IPRO ESRD Network Program Customer Support Portal

In an effort to provide more comprehensive support with the hopes of improving overall data quality, the Network began using Freshdesk, a web-based ticket management and knowledgebase application. It has up-to-date articles, links, and visual aids for CROWNWeb, NHSN, the Quality Incentive Program (QIP) and Dialysisdata.org in one place. Information is provided in the easy-to-use and searchable knowledgebase. Freshdesk provides a platform to submit questions via the portal or email. Network staff will respond by email, phone or WebEx. Please send an email to support@IPRO.freshdesk.com or go to https://ipro.freshdesk.com/support/login.

April 11, 2018

Promotion of Patient Experience Week (April 23-27)

Patient Experience (PX) Week is an annual event established by The Beryl Institute

to honor individuals responsible for providing patient care. PX Week provides a focused time for organizations to celebrate accomplishments, re-energize efforts and honor the people who impact patient experience every day. The Beryl Institute is a global community of practice dedicated to improving the patient experience through collaboration and shared knowledge.

According to the Institute, “Improving health outcomes for patients starts on the front line with doctors, nurses, administrative staff, and executive team members.” Research has shown that better patient experiences can impact the level of patient engagement, and patients who are active members in their healthcare achieve better clinical outcomes.

For more information on Patient Experience Week, click here.

April 11, 2018

CMS Emergency Preparedness Final Rule Webinar: Tuesday, April 24, 2018 from 1pm to 2pm, EST

The International Association of Emergency Managers (IAEM) USA Healthcare Caucus has announced its second webinar in partnership with the Centers for Medicare & Medicaid Services (CMS) on the Emergency Preparedness Final Rule. The webinar will be held on Tuesday, April 24, 2018 from 1pm to 2pm, EST.

Please join Caecilia (Cece) Blondiaux with the Quality, Safety & Oversight Group (QSOG). Ms. Blondiaux will provide a recap and updates on the final rule. She will also highlight and discuss key areas in which CMS is seeing an increased number of deficiencies as related to the final rule. There will be approximately 20-25 minutes allotted for a question and answer session at the end of the webinar. For efficiency and to answer as many questions as possible, IAEM requests that questions be submitted in advance to iaem.health@gmail.com, no later than April 16, 2018.

April 11, 2018

Benefits of Peer to Peer Mentorship for Dialysis Patients

The IPRO ESRD Network program provides technical assistance to facilities in multiple ways including education and resources to support patient engagement at the facility level. One way the Network encourages patient engagement is through the assistance we offer to local facilities in implementing or learning more about available peer mentorship/ambassador programs.

According to an article published in 2015, “Potential Impact of Peer Mentoring on Treatment Choice in Patients with Chronic Kidney Disease: A Review,” written by Nasrollah Ghahramani MD, FACP, FASN, peer to peer programs have shown to help patients become more involved in their health care. Patients who work with a peer as a mentor are able to make more informed decisions about their dialysis treatment options and are better informed about transplant processes. Being informed about health care decisions by peers with shared experiences can build self-confidence which then leads to overall better health outcomes.

To read more about Ghahramani’s findings, click here.

To learn more about patient programs offered by your Network or local agencies, contact your ESRD Patient Services Department. Our Patient Services Team is here to assist with resources on the benefits of implementing patient peer programs or other patient support programming at your facility.

March 14, 2018

Are You Inviting Care Partners and Family Members to Patient Plan of Care Meetings?

You can involve family members and care partners in patient plan of care (POC) meetings via telephone… patients too!

Part of the responsibility of the interdisciplinary team (IDT) is to include patients, and if requested, their care partners and family members in both developing/setting goals and reviewing the patient plan of care.

Is it acceptable to hold a plan of care meeting with the IDT and the patient, their care partner or family members (if requested) via telephone conference? As stated in the CMS Interpretive Guidance for the Conditions for Coverage for End-Stage Renal Disease Facilities, the answer is “yes.”

“A substitute mechanism for a team conference needs to facilitate discussion among team members about the information gathered from the comprehensive patient assessment and provide the opportunity for team coordination and development of an effective, individualized plan of care for the patient to ensure the desired outcomes are achieved. To facilitate full team participation in conferences, any member, including the patient, may participate through telecommunication.”

CMS Interpretive Guidelines (see page 205): https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/downloads/SCletter09-01.pdf

For more information on the regulations on plans of care, see the CMS Conditions for Coverage for end-stage renal disease facilities. Subpart C – Patient Care: https://www.gpo.gov/fdsys/pkg/CFR-2011-title42-vol5/xml/CFR-2011-title42-vol5-sec494-90.xml

March 14, 2018

ESRD Community Receives National Recognition: Congratulations!

The annual Centers for Medicare & Medicaid Quality Conference was held this year in Baltimore, Maryland on February 12 – 14. This meeting is attended by more than 2,500 individuals from across the nation. Attendees, representing a diversity of organizations that support the Medicare and Medicaid healthcare delivery system, come together to focus on bringing to life CMS’ national goals and priorities. Network staff and ESRD patients from across the country attended the conference. This year the ESRD community was recognized nationally for our quality improvement work; specifically for the success of the 18 ESRD Networks and our facility partners across the country in achieving close to a 42% national reduction in bloodstream infections.

Achieving Quality Success

“We all understand the importance of quality. Whether we’re buying something on Amazon or researching nursing homes, we want the best. Patients entering our health care system also want to be assured they’re receiving quality care. Our obligation at CMS is to ensure quality for all.

Through Patients Over Paperwork (the theme of this year’s Quality Conference), we’re advancing quality care to establish a system that always put patients first. Working with the State Medicaid Quality Champions and our many Quality Networks, we’re already making an extraordinary difference:

Quality efforts are being supported in 12,000 nursing homes, 4,000 hospitals, 400 community coalitions, and more than 500,000 providers
Quality efforts in just ONE hypertension control network reduced hospital read admissions by 45% and saved more than $33 million
Quality efforts in 18 ESRD Networks produced an almost 42% national reduction in bloodstream infection.

These are just a few outstanding examples of our shared work to improve quality and safety. It all deserves a round of applause! I’m proud and grateful for what we’ve accomplished, but I also know there’s much more to do to build on these extraordinary steps.”

March 14, 2018

ESRD QIP: Final Rule for CY 2018

The Centers for Medicare & Medicaid Services (CMS) hosted a call on Thursday, February 22, 2018, discussing provisions in the Calendar Year (CY) 2018 End-Stage Renal Disease (ESRD) Prospective Payment System final rule, including plans for the ESRD Quality Incentive Program (QIP) in Payment Year (PY) 2019, 2020, and 2021.

Topics included:

ESRD QIP legislative framework
Measures, standards, scoring method, and payment reduction scale for PY 2021
Modifications to PY 2019 and PY 2020 policies

CMS Slide Presentation on ESRD QIP: Prospective Final Rule for CY 2018 and Overview of QIP.

For additional information please visit the ESRD QIP webpage: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/ESRDQIP/index.html

March 14, 2018

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.

March 14, 2018

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:

- Home Modality Comparison https://homedialysis.org/documents/ModalityComparison.pdf
- Kidney Dialysis vs. Transplant http://www.nationalkidneycenter.org/wp-content/uploads/2011/12/Kidney-Dialysis-vs-Transplant-Comparison-Chart.pdf
- Which Dialysis is Right for You Survey https://mydialysischoice.org/

March 14, 2018

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

March 14, 2018

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

March 14, 2018

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.