Implementation of the anemia guidelines

Implementation of the National Kidney Foundation-Dialysis Outcomes Quality Initiative (NKF-DOQI) Guidelines for the treatment of the anemia of chronic renal failure is a great challenge to all concerned with the improvement in the quality of life and survival of patients with chronic renal failure. These include physicians, nurses, technicians, dietitions, social workers, administrators, and private and public (Health Care Financing Administration) payers of the care. The principles of the process of implementation are reviewed and the barriers that can prevent implementation are discussed, showing how most of these can be overcome. Several of the more controversial Guidelines are discussed in detail, showing that with protocols that address the means for implementation, the goals of these Guidelines can be achieved. (C) 1999 by the National Kidney Foundation, Inc.