ECMC Dialysis Services and Medical Leadership
Dr. Mandip Panesar, Medical Director of Dialysis at Erie County Medical Center, discusses the hospital's dialysis service and why the service is critically important.
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Mandip Panesar, MS, MD
Mandip Panesar, MS, MD medical leadership assisting physicians in the delivery of patient care, medical education/research and the advancement of clinical quality/safety initiatives through the use of ECMC clinical information system(s).Learn more about Mandip Panesar, MS, MD
Transcription:
Bill Klaproth (Host): For patients facing end-stage kidney failure, kidney dialysis serves as an artificial replacement for the body’s kidney functions including waste removal. With the opening of the Regional Center of Excellence, Western New York outpatients now have access to the region’s largest and most up-to-date kidney dialysis unit. And here to talk with us about ECMC Dialysis Services and medical leadership is Dr. Mandip Panesar, the Medical Director of Dialysis at ECMC. Dr. Panesar thank you for your time. First off, can you tell us about the new Regional Center of Excellence?
Mandip Panesar, MD, MD, FASN (Guest): Sure. The Regional Center of Excellence was really the first service that came about when Great Lakes Health was formed. When Buffalo General and Erie County Medical Center each had its own outpatient dialysis program; there was a recognition that we could have efficient dialysis care for patients if we unified both dialysis units into one center; one center of excellence, a comprehensive center, not only in terms of efficiencies but also better patient care. Because now we will be able to standardize care amongst the healthcare system. So, from that, we developed a very large and probably the largest dialysis unit within a very large distance area; definitely within the region; a 36-station outpatient facility. With that, each treatment bay is separate. Many patients will have designated areas with their own storage facility, obviously dialysis machine, a dedicated nurse and obviously chair and dialysis machine with a TV. And that model carries out into each of 36 stations. So, when you talk about the center itself, not only do we offer an outpatient program, but we also offer again, this is a comprehensive unit, so we offer a home dialysis program as well so patients can have the option of doing their dialysis not only center-based where they come into the hospital for treatment, but they can also do their dialysis treatment at home.
Bill: Very comprehensive and you mentioned dedicated nurses. You employ a nursing care model. Patients will always be cared for by an RN or an LPN throughout every single dialysis treatment. Can you tell us more about that?
Dr. Panesar: Sure. Nationally, there appears to be a model that where they have employed dialysis technicians and although there is nothing wrong with, when we formed this unit, this Center of Excellence; we felt that we wanted to go above and beyond what the standard was and therefore, we developed and adopted a nursing model meaning that at any time during your dialysis treatment, you will always be cared for by a registered nurse or an LPN. And we feel that in terms of care, that nursing model would be far superior to any other model that exists out there. Just because when you go to a hospital, when you go to any medical facility; you really want to be taken care of by healthcare professionals, by either a physician or a nurse and we feel that dialysis being such an involved procedure, that when you know that you have a nurse taking care of you and you have a physician taking care of you; there is a sense of reassurance and something that can be stressful for a patient. We feel that by having that nursing model, helps ease some of that unnecessary stress.
Bill: Reassurance is so important and in addition to the dedicated nurses, can you tell us about other members of the team, such as the medical director, a dietician and you also have a social worker as well. Can you tell us about that complete team?
Dr. Panesar: Oh absolutely. So, this is known as your interdisciplinary team and from that includes not only your medical director of the dialysis unit, we also have the unit manager and again, we have gone above and beyond what we feel is the standard model. So, again, we have the medical director, your nurse manager, or unit manager, we also have team leaders and then from the team leaders we have got your charge nurse and your individual suite nurse and your LPN. And on top of that, we also have social workers and dieticians involved. So, this is a very involved team. It’s a multidisciplinary team because we feel that dialysis, end=stage renal disease is a very complex disease. You need that multidisciplinary team. The sheer complexity of what happens to a patient when they undergo dialysis can be enormous and without an interdisciplinary team; it would be very difficult to care for patients. So, we again, have gone above and beyond I would say what is the standard model because we have employed more nurses, team leaders, and then having the social work to take care of a lot of the social needs of the care and then as well as a dietician.
Bill: And earlier, Dr. Panesar, you mentioned 36-stations. Can you also talk about the four isolation treatment stations for patients with unique and different medical needs?
Dr. Panesar: We have four isolation stations where if any patient who has a communicable disease such as an infectious disease, we would like to put them in their own designated treatment area. And that means that there’s a certain skill that’s involved, certain precautions that we would have to take, not only for patient’s safety but as well as safety for other patients with the unit and including the staff. So, we have four designated stations and to my knowledge, we are probably one of the very few centers within the region that have so many designated stations.
