A Risk-Informed Transitional Care Framework for Patients with Glomerular Disease.

Patients with glomerular disease (glomerulonephritis, GN) experience complex care transitions that increase the risk of fragmented care, delayed decision-making, and inadequate preparedness. Within the Mid-Atlantic Glome - rulonephritis Network (MAGNET), an interdisciplinary nephrology care team ide...

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Publicado en:Nephrology Nursing Journal Vol. 53; no. 1; pp. 33 - 42
Autores principales: Paulus, Amber B., Munjwani, Kabir, Kidd, Jason M.
Formato: CEU critical path pictorial protocol tables/charts Journal Article
Publicado: American Nephrology Nurses' Association Jan/Feb2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan/Feb2026
      vid: 53
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      pub: American Nephrology Nurses' Association
      place: Pitman, New Jersey
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        10.37526/1526-744X.2026.53.1.33
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        atl: A Risk-Informed Transitional Care Framework for Patients with Glomerular Disease.
      aug:
        au:
          Paulus, Amber B.
          Munjwani, Kabir
          Kidd, Jason M.
        affil: Assistant Professor and Associate Chief Nephrology Research & Data Analytics, Department of Internal Medicine, Division of Nephrology, School of Medicine, Virginia Commonwealth University, Richmond, VA
      sug:
        subj:
          Transitional Care
          Glomerulonephritis Therapy
          Education, Continuing (Credit)
          Multidisciplinary Care Team
          Nurse-Physician Relations
          Collaboration
          Patient Identification
          Risk Assessment
          Decision Making, Clinical
          Health Services Needs and Demand
          Information Needs
          Immunosuppressive Agents
          Implementation Science
          Health Care Delivery, Integrated
          Program Development
          Program Implementation
      ab: Patients with glomerular disease (glomerulonephritis, GN) experience complex care transitions that increase the risk of fragmented care, delayed decision-making, and inadequate preparedness. Within the Mid-Atlantic Glome - rulonephritis Network (MAGNET), an interdisciplinary nephrology care team identified the absence of a standardized approach to support patients across key transition points, including transplant referral, dialysis planning, and pediatric-to-adult care. In response, the PATHWAY GN protocol was developed as an interdisciplinary transitional care model embedded within routine nephrology practice. This article describes the design, core components, and implementation strategy of PATHWAY GN, highlighting a nurse-physician collaborative approach to patient identification, transition support, care coordination, and engagement in glomerular disease care.
      pubtype: Academic Journal
      doctype:
        CEU
        critical path
        pictorial
        protocol
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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