Glavinovic T, Kashani M, Al-Sahlawi M, et al. - As there exists little evidence about optimal peritoneal dialysis (PD) access insertion pathways, benchmarking for patency targets, and definitions of access dysfunction, researchers assessed patients with PD catheters inserted at a single center in Toronto, Canada, in this quality improvement (QI) project after establishment of PD catheter insertion protocols, a PD access coordinator, PD access operator training, and outcomes reporting. From January 2012 to December 2017, overall 297 first PD catheters were inserted. Compared with advanced laparoscopic [AL]-placed catheters, the placement of interventional radiology [IR] PD catheters (n = 94) was done in older patients with greater comorbidities and less prior abdominal surgery. The requirement for urgent dialysis given resource availability and prohibitive surgical risk were the indications for IR insertion. The overall (primary and secondary) dysfunction rates of IR-inserted catheters was 17%. For non-embedded AL catheters, 16.1% of overall dysfunction was reported. For non-embedded AL catheters and for embedded AL-inserted PD catheters, the overall dysfunction rate was 16.1% and 24.6%, respectively. Tracking, outcome reporting, defining PD catheter dysfunction and PD access insertion pathway development were all incorporated in this PD catheter QI initiative, which offers crucial insights into opportunities for program improvement.