Pathways Project Pragmatic Lessons Learned: Integrating Supportive Care Best Practices into Real-World Kidney Care.

Treatment of patients with kidney disease is provided in a complex system, especially when considered across the continuum, from chronic kidney disease to kidney failure on dialysis, and at the end-of-life. Even among enthusiastic early adopters of kidney supportive care, 18 months was insufficient time to implement the three prioritized kidney supportive care best practices. Concentrating on a few key practices helped teams focus and see progress in targeted areas. However, impact for patients was attenuated because federal policy and financial incentives are not aligned with kidney supportive care best practices and goals.