Patient-Driven Care at Ryhov Hospital

Ryhov Hospital is a county hospital in Jönköping, Sweden, with a dialysis unit for patients with renal disease.

The Problem
Ryhov Hospital transitioned more than 52 percent of its traditional peritoneal and hemodialysis patients to a self-management program for patients undergoing dialysis. This change in approach was driven by a single patient seeking to take charge of his own care and improve his quality of life.

The Solution
A patient on dialysis at the hospital asked to learn how to perform self-dialysis. In response to this request, a nurse at Ryhov Hospital taught the patient how to use the dialysis machine, interpret lab values and document his care at the dialysis protocol. Shortly afterward, the patient was managing his own dialysis and experiencing fewer side effects of the treatment, such as nausea, edema and hypotension. The patient and the nursing staff took this success to the next level and began training other dialysis patients interested in self-dialysis. Patients document their blood pressure, weight, dryweight, blood flow, dialysis flow, symptoms, amount of water drawn, etc. on a report form, and the doctor or nurse enters their information in the record system.

The Result
Currently 52 percent of Ryhov Hospital's dialysis patients are on self-dialysis. With the reduction in side effects from self-dialysis, patients have dialysis more often and infection rates have declined.

Lessons Learned
Responding to the preferences of patients and engaging them as full partners in care can result in better outcomes, fewer complications and increased patient and caregiver satisfaction.

Contact Information
Britt-Mari Banck
+(46) 36 32 69 71
Brit-mari.banck@lj.se

This case study was originally featured in the HPOE guide: 'Engaging Health Care Users: A Framework for Healthy Individuals and Communities,' published January, 2013.

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