Development of a Duplex Ultrasound Service for Dialysis Patients with Vascular Access Problems

Abstract Change is often seen as threatening and is usually met with some resistance. Old methods are perceived to be 'safe' with change often disruptive in the short term. Patient choice, combined with appropriately trained and dedicated staff working as part of an integrated team, can vastly improve service provision for ultrasound patients. Simple changes can sometimes drastically improve outcomes without necessarily involving an increase in resources. This article illustrates steps that can be taken to identify problems, using the model of a dialysis fistula ultrasound service, and demonstrates how implemented change can improve services to patients and to referring clinicians.