Ms Bronwyn smaill1
1Fresenius Medical Care, Ellenbrook, Australia
Biography:
I began my nursing career in 1999 in haematology and renal care in Sydney before moving to Wellington, New Zealand, where I worked in an acute renal ward and dialysis unit and completed my renal certificate. In 2007, I relocated to Western Australia to join the newly established Fresenius Home Dialysis team, helping build a statewide home therapy program. Over the next 17 years, I progressed from RN to CN and later Clinical Coordinator. Today, I continue my professional growth as the National Quality and Safety Coordinator for Fresenius Medical Care, supporting excellence in patient care across Australia.
Abstract:
Background:
In 2007, Fresenius Medical Care was awarded the statewide contract for home dialysis in Western Australia, a region spanning 2.5 million square kilometres and stretching from remote desert communities to metropolitan Perth. With some patients living more than 2,000 kilometres from the nearest renal clinic, the challenge was clear: create a home dialysis programme capable of delivering safe, high quality training and long term support across vast and isolated landscapes.
Aim:
To develop a sustainable, adaptable training model that met the needs of patients with diverse backgrounds, varying health literacy, and limited access to local health services, while enabling them to remain safely at home for as long as possible.
Methods:
Developing a structured yet flexible training curriculum took years of refinement. Early reviews showed significant variation in staff teaching styles, prompting the introduction of standardised nurse training focused on effective teaching methods. This consistency strengthened patient confidence, safety, and skill retention, supporting long term success on home therapies.
Results:
The programme has expanded from mostly Perth based patients to a statewide service. Patients now receive training and support in some of the most geographically isolated regions in Australia, and many have remained at home for years, close to family, community, and Country.
Conclusion:
By combining consistent training materials with dedicated nurse education on how to teach, the programme has improved outcomes, expanded access, and reduced the personal, cultural, and emotional disruption caused by relocation. This model offers insight into delivering equitable, sustainable home dialysis across vast environments.