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Outpatient Continuity Experiences

Each fellow will be assigned a standing set of office hours, one-half day each week, in Nephrology Associates' office. In addition to evaluating new referrals and hospital follow-up, each fellow will acquire a panel of pre-end-stage kidney disease patients which they, along with the precepting attending nephrologist, will serve as the patient's primary nephrologist for the duration of their fellowship. The attending nephrologist will select patients to be followed by the fellow from among those in his or her practice.

Outpatient hemodialysis and home continuity experiences

Care for the chronic dialysis patient is team-based, and the fellows are expected to be integral members of the team caring for their assigned dialysis shifts. Each fellow will be assigned the primary-care responsibility for one shift of dialysis patients and will be directly supervised by one attending. Both will work in conjunction with an advanced practice nurse (APN) employed by Nephrology Associates. Weekly, the fellow will round with the APN and contact the shift's attending nephrologist for discussion and review of active clinical problems.

Once a month, the fellow will make chairside rounds at the hemodialysis unit with the supervising attending and APN, during which time the patient's care will be reviewed. Additionally, academic discussion of ESRD issues will occur.

For their home dialysis experience, each fellow will be assigned approximately five home dialysis patients, under the supervision of a singe renal attending.  Patient sessions will take place monthly. Fellows will meet with the attending nephrologist each session for discussion and review of active clinical problems, as well as for academic discussion of ESRD issues.

The fellows will follow and manage the dialytic needs of their patients if admitted at Christiana Hospital (if the fellow is on an inpatient rotation) to maintain continuity of care.

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