Partner Spotlight: Trinity Medical Group | National Kidney Foundation of Michigan

HELPING RURAL COMMUNITIES DETECT KIDNEY DISEASE EARLIER

Chronic kidney disease (CKD) often develops without noticeable symptoms, making early detection an important part of helping people protect their kidney health. Through the CKD Learning Collaborative, the National Kidney Foundation of Michigan (NKFM) and Michigan Center for Rural Health (MCRH) worked with six Rural Health Clinics across Michigan to strengthen how CKD is detected, diagnosed, and managed.

In September 2025, the National Kidney Foundation of Michigan (NKFM) partnered with the Michigan Center for Rural Health (MCRH) to launch the CKD Learning Collaborative with the goal of helping more people receive timely detection and care. Six Rural Health Clinics across Michigan worked together to strengthen how chronic kidney disease is identified, diagnosed, and managed. Clinic teams received education from kidney health experts, practical tools, one-on-one support, and patient education resources to help improve care in their communities. (https://mcrh.msu.edu/).

Together, NKFM and the Michigan Center for Rural Health also developed the CKD Rural Health Toolkit to help rural healthcare providers continue improving kidney care long after the collaborative ended.

The collaborative helped healthcare teams test small changes in their daily work that can make a big difference for patients. By improving screening, patient education, and care coordination, clinics are helping more people learn they have kidney disease before it worsens.

Throughout this blog series, we’re highlighting participating clinics and the work they’re doing to improve kidney care in rural Michigan.

Trinity Medical Group participated in the CKD Learning Collaborative through its medical centers in Hart, Whitehall, Ludington, and Shelby. The team focused on improving early CKD detection and management by increasing staff knowledge and confidence around kidney disease screening and patient education.

Clinical staff received education about six key CKD risk factors and how to understand important kidney health tests, including the urine albumin-to-creatinine ratio (uACR) and estimated glomerular filtration rate (eGFR). Providers were also encouraged to start conversations about kidney health earlier, helping patients better understand their risk and make lifestyle changes that may slow the progression of kidney disease.

Making CKD Screening Easier

Despite these challenges, the team made important improvements to support kidney disease detection and management. Through the collaborative, they successfully changed the name of the urine albumin-to-creatinine ratio (uACR) test in Epic from “Microalbumin, Spot Urine” to “uACR.” This change helped reduce provider confusion, align the test with quality measures, and improve the accuracy of quality reporting.

Education was only one part of Trinity Medical Group’s work. The team also developed a standardized CKD order set in Epic, its electronic health record system.

The new order set makes it easier for providers to order appropriate laboratory tests and follow evidence-based screening guidelines for patients at high risk for CKD. By building these tools into existing workflows, Trinity is working to make kidney disease screening a more consistent part of patient care.

“This initiative was a huge help in filling in gaps of education and awareness- both for providers and our patients! Thank you for everything you do every day!” – Trinity Medical Group

Continuing the Work

Like many quality improvement efforts, creating new tools is only the beginning. One challenge for Trinity Medical Group has been encouraging consistent use of its CKD Smart Phrase in the electronic health record and helping providers routinely start conversations about kidney health with patients who may be at risk.

Moving forward, Trinity Medical Group plans to continue monitoring its CKD screening workflow, reviewing performance data and provider feedback, and reinforcing best practices. These efforts can help sustain improvements in early CKD identification, create more consistent care across clinics, and make sure patients receive timely education and support.

We’re grateful to the Trinity Medical Group teams in Hart, Whitehall, Ludington, and Shelby for their commitment to improving kidney health and helping more people receive the information and care they need.

Through their partnership, NKFM and MCRH developed a CKD Rural Health Toolkit to support health professionals working to improve chronic kidney disease detection and care in rural communities.

Learn more about NKFM’s work to improve early CKD detection and care, including the CKD Learning Collaborative, CKD Rural Health Toolkit, and provider resources here.