Bill: Dr. Panesar let’s talk more about easy access and patient convenience. I know it’s very important to you at ECMC, in fact, you have dedicated six parking spaces specifically marked in the DCM circle for people having dialysis. Can you talk about that?
Dr. Panesar: I think the first thing that we do in terms of ease of access, we do recognize that being on dialysis can have certain impacts on your life and we try to accommodate a patient’s lifestyle, life schedule to their dialysis schedule. So, we try to schedule their treatments, try to give them a schedule that obviously incorporates their personal needs as well as the needs of their caregivers. An example that I always like to give is sometimes if patients have transportation issues or they have – or if their loved one or their caregiver are the ones who are driving them to their dialysis treatments, we understand that the caregiver – this will impact their life, they have jobs, they have families as well so we try to accommodate the patient’s treatment schedule to take into account the overall patient experience and the impact that it has on their life. We know that some patients actually elect to drive themselves so in order to accommodate the distance between the parking lot and the front entrance of our building; we have designated spots for them to keep the shortest distance. Because we understand dialysis can impact someone’s life. We try to make these small changes so that convenience is a big – is really important in terms of the care of the patient.
Bill: And we have covered a lot of ground here Dr. Panesar, thank you for your time. What else should we know about the ECMC Dialysis Services?
Dr. Panesar: Knowing that when you do come to ECMC for dialysis that you will always be taken care of by an interdisciplinary team. You have the medical director, you have a 100% nursing model, you have your own nephrologist taking care of you, but to understand that there’s more than one healthcare professional including dieticians and social workers. That this is an interdisciplinary comprehensive team. And number two is that as devastating as having end-stage renal disease can be; I really would like to share that you have options, that you have at least three types of dialysis available to you, not only do you have center-based dialysis, you have peritoneal dialysis which you can do at home as well as home hemodialysis again, in the luxury of your own personal surroundings. And then ultimately, we have a complete comprehensive transplant program. So, again, this is not a dead-end street, that there are multiple options and our unit, our Center of Excellence offers all of the modalities that could be available to you. We leave nothing behind. We are offering all potential solutions to having end-stage renal disease.
Bill: Dr. Panesar thank you for your time. This have been very, very informative and for more information please visit www.ecmc.edu, that’s www.ecmc.edu. This is the True Care Healthcast from Erie County Medical Center. I’m Bill Klaproth. Thanks for listening.
Bill Klaproth (Host): For patients facing end-stage kidney failure, kidney dialysis serves as an artificial replacement for the body’s kidney functions including waste removal. With the opening of the Regional Center of Excellence, Western New York outpatients now have access to the region’s largest and most up-to-date kidney dialysis unit. And here to talk with us about ECMC Dialysis Services and medical leadership is Dr. Mandip Panesar, the Medical Director of Dialysis at ECMC. Dr. Panesar thank you for your time. First off, can you tell us about the new Regional Center of Excellence?
Mandip Panesar, MD, MD, FASN (Guest): Sure. The Regional Center of Excellence was really the first service that came about when Great Lakes Health was formed. When Buffalo General and Erie County Medical Center each had its own outpatient dialysis program; there was a recognition that we could have efficient dialysis care for patients if we unified both dialysis units into one center; one center of excellence, a comprehensive center, not only in terms of efficiencies but also better patient care. Because now we will be able to standardize care amongst the healthcare system. So, from that, we developed a very large and probably the largest dialysis unit within a very large distance area; definitely within the region; a 36-station outpatient facility. With that, each treatment bay is separate. Many patients will have designated areas with their own storage facility, obviously dialysis machine, a dedicated nurse and obviously chair and dialysis machine with a TV. And that model carries out into each of 36 stations. So, when you talk about the center itself, not only do we offer an outpatient program, but we also offer again, this is a comprehensive unit, so we offer a home dialysis program as well so patients can have the option of doing their dialysis not only center-based where they come into the hospital for treatment, but they can also do their dialysis treatment at home.
Bill: Very comprehensive and you mentioned dedicated nurses. You employ a nursing care model. Patients will always be cared for by an RN or an LPN throughout every single dialysis treatment. Can you tell us more about that?
