Organization: Fort Macleod Health Centre

Southern Alberta’s kidney-care system is getting more room to grow as cases of advanced kidney disease have risen by 20 per cent over the past five years.

A new hemodialysis unit at Chinook Regional Hospital in Lethbridge increases weekly treatment capacity by 25 per cent, while an expanded kidney-care clinic gives patients more options for home-based dialysis.

The province has invested $23.4 million in the expansion, increasing the number of treatment stations at the hospital from 24 to 30 and allowing the hemodialysis unit to support up to 180 patients each week.

The expansion is more than a Lethbridge project. It is part of a regional kidney-care system that serves patients from Pincher Creek, Crowsnest Pass, Fort Macleod and other surrounding communities.

For rural patients, distance is part of the picture. Hemodialysis is typically needed three times a week, and the drive to Lethbridge is about 100 kilometres each way from Pincher Creek and about 150 from Crowsnest Pass.

Although there are dialysis centres in Blairmore and Fort Macleod, patients typically receive their first few treatments in Lethbridge before they can transition closer to home. The Lethbridge expansion does not add spaces at the rural centres, but growth in home dialysis could let more patients avoid the drive.

Shakhawat Hossain, patient-care manager with Alberta Kidney Care South, says the larger Lethbridge unit is important because patients starting dialysis need closer monitoring during the first few weeks.

“Usually when we start this treatment, especially the hemodialysis treatment, we try to keep them in our bigger centre, and our bigger centre is Lethbridge for this area,” he says.

Once patients are stable, the care team can move them to a rural centre, based on where they live and available space. Crowsnest Pass Health Centre and Fort Macleod Health Centre are the two rural options in the area.

Fort Macleod has capacity for 38 patients, while Crowsnest Pass has capacity for only five, Hossain says.

Staff settle into new shared space

The Lethbridge unit, which opened in late July, “has been good so far,” Hossain says.

“We’re adjusting some things here and there, and finding out what’s been working, what’s not, and working with the rest of the team, making sure that everybody is satisfied and making sure that we provide the best care possible.”

The new unit also brings staff together in one location. Previously, the dialysis team worked in a unit outside the main area, which made communication between nurses and other staff more difficult, Hossain says.

The new space is brighter and larger, allowing staff to work more closely and support each other during patient care.

A system under growing pressure

Hossain says the services offered have not changed. What has changed is the unit’s ability to keep pace with a growing patient population.

The Lethbridge centre was not over capacity, but he says it was getting close.

“Even in the next five years, if our number goes to 160, 170, we’re ready for it,” Hossain says.

Planning for the new unit factored in projected demand across the wider region, which includes Taber, Cardston, Pincher Creek, Crowsnest Pass, Fort Macleod and Picture Butte, among others.

Increasing the number of patients who can be treated at home will be a key measure of the program’s success, Hossain says.

Patients can choose between two options: peritoneal dialysis and home hemodialysis. The kidney-care clinic has four clinical rooms and five treatment areas, and supports both.

“Over the coming months, we’re looking to see if we can increase our home modality capacity so that we can have more and more patients receiving their treatment in their home,” Hossain says.

Alberta Health Services will also track patient comfort, treatment effectiveness and staff satisfaction in the months ahead, he adds.

The home-based approach could also help reduce pressure on hospital-based care, although Hossain says it is too early to tell whether the new unit has affected emergency department wait times or patient flow.

How patients get access

Patients with chronic kidney disease are followed regularly through the clinic. When a nephrologist determines a patient needs dialysis, a modality team explains the options.

After discussion with their care team, patients can choose between peritoneal dialysis, home hemodialysis or in-centre dialysis, depending on what fits their needs.

Province highlights closer-to-home care

In a July 30 media release, Adriana LaGrange, Alberta’s minister of hospital and surgical health services, framed the expansion as part of the province’s push to deliver care closer to home.

Martin Long, minister of infrastructure, said the new renal program providing home-dialysis training supports a service many Albertans rely on multiple times a week.

The province says the $23.4-million investment is part of broader health-care infrastructure spending in southern Alberta.

It also includes $59 million over three years for cardiac services at Chinook Regional Hospital and Medicine Hat Regional Hospital, and $74 million over three years for a new health centre in Cardston.