking back: Local initiatives brought our first strategic plan to life

Ontario’s 26 Regional Renal Programs are where dedicated front-line healthcare professionals and behind-the-scenes program administrators bring the Ontario Renal Plans to life. Here, we provide a snapshot of just some of these initiatives.

Map of LHINS

Erie St.Clair

Windsor Regional Hospital
In alignment with ORP I’s goal to strengthen kidney care through research, we are performing a randomized controlled trial that examines the use of medication to optimize dialysis access function. Funded by a grant from the Kidney Foundation of Canada, this research aims to improve patient care by reducing catheter clotting.

South West

London Health Sciences Centre
We initiated an urgent-start peritoneal dialysis (PD) program in July 2010, which has improved the uptake of home dialysis among our patients. Our team assesses patients within 24 hours of referral from a nephrologist; if eligible and interested, the patient starts on PD usually within 24 to 48 hours of PD catheter insertion.

Waterloo Wellington

Grand River Hospital
Introduction of our home hemodialysis program has been successful, and a number of our patients are now preparing to start home dialysis. Our efforts have been aided by our relationships with Community Care Access Centres, which support our patients, and operational changes such as monthly performance reviews of all new dialysis starts.

Hamilton Niagara

St. Joseph's Healthcare Hamilton
Our Optimal Start initiative ensures that 100% of our pre-dialysis patients receive standardized education about access options and dialysis modalities. We have been successful in meeting our goals to increase the number of patients on home dialysis and decrease the number of patients with permanent central venous catheters.

Niagara Health System
We are implementing a trial project to develop an online community for our CKD patients. The goal of this project is to improve patient involvement in decision-making through increased opportunity to connect with fellow patients about treatment and care decisions. Online content is being shaped by a patient survey, focus groups and ongoing user feedback.

Central West

William Osler Health System
At Brampton Civic Hospital, we developed an Access Procedure Station. This service allows trained nursing staff to cannulate patients using ultrasound-guided technology. Approximately 2,500 procedures using this technology were performed from April to October 2014, resulting in a 98% reduction in infiltration observed over 6 months, and a reduction in patients’ pain and anxiety.

Mississauga Halton

Halton Healthcare Services
We collaborated with Trillium Health Partners to develop and implement standardized peritoneal dialysis (PD) education materials. By providing consistent education and information on PD, we ensure that all patients, regardless of where they live in the Mississauga Halton Region, have ready access to services and resources for PD support.

Trillium Health Partners
At Credit Valley Hospital, we piloted and implemented a community cannulation assistance training program to provide patients with end-stage kidney disease who are unable to self-cannulate the opportunity to do home hemodialysis. This program has improved the quality of life of some patients who previously would have received their therapy in the hospital.

Toronto Central

St. Joseph’s Health Centre
At our new Peritoneal Dialysis Body Access Clinic, our urologist and home dialysis team are improving PD access by working with patients to ensure catheter position, informed consent, and thorough and effective pre-operative preparation and post-operative communications occur.

St. Michael’s Hospital
In March 2014, our team started offering telemedicine clinic visits, improving our ability to offer dialysis and follow-up as close to patients’ homes as possible. This marriage of technology and innovation improves our patients’ overall experiences.

Sunnybrook Health Sciences Centre
Our Interdisciplinary Vascular Access Best Practice Team implemented a number of best practices to improve hemodialysis access, treatment and quality of life for our patients: an interdisciplinary vascular access clinic; the EMLA (topical anesthetic) program; the observed cannulation program; and continuous quality assurance practices.

University Health Network
Working to enhance transition to home dialysis, we established 3 complementary programs: bedside PD catheter insertion to facilitate transition; the Dialysis Start Unit; and the eHome initiative, which also supports the placement of more permanent vascular accesses. We also established an in-facility nocturnal hemodialysis unit and expanded our geriatric-nephrology consultative service in addition to our established Toronto Rehabilitation Institute facility.


