Spreading the word: How renal integration in the Top End has doubled home therapies intake in less than 2 yrs

Mrs Amanda Elzini1

1Top End Health Service, Darwin, Australia


In an ever-increasing demand for service, a stronger focus on Renal Home Therapies (RHT) was required in the Top End.  With difficulties in maintaining service due to need exceeding availability, RHT moved from the satellite service umbrella into its own branch with a dedicated manager.  By November 2018, RHT was able to relocate to one building to provide CKD, PD, HHD, Transplant, and Supportive care under one roof.  With better access to resources, focus on pathways to home and a multi-disciplinary approach to care, RHT has seen a spike in interest and clients utilising the home therapy model of care.


Key Performance Indicators were developed and consumer engagement actioned


Discussion of results will include and not limited to:

  • An increase of 30% of CKD Stage 5 patients who had AV-Fistula or tunnelled line access created in preparation for RRT.
  • An increase of 50% in the total number of PD patients undertaking treatments at home or in the community.
  • An improvement in the number of patients attending PD education sessions


The creation of RHT has supported an increase in referrals and use of service.  Since opening, RHT has demonstrated the benefits of co-locating the CKD nurse with home based therapies and positively influenced the patients and their journey, through improvement in patient flow and integration of service.


Amanda has been working in Renal for the last 17 years, completing both a Post Graduate Certificate in Nephrology Nursing and a Masters Degree in Nursing.  Amanda has worked throughout Australia and the Middle East during her career, primarily in the Haemodialysis space.  Amanda has had the privilege of managing Renal Health Centres across the Kimberley and was an active member in the design and development of Renal Hostels and new renal unit builds in the Kimberley.  A passion for Aboriginal health and providing care closer to home, Amanda took on the newly appointed position role of Renal Home Therapies with Top End Renal Services in early 2018.  It has been an exciting and challenging time with many changes needed to the approach to care and improving patient pathways home.  Amanda has been able to accomplish key strategies with the support of a fantastic Renal Home Therapies team!


The ASM is hosted by Australian and New Zealand Society of Nephrology.

The aims of the Society are to promote and support the study of the kidney and urinary tract in health and disease, and to ensure the highest professional standards for the practice of nephrology in Australia and New Zealand.

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