Dialysis Clinic, Inc.

Dialysis Clinic, Inc. (DCI) Ball Square Somerville Home Dialysis Program

"The nephrologists who refer patients to the DCI Ball Square Somerville Home Dialysis Program are unanimous in their praise of our staff," says Dr. Klemens Meyer, Professor of Medicine at Tufts University School of Medicine, who directs the DCI Ball Square home program. "There's a reason for that. They are extraordinarily dedicated and experienced people who have devoted themselves to kidney failure treatment."

We were actually the first peritoneal dialysis program in the Boston area, founded at Tufts Medical Center by John Harrington, MD and Peachy Simon, RN in 1981, and operated by DCI since 1986. Our nurse manager, Jane Maxim, had begun her work in dialysis in the 1970s, and had joined us as a staff peritoneal dialysis nurse in 1982. We moved our peritoneal dialysis program from the Tufts Chinatown campus to Somerville in 2002, to establish a regional home dialysis program. We now treat almost sixty peritoneal dialysis patients and six home hemodialysis patients from across Massachusetts. Some patients drive for several hours because they want the individual attention we give our patients.

Although we moved out of Chinatown, serving the Greater Boston Asian community remains an important part of our mission. We hold regular treatment options meetings for patients who speak Cantonese and Mandarin, as well as sessions for those who speak English, and one of our staff is fluent in both Chinese dialects. Even before she joined us, we had successfully trained many home dialysis patients who spoke no English. We have also trained many people whose vision and coordination is limited. What others see as contraindications, we see as challenges, and we take them on.

Jane describes our relationship to our patients: "One of our patients was an elderly gentleman. He came in saying that he'd had a good life, but that he was certain that he couldn't do PD independently. He could, and he did, for three years, but every time something happened to disconcert him, he'd say that he'd had a good life, he had a deep faith, and he was ready to die. We'd go out to his house, show him what to do, and he'd say ‘Is that all? I can do that.' Often, it's the family that thinks it's too much. It's a matter of teamwork: we have parents dialyzing children, children dialyzing parents, adult siblings dialyzing each other, partners dialyzing each other. Sometimes, there are huge cultural issues. I remember one woman we trained in Chinatown. Two of our Cantonese-speaking staff were helping me to train her. She did very well, but when she was done training, she announced that her daughter, who worked full time, would do this for her, if she was a good daughter. There were five women in the room: the patient, the daughter, the two other staff, both of whom were about the daughter's age, and I. Pretty soon, I was the only one in the room not weeping, because I didn't speak Cantonese, and didn't understand what was upsetting everyone. In the end, the patient did PD herself, and she did fine."

Another nurse compared our program to others she has observed: "We are well staffed, with excellent staff retention, and nurses are directly available to the patients 24 hours a day, 7 days a week. We aren't wasteful, but we don't pinch pennies. Our nephrologists are responsive. We have excellent relationships with all of our surgeons and radiologists, and when we have problems with a catheter or a fistula, they talk to us. I think that what is most characteristic of our program is the persistence of our care. We really follow up closely. We know our patients. We know who they are, and we're personally invested in their wellbeing. We know where they go on weekends, and why they're not hooking up to the cycler til late, or skipping a hemo treatment."

We consider home dialysis the second best kidney failure treatment, after transplantation; when DCI sponsored community service projects to celebrate its 40th anniversary, we put together an award-winning project on organ donor awareness at Somerville High School. We do everything we can to support our patients on the way to transplantation.

We serve a wide variety of patients, and they are all part of our extended family. One of our patients had a third grade education and had been incarcerated. Another patient is a pre-med, one a retired pilot, one a college instructor, one an internist who actively teaches medical students. Several travel widely and regularly.

We are now one of the largest home dialysis programs in Greater Boston. We are proud that we recently received DCI's 2013 Darwin Peterson Award for Peritoneal Dialysis, awarded to the program with the highest overall quality across DCI's forty-two home dialysis programs. We believe in DCI's mission: "We are a non-profit service organization. The care of the patient is our reason for existence."