How many of us remember the old days when there was haemodialysis, peritoneal dialysis, some home haemodialysis training, the Physicians would see a lot of patients in their offices and the dialysis nurse was a jack of all trades?

Well how times have changed and thank goodness! Ten years ago, with the incidence of chronic kidney disease (CKD) on the rise, the renal services at The Canberra Hospital made a conscious decision to begin its journey to move from a focus on dialysis services to a preventative health model with increased consumer involvement.

Over the past ten years the service has introduced a number of roles and services to streamline and improve continuity of care. They include:
• Recipient and Live Renal Transplant Coordination
• Predialysis Coordination
• Hypertension nurse
• Clinical Nurse Consultant Renal Outpatients
• Vascular access nurse
• Nurse Practitioner (Chronic Kidney Disease)
• Research
• Quality Improvement Coordinator
• Data Collection Officer

This presentation outlines how the service made this move with the evolution of nephrology nursing roles to case manage and coordinate specific services, the creation of a renal outpatients department and the ongoing plan to manage the ever increasing needs of clients with chronic kidney disease. The impact of the changes on renal services, further service expansion and future needs are identified. Throughout these changes, we have encouraged consumer interest and participation. This presentation shares our experience of the challenges the service has encountered on its journey to move into the future.