الفهرس 
A study of the effect of a continuous improvement project on the improvement of guideline compliance and clinical targets of chronic hemodialysis patients
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Abstract
Background: Failure to comply with international guidelines is a widespread problem in Egypt. Objectives: To augment and measure continuous improvement efforts and their results in the 2 dialysis units of Kasr Al Ainy. Methods: Measurement of labs, quality of life, infection control and patient education campaigns, strategic planning, job analysis and auditing initiative. Results: The frequency of lab measurement showed marked improvement. Lab target achievement: E.g. Improvement between 2007 and 2012 AND statistically significant improvement again between 2012 and 2013 in: {u2022} Hemoglobin levels targets 9-13g/dL (e.g. 53.2% then 59.3% then 67.5% in Unit A, & 42.4% then 49.5% then 70.2% in Unit B) {u2022} Phosphorous 3.5{u2013}5.5 mg/dL. In Unit B ( 33% then 47.6% then 58.0%) {u2022} PTH (34.0% then 54.2% then 57.3%) Large opportunities for development are present especially in the URR. Statistically significant improvement in the 2SF-12 Physical Composite3 QoL score (from 31.4 % +/-11.2 to 35.2 +/- 10.8%). Statistically significant improvements in results of patient satisfaction questionnaires. Post-educational test results (74.4%, SD +/- 18.4) showed a significant improvement compared to pre-test (52.6%, SD +/- 18.1). Significant improvement in infection control precaution compliance (Glove wearing 52% versus 25%; Disinfection 96% versus 45%) Comprehensive 2desired outcomes3, key performance indicators and action plans are now available e.g. Job analysis demonstrated physician work hour (e.g. demonstrators 14.7 h/week) and resulted in recruitment of new residents. Conclusion: Continuous improvement efforts had a profound impact and need to be promoted