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Home Renal Failure & Dialysis 
Management 

Post Acute Care/ Discharge Care
 

BridgeCare's Discharge Service offers 60 days of renal failure management and assistance in starting home dialysis for qualifying patients.  

Home Renal Failure Management

BridgeCare Specialists of Michigan offers several ways to reduce costs for renal failure patients that can be done at home. Here are some examples:

  1. Home dialysis education to qualifying patients*: Home dialysis, such as peritoneal dialysis (PD) or home hemodialysis (HHD), can reduce the cost of renal replacement therapy by eliminating the need for frequent trips to a dialysis center. In addition, home dialysis can provide patients with greater flexibility and independence.
     

  2. Medication management: Medications are an important part of managing renal failure, but they can be costly. BridgeCare can reduce costs by working with patients to find the most cost-effective medications and by using generic drugs when available.
     

  3. Nutrition management: Proper nutrition is important for renal failure patients, but specialty renal diets can be expensive. BridgeCare can reduce costs by having the patient work with a registered dietitian to develop a cost-effective renal diet that meets their nutritional needs.
     

  4. Monitoring and self-care: Regular monitoring and self-care can help prevent complications and reduce the need for hospitalization. BridgeCare can reduce costs by improving patient health literacy, helping patients monitor their blood pressure and blood sugar levels, performing regular self-examinations, and following treatment plans closely.
     

  5. Education and support: Education and support can help patients better manage their condition and avoid costly complications. BridgeCare can reduce costs by offering educational programs, joining support groups, and working with their healthcare team to develop a comprehensive care plan.
     

Overall, there are several ways to reduce costs for renal failure patients that can be done at home. By working closely with BridgeCare and taking an active role in their care, patients can reduce costs while still receiving effective and comprehensive care.

 

* Home dialysis is an option for many patients with end-stage renal disease (ESRD), but not all patients will be eligible. The decision to undergo home dialysis is based on a variety of factors, including the patient's medical history, lifestyle, and personal preferences. Here are some general guidelines for who can qualify for home dialysis:

  1. Good physical health: Patients who are physically able to perform their own dialysis treatments or have a caregiver who is able to assist with treatment may be eligible for home dialysis.

  2. Adequate home space: Patients who have a suitable space in their home for a dialysis machine and supplies, as well as adequate space for the safe disposal of medical waste, may be eligible for home dialysis.

  3. Good cognitive function: Patients who are able to understand and follow instructions for home dialysis treatment may be eligible.

  4. Good support system: Patients who have a strong support system, including a caregiver who can assist with treatment and a healthcare team that is available for support and monitoring, may be eligible for home dialysis.

  5. Willingness to participate: Patients who are motivated and willing to participate in their own care, including attending regular training sessions and monitoring their own health, may be eligible for home dialysis.

It is important to note that the decision to undergo home dialysis is made on a case-by-case basis, and patients can work closely with their BridgeCare provider to determine if home dialysis is an appropriate option for them.



 A broad range of services is offered to complement all other care and designed to ensure healthcare continuity, avoid preventable poor outcomes, and promote the safe and timely transfer of patients.

Eligibility

BridgeCare can accept referrals from the  following locations: ​

  • Inpatient acute care hospital

  • Inpatient psychiatric hospital

  • Inpatient Rehabilitation

  • Hospital Observation Units

 

Patients leaving the Emergency Room or Urgent care are not eligible for discharge services through BridgeCare.​

Virtual Care

BridgeCare coordinates video visits in the comfort of the patients home.

What we do:

01

Quick Follow-Up Contact

If patients don't hear from us while they're still in inpatient care, they can expect a call within the first day or two after discharge.

03

Review of Discharge

We go over the patient's inpatient stay and help them make an indivualized plan of recovery.

05

Signing Orders

BridgeCare partners closely with home cares to make sure patients are getting the services they need, as soon as they can.

07

Weekly Follow-Ups

We offer weekly video or phone follow-up appointments . We check in with a patients' progress and make sure their needs are being met.

02

Appointments Within 7 Days

All our new patient appointments typically happen within the first seven days of discharge, which helps 'bridge' patients and meet their most pressing needs. 

04

Medication Management

Our providers  adjust medications, refill prescriptions, and even oversee IV antibiotics and parenteral nutrition. 

06

Patient Education

For patients with chronic conditions, BridgeCare offers health literacy coaching. Our goal is to make sure patients understand how to best care and advocate for themselves. In doing so we can empower them to seek care at the appropriate places. 

08

Patient Transition

When it's time for patients to 'graduate' from our services, we ensure they have enough medications and resources to take the next step in their care. 

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