Humber River Hospital
We are developing a strategy to decrease prevalent central venous catheters in our busy in-facility hemodialysis unit. The project’s structured, planned approach to vascular access will provide opportunities for nurses to improve cannulation skills and patient outcomes.

Mackenzie Health
Our Patient Education Resource Centre in Oak Ridges opened in November 2014. The new centre helps patients and families learn more about dialysis treatment options, enabling transition to home therapy and dialysis access creation.

Central East

Lakeridge Health
We added a new transition nurse (Independent Dialysis Coordinator) to the team, enabling us to enhance the patient experience by providing early education on all types of renal replacement therapy, including supportive care. We also developed corresponding tools and processes for staff and patients to support the uptake of home dialysis.

Peterborough Regional Health Centre
In March 2014, we launched a transition unit with the goal of enhancing patient experience by offering patients early education about treatment options, transplant awareness, and achieving appropriate body access. Since the opening of the transition unit, 100% of our acute/crash start patients are receiving education to help them make informed decisions.

The Scarborough Hospital
We completed an evaluation study of the Self-Management CKD Educational Manual that our team developed and that we provide to all new patients in our program. The study found the manual to be an effective tool in supporting patients’ learning, rating 3 or higher (on a scale of 1 to 5) on a variety of factors such as comprehension, acceptability, content and language.

South East

Kingston General Hospital
The addition of a committed Body Access Coordinator has brought dedicated clinical teams and departments together to deliver high-quality kidney care for our patients. With this, we are able to support our patients on dialysis with the best possible vascular access.


The Ottawa Hospital and Renfrew Victoria Hospital
We developed and implemented a patient decision aid (Shared End-Stage Renal Patients Decision Making, or “SHERPA –DM”) to help patients make informed decisions about renal replacement therapy. Patients and healthcare professionals reported the tool to be appropriate and user friendly. The project received great positive feedback when presented at an international symposium in Spain this past September.

North Simcoe Muskoka

Orillia Soldiers’ Memorial Hospital
We developed new processes and procedures to ensure that every patient who starts dialysis is informed and educated about the choices available for renal replacement therapy. To date, 100% of incident patients in our program have received modality education.

North East

Health Sciences North
Our Body Access/Independent Dialysis coordinator worked with the nephrology management and pre-dialysis program to organize and coordinate an education roadshow. Reaching all 6 satellite locations, we were able to provide information about renal replacement options to pre-dialysis patients and families who previously would have had to travel to receive this education.

North Bay Regional Health Centre
Our team has aimed to reduce the number of suboptimal starts by using incremental PD as the solution to a number of challenges we face, including having no surgeon available for months at a time. Another key to this success has been assigning patients to one nurse to manage their care; this ensures patients receive timely education about incremental PD and promotes a trusting nurse-patient partnership, which will allow more confident decision-making.

Sault Area Hospital
Recognizing the need for accurate data collection, our regional renal program introduced the role of Renal Database Coordinator. The coordinator provides our team with more real-time data to shift attention, make changes, identify trends and celebrate met targets. As a result, we are one of the first hospitals to pass all the data quality tests to switch to the new ORN reporting web-based interface.

Timmins and District Hospital
In 2014, we met our goal of completing 100% of our home visits for all our current PD patients during the summer and early fall to provide the patients and their family with education and tools and ensure that their home environments were conducive for success. For patients with distance issues, education was provided via Ontario Telemedicine Network.

North West

Thunder Bay Regional Health Sciences Centre
In the less than 5 months since the arrival of our new vascular surgeon in July 2014, patients have attended 70 appointments for vascular access assessment or complication management, and 32 patients have had vascular access surgeries. Recruitment of this surgeon has significantly improved our ability to offer care closer to patients’ homes, as they previously would have had to travel for these procedures.

1Erie St. Clair 8Central
2South West 9Central East
3Waterloo Wellington 10South East
4Hamilton Niagara 11Champlain
5Central West 12North Simcoe Muskoka
6Mississauga Halton 13North East
7Toronto Central 14North West