Increasing Living Donation in the ESRD population

According to the Organ Procurement & Transplantation Network (OPTN), as of March 12, 2018, there are 95,357 people in the United States waiting for kidney transplants.   Every year five thousand of those people die awaiting a kidney transplant; the current average wait for a kidney transplant is 3.6 years due to the shortage of organs. Increasing living donation is a solution to the organ shortage. Living donation also has many benefits, which include: improved organ/graft survival, decreased need for antirejection medications, immediate organ function post-surgery, and immediate placement on the wait list for a deceased organ transplant as you await your living donor work up.

Unfortunately one of the most significant barriers to increasing living donation is the discomfort that patients feel discussing the topic of organ donation with friends and family.  The National Kidney Foundation has developed a campaign, “The Big Ask/The Big Give” to assist patients in understanding the benefits of living donation and prepare them for this discussion.  Reviewing these materials with patients in your facility who are considering transplant or on the wait list already may help them prepare for this difficult, yet potentially lifesaving conversation.

Materials are available at the NKF site at https://www.kidney.org/transplantation/livingdonors/how-to-make-the-ask in both English and Spanish.

Modality Education Once a Year is Not Enough

Modality options are often presented to patients in the hospital after they have had a central venous catheter placed and are in the acute dialysis setting or upon admission to a new in-center dialysis facility. Understandably, it is very difficult for patients to process all the information that they are receiving at this time, all while being very ill.

If modality education is addressed on admission and not addressed again until the 30 day care plan, it is likely that the patient has already forgotten most of what was presented to them.  Modality education is often presented to a patient only three to four times during their first year on treatment. It is easy to understand why patients choose to stay on in-center hemodialysis therapy, which they are exposed to three times a week for four hours a day, rather than switch to a therapy they know very little about and to which they have had no exposure.

Modality education needs to be an ongoing conversation with patients. Patients need to know the benefits of all renal replacement therapies to make an educated choice about the right type of renal replacement therapy for them.

The following tools can be utilized to educate patients on modality options:

World Kidney Day

Celebrated every year on the second Thursday of March, World Kidney Day (WKD) is a global campaign that aims at increasing awareness of the importance of kidney health and reducing the impact of kidney disease and its associated problems worldwide.

This year WKD and the International Women’s Day 2018 are commemorated on the same day, offering us the opportunity to reflect on the importance of women’s health and specifically their kidney health. On its 13th anniversary, World Kidney Day promotes affordable and equitable access to health education, healthcare and prevention for kidney diseases for all women and girls in the world.

According to the WKD website, http://www.worldkidneyday.org/, chronic kidney disease (CKD) affects approximately 195 million women worldwide and it is currently the 8th leading cause of death in women, with close to 600,000 deaths each year.

Healthcare professionals are encouraged to share key objectives of the WKD campaign, which include:

  • Raise awareness about how diabetes and high blood pressure are risk factors for kidney health, and encourage preventive behaviors,
  • Educate all medical professionals about their key role in detecting and reducing the risk of CKD, and
  • Encourage transplantation as a best-outcome option for kidney failure, and the act of organ donation as a life-saving initiative.

To download 2018 campaign materials, got to http://www.worldkidneyday.org/2018-campaign

How Can Dialysis Facilities Benefit from the Health Information Exchange (HIE)?

Information on infections identified in the hospital setting and reported in the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN), is not easily obtained by dialysis providers. Access to these data can improve surveillance of bloodstream infections and patient outcomes. Enrollment in the Health Information Exchange (HIE) can overcome this barrier. A recent article published in Nephrology News & Issues, ” Closing the information gap: Health information exchange in dialysis“, gives an overview of the benefits of HIE and how it provides a vehicle for improving the quality and safety of patient care.

For more information on HIE, go to https://www.healthit.gov/providers-professionals/health-information-exchange/ .

For information on HIE in your state, go to https://www.healthit.gov/policy-researchers-implementers/state-health-information-exchange-cooperative-agreement-program-key

Personnel Update – Action Required

As a Medicare-certified dialysis unit, CMS expects your facility to keep Personnel Details in CROWNWeb up-to-date, within five business days of staff changes, and to review Facility Personnel information at least quarterly. CROWNWeb is the Network’s authoritative source for facility contact information. Accurate personnel information is needed to ensure proper communication among facilities, the ESRD Networks, and CMS. Instructions on how to update the information in the CROWNWeb system can be found in the Facility Personnel Update Guide.

Please continue to review personnel information for your facility in CROWNWeb and make any necessary changes.