Category: Patient-Centered Care

CMS/NKF Webinar on CKD Risk Reduction

CMS and NKF will present a May 22, 2019 webinar on on Population Health Strategies for Kidney Disease Risk Reduction, at noon PST. Nephrologists, dialysis facility medical directors and renal care providers are invited and encouraged to attend. The NKF CKD Change Package will be introduced, systematic strategies for improving identification and management of CKD will be described, and a population health strategy for registry function, QI, and patient engagement for people living with CKD will be presented. Register for the webinar at https://meetings-cms.webex.com/meetings-cms/onstage/g.php?MTID=e06e8b0a5642756b1b7a7e0998d0eeeb8. Find the NKF CKD Change Package at https://www.kidney.org/sites/default/files/02-11-8036_JBI_CKD_ChangePackV17.pdf.

January 2019 Learning and Action Network (LAN) Webinars

The ESRD National Coordinating Council will host four January webinars to introduce 2019 QIA projects, all to be held 3-4 PM EST.  Find more information and register at the links provided:

National QIA Webinars

The ESRD National Coordinating Council will host four January webinars to introduce 2019 QIA projects, all to be held at noon PST. Find more information and register at the links provided:

New Priorities and Goals Planned for ESRD Stakeholders

The Department of Health and Human Services