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Improving patient experience as part of the dialysis treatment selection process

THE CUSTOMER: Nephrology Department at Meir Hospital

Case Study


Advanced-stage kidney disease patients are required to choose the type of dialysis treatment they will undergo. This important choice directly impacts their quality of life and health. However, the choice is not simple and involves a variety of considerations including clinical parameters, personality traits, existing support circles, and more.

The Nephrology Department at Meir Hospital, in collaboration with the Clalit Innovation Department, approached us to address the complex choice experience. We embarked on a project aimed at helping patients feel that they have chosen the right treatment for themselves and that the selection process itself was positive and successful.


To gain a deep understanding of patients' experience in the pre-dialysis stage, we conducted observations and interviews with patients and the department's staff. Our initial assumption was that the problem's focus was on how the choice process was conducted, for example: difficulty understanding information or balancing between considerations. To our surprise, we found that for the patients, the choice process is not dominant. In fact, from their perspective, they are not facing a choice, and the process does not really occur, despite the staff's efforts to promote it.

Specifically, we identified four factors leading to this situation:
1. Suppression of the patients' need for dialysis treatment.
2. Patients' passive approach to managing their treatment.
3. An undefined choice process within the patient's journey.
4. A lack of organizational tools for the staff to promote the choice process.


The development of solutions was done through an ideation workshop with the department and hospital team, where a variety of responses were developed for the factors weakening the choice process. For example, these are two solutions proposed to address the suppression of the need for dialysis treatment: the first is a visual interface that shows each patient the deterioration of their indicators over time, thus illustrating their health condition. The second solution is creating a system where veteran patients mentor new patients, offering them support and knowledge from their personal experience.


Nine solutions that provide a quality and in-depth response to the needs of the department and patients, without adding work to the already busy staff. The solutions were warmly adopted by the department and are currently in the implementation stages by various hospital entities.

One of the key solutions being implemented is adapting the department's work software, Chameleon, to support the choice process. Updating the software allows the team to work collaboratively to promote the patients' choices and easily follow their progress in the process. In addition, the project led the department to a clear definition of the components of the pre-dialysis stage and the choice process within it. Turning the choice process into a sequence of concrete actions makes it easier for the staff to implement and allows patients to face the choice in a gradual and less intimidating manner.
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