DART Implementation Study

DART (Decision Aid for Renal Therapy) is an interactive, self-paced, online decisional aid designed to help older adults with advanced chronic kidney disease (CKD) understand their treatment options, make goal-concordant and timely decisions, and communicate with their care teams to make better decisions that match their goals and preferences. DART is hosted by the patient education platform Wolters Kluwer-UpToDate.

The REACH Lab at Tufts University, led by Dr. Keren Ladin, is currently conducting an implementation study with support from the Patient-Centered Outcomes Research Institute (Award: CDR-2017C1-6297) that aims to fully implement DART into real-world healthcare settings in partnership with six diverse healthcare sites.

As part of a broader toolkit being developed to help sites implement DART, we have included relevant resources here to support sites currently in the initial stages of navigating integration and delivery of DART into their healthcare systems.

Project Overview

The DART core concepts and evidence base document introduces the core concepts of DART, including why it was created, the evidence base supporting the effectiveness of DART gathered from the DART clinical trial study, and the benefits of DART for patients and healthcare staff.
The project abstract DART implementation guide outlines the goals of the DART implementation project, including its objective and aims, implementation approach, and evaluation framework.
The document what your patient experiences using DART describes the DART video’s core components and topics, and how it supports patients with decision-making guidance. Several images depict the visuals associated with the DART tool.

Patient-facing Materials: DART Delivery, Communication and Engagement

Patient facing materials: These materials are examples of DART delivery and communication materials to help introduce DART to patients, support them navigating the tool, and learn the purpose of DART. Examples of these include:

Implementation Guidance and Tools

To help healthcare sites implement DART, we have generated a set of materials that aim to help sites make key decisions about how to implement DART in their unique settings. The roles & responsibilities document outlines the different potential roles in site teams, including the site champion, Nurse/CKD educator, Nephrologist, and Nephrology/Administrative leader. The purpose and responsibilities of each role are also outlined, with the goal of increasing the synergy of each role.
The potential options for DART delivery workflows document outlines some potential options which sites may consider to establish processes for identifying DART-eligible patients and referring them to the tool.
Part of the DART implementation process is understanding the exact parameters for how DART is integrated into clinical workflows. The DART workflow planning worksheet has been created to define site-specific workflows for introducing and using DART.

Training & Support Materials

The DART overview for clinicians one-pager document gives a comprehensive overview of what DART is, the evidence base for DART and the patient benefits, as well as considerations for how DART can fit into your workflow.
The DART overview for clinicians flyer gives a quick, digestible overview of what DART is, for which patients DART is beneficial, and a diagram depicting the integration of DART in clinical workflows.
The clinical delivery of DART FAQ addresses questions sites might have about DART delivery, including for whom DART is intended, implications of using DART for billing and physician time, and how to use the preference sheets in treatment discussions.
The DART benefits and incentives outlines ways in which DART can benefit clinicians and patients, including saving clinicians’ time, increasing patient satisfaction, and promoting more productive visits.