Author: IPRO

Understanding the End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP)

CMS implemented the ESRD QIP in 2012 to promote patient health by providing a financial incentive (pay for performance) for renal dialysis facilities to deliver high quality patient care. Measurements for the 2018 calendar year, which will be reflected in the 2020 payment year, are separated into three components: clinical, safety and reporting. Dialysis facilities are required to report quality measurements to CMS. These quality measurements are made available to the public.
Additional Information about the ESRD QIP:

Living Non-Related Transplant and Paired Kidney Exchange

According to the United Network for the Organ Sharing (UNOS) nationwide, more than 120,000 people are on the waiting list for an organ transplant as of May 2018. Many face a lengthy wait for an available organ. To spare an individual patient a long and uncertain wait, relatives, loved ones, friends, and even individuals who wish to remain anonymous may serve as living donors. About 6,000 transplants each year are made possible by living donors. Two types of non-related kidney donation are:
1.  Non-directed donation. With this type of donation the donor does not name the specific person to get the transplant. The match is arranged based on medical compatibility with a patient in need. Some non-directed donors choose never to meet their recipients. In other cases, the donor and recipient may meet at some time, if they both agree, and if the transplant center policy permits it.
2.  Paired kidney exchanges. This type of donation is becoming very common and an exciting option for kidney recipient and donor pairs who are not compatible with each other. Previously, people with kidney failure who had an incompatible donor were not able to benefit from the transplant being offered to them. However, paired kidney exchange programs are having a significant impact on the expanding options of living kidney transplants. Paired exchanges are now allowing transplants to occur between incompatible donor pairs and in a few unique ways.
There are many types of living kidney donations. The Network encourages dialysis facility staff to educate patients and care givers about transplant options and provide resources to help them make informed decisions.
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CDC Extends Deadline for Submission of NHSN “Agreement to Participate and Consent” form to June 15, 2018

NHSN’s stated purposes have been recently updated with new provisions for sharing data with local and territorial health departments and with the Centers for Medicare & Medicaid Services (CMS). As a result all newly enrolled facilities must accept the Agreement to Participate and Consent upon enrollment, and all currently participating facilities must accept or “re-consent” to the Agreement.
  • Currently enrolled facilities are required to accept the new Agreement to Participate and Consent electronically by June 15, 2018.
  • If a facility fails to re-consent by the deadline, its NHSN functionality will be suspended until the consent form is accepted.
  • Newly enrolled facilities must consent within 60 days of enrolling in NHSN.
  • After submitting enrollment forms, the person(s) listed as the Dialysis Component Primary Contact and the Healthcare Personnel Primary Contact must log in to the enrolled facility in NHSN.
  • On the Dialysis component homepage, the primary contact should review the electronic consent form and then check the ‘Accept’ box and click ‘Submit’.
  • For more information contact NHSN@cdc.gov with “consent form” in the subject line or visit https://www.cdc.gov/nhsn/about-nhsn/faq-agreement-to-participate.html.

CMS Introduces the ESRD QIP Listserv on QualityNet

Effective at the end of April 2018, CMS will distribute program updates and other important communications exclusively via the End-Stage Renal Disease Quality Incentive Program (ESRD QIP) listserv. This listserv will replace current email blasts from the ESRD QIP mailbox.

Signing up is easy! Simply go here to create your ESRD QIP listserv account by selecting the option for the ESRD QIP. CMS will use the online listserv to distribute communications about changes to ESRD QIP policy and process to the ESRD QIP stakeholder community. You will need to create a user account to receive future communications from the listserv.

If you have any additional questions or concerns, please contact the ESRD QIP team using the ESRD QIP Q&A Tool.

Offering Support for Patients Beyond the Dialysis Center

When starting dialysis, patients are often overwhelmed with the adjustment to their new lifestyle. Navigating end stage renal disease, especially for new patients, can become frustrating, and sometimes can lead to patients feeling defeated by their chronic illness. Additionally, patients experience feelings of loneliness or isolation.

According to the American Association of Kidney Patients (AAKP), becoming involved in a support or adjustment group offers patients emotional support, reduces the feelings associated with loneliness, and provides a safe and secure platform to discuss feelings and emotions commonly associated with the diagnosis of renal failure. A patient making the decision to attend a support or adjustment groups signifies the first step towards acceptance and understanding of their diagnosis.

Initiating, implementing, and sustaining a support group can have its challenges. AAKP offers the Community Patient Support Group Guidebook. The resource was created to assist patients, family and caregivers, and dialysis providers with starting patient support or adjustment group in your service area. The AAKP website offers several ideas for session topics and patient education materials. Visit http://www.aakp.org/ for additional information or call (800)749-AAKP.

Shared Decision Making: The Pinnacle of Patient-Centered Care

In 1988, researchers from the Harvard Medical School, on behalf of the Pickler Institute, developed the model known as the Eight Dimensions of Patient-Centered Care. The model challenges clinicians to cultivate a better understanding of a patient’s illness and address their needs. Secondary to knowledge gain, patients are viewed as equals to clinicians when making decisions about their healthcare.

A component of patient-centered care includes the concept of shared decision making or a process where patients work alongside their clinicians to make decisions about their treatments and care plans. Clinical evidence is reviewed to weigh the risks and outcomes associated with the decisions keeping a focus on the patient’s preferences and values. Benefits that come from patients engaging in the shared decision process include understanding their health along with the pros and cons of different options, being better prepared to collaborate with their healthcare team, and most importantly they are more likely to follow through on their decisions. For more information and tools on shared decision making, visit the New England Journal of Medicine at www.nejm.org and the National Learning Consortium at www.healthit.gov.

NCC QIA LAN Information and Resources

All facilities are invited to participate in the National Coordinating Center (NCC) Learning & Action Networks (LANs) to support Quality Improvement Activities (QIA). LANs provide a forum for bringing together healthcare professionals, patients, and other stakeholders around an evidence-based agenda to achieve rapid-cycle, wide-scale improvement.

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