Dr. Panesar: Sure. Nationally, there appears to be a model that where they have employed dialysis technicians and although there is nothing wrong with, when we formed this unit, this Center of Excellence; we felt that we wanted to go above and beyond what the standard was and therefore, we developed and adopted a nursing model meaning that at any time during your dialysis treatment, you will always be cared for by a registered nurse or an LPN. And we feel that in terms of care, that nursing model would be far superior to any other model that exists out there. Just because when you go to a hospital, when you go to any medical facility; you really want to be taken care of by healthcare professionals, by either a physician or a nurse and we feel that dialysis being such an involved procedure, that when you know that you have a nurse taking care of you and you have a physician taking care of you; there is a sense of reassurance and something that can be stressful for a patient. We feel that by having that nursing model, helps ease some of that unnecessary stress.
Bill: Reassurance is so important and in addition to the dedicated nurses, can you tell us about other members of the team, such as the medical director, a dietician and you also have a social worker as well. Can you tell us about that complete team?
Dr. Panesar: Oh absolutely. So, this is known as your interdisciplinary team and from that includes not only your medical director of the dialysis unit, we also have the unit manager and again, we have gone above and beyond what we feel is the standard model. So, again, we have the medical director, your nurse manager, or unit manager, we also have team leaders and then from the team leaders we have got your charge nurse and your individual suite nurse and your LPN. And on top of that, we also have social workers and dieticians involved. So, this is a very involved team. It’s a multidisciplinary team because we feel that dialysis, end=stage renal disease is a very complex disease. You need that multidisciplinary team. The sheer complexity of what happens to a patient when they undergo dialysis can be enormous and without an interdisciplinary team; it would be very difficult to care for patients. So, we again, have gone above and beyond I would say what is the standard model because we have employed more nurses, team leaders, and then having the social work to take care of a lot of the social needs of the care and then as well as a dietician.
Bill: And earlier, Dr. Panesar, you mentioned 36-stations. Can you also talk about the four isolation treatment stations for patients with unique and different medical needs?
Dr. Panesar: We have four isolation stations where if any patient who has a communicable disease such as an infectious disease, we would like to put them in their own designated treatment area. And that means that there’s a certain skill that’s involved, certain precautions that we would have to take, not only for patient’s safety but as well as safety for other patients with the unit and including the staff. So, we have four designated stations and to my knowledge, we are probably one of the very few centers within the region that have so many designated stations.
Bill: Dr. Panesar let’s talk more about easy access and patient convenience. I know it’s very important to you at ECMC, in fact, you have dedicated six parking spaces specifically marked in the DCM circle for people having dialysis. Can you talk about that?
Dr. Panesar: I think the first thing that we do in terms of ease of access, we do recognize that being on dialysis can have certain impacts on your life and we try to accommodate a patient’s lifestyle, life schedule to their dialysis schedule. So, we try to schedule their treatments, try to give them a schedule that obviously incorporates their personal needs as well as the needs of their caregivers. An example that I always like to give is sometimes if patients have transportation issues or they have – or if their loved one or their caregiver are the ones who are driving them to their dialysis treatments, we understand that the caregiver – this will impact their life, they have jobs, they have families as well so we try to accommodate the patient’s treatment schedule to take into account the overall patient experience and the impact that it has on their life. We know that some patients actually elect to drive themselves so in order to accommodate the distance between the parking lot and the front entrance of our building; we have designated spots for them to keep the shortest distance. Because we understand dialysis can impact someone’s life. We try to make these small changes so that convenience is a big – is really important in terms of the care of the patient.
Bill: And we have covered a lot of ground here Dr. Panesar, thank you for your time. What else should we know about the ECMC Dialysis Services?
Dr. Panesar: Knowing that when you do come to ECMC for dialysis that you will always be taken care of by an interdisciplinary team. You have the medical director, you have a 100% nursing model, you have your own nephrologist taking care of you, but to understand that there’s more than one healthcare professional including dieticians and social workers. That this is an interdisciplinary comprehensive team. And number two is that as devastating as having end-stage renal disease can be; I really would like to share that you have options, that you have at least three types of dialysis available to you, not only do you have center-based dialysis, you have peritoneal dialysis which you can do at home as well as home hemodialysis again, in the luxury of your own personal surroundings. And then ultimately, we have a complete comprehensive transplant program. So, again, this is not a dead-end street, that there are multiple options and our unit, our Center of Excellence offers all of the modalities that could be available to you. We leave nothing behind. We are offering all potential solutions to having end-stage renal disease.
Bill: Dr. Panesar thank you for your time. This have been very, very informative and for more information please visit www.ecmc.edu, that’s www.ecmc.edu. This is the True Care Healthcast from Erie County Medical Center. I’m Bill Klaproth. Thanks for listening.