#1374 Time and motion study in a peritoneal dialysis program using Sharesource Analytics 1.0 remote patient management

Abstract Background and Aims Peritoneal dialysis (PD) programs worldwide are challenged by a shortage of trained personnel, high workloads, and multiple tasks, some of which are performed in the patient's home. Remote patient management (RPM) of PD patients may improve outcomes but adds to workload concerns. The objective of this study was to estimate the time spent by nephrologists and nurses in PD programs using Sharesource Analytics 1.0 RPM in Colombia. Method An external consultant used continuous time measurements to perform the time and motion methodology and measure the takt time defined as the period of time or cadence in which a task must be performed, in this case specialized peritoneal dialysis consultation. Three hundred thirty-six hours were measured for nurses and 196 hours for nephrologists. The study was conducted in four dialysis clinics of Renal Care Services in Colombia. Time was measured for nurses and nephrologists regarding all the APD program activities, including the time spent in Sharesource Analytics 1.0 for daily remote monitoring and the review performed during the monthly comprehensive peritoneal dialysis program consultation. Results 13 nurses and 7 nephrologists participated in this study. The ratio between PD patients and nurses was 45:1, and between dialysis patients (PD and HD) and nephrologists was 140:1. The nurse's time spent on daily RPM follow-up and during the monthly comprehensive consultation averaged 2 minutes per patient, and similar results were observed in the nephrologists' review of Sharesource Analytics 1.0 in that consultation. The takt time for nephrology was 35 minutes; 16 minutes were spent directly evaluating the patient. Nurses see a new patient every 34 minutes and spend 24 minutes directly assessing the patient (Fig. 1). We found that remote monitoring consumes only 1% of the time spent by nephrologists and 3% of nurses each day (Fig. 2). Conclusion RPM support for PD patients can improve clinical outcomes. The time invested in RPM with Sharesource Analytics 1.0 does not exceed 5% of the daily task time for the PD team demonstrating its overall efficiency.