Introduction: The vascular access for hemodialysis constitutes the angular stone for the handling of the patients who suffer for chronic renal insufficiency and require prolonged therapy. The handling of the accesses and in particular the arteriovenous fistulas are assumed in the immense majority of the services of health by the vascular surgeons, it is increased and acquired more use in present times when understanding to the hospital or center of health like a company or integrating them with the contract of companies for its operation in the concept of integral health services and to the patient like client, forces to establish organizational schemes for the benefit and implementation of these services of standarized way and with the required quality. Objective: To propose an organizational chart of operation for the evaluation, creation and handling of vascular access for hemodialysis and to demonstrate its feasibility. Patients and method: Design and proposed a protocol of handling of the vascular access for the patients who was put under hemodialysis in the unit of Bernardo Sepulveda general hospital from Ixtapa-Zihuatanejo operated by Medika Humana company of the Vitalmex Group, this protocol was implemented and the data of the procedures as well as the handling of the access would take shelter in the Nefrolink system. Results: 23 arteriovenous fistulas with different variants from surgical techniques were performed, and in all the cases was applied the protocol design previously raised, obtaining the use of all of them, reporting two failures that were corrected, all this in a period of ten months since May of the 2006 to February of the 2007 both months including and with an evaluation at the year of the cut of this series. Conclusions: Is demonstrated that was feasible to apply part of the organizational chart of operation for the evaluation, creation and handling of accesses for hemodialysis. The volume of complications is low and in relation to an evaluation and pursuit of the cases, this dice by the interrelation between nephrologists, vascular surgeon as well as the other parts implied in the evaluation and pursuit of the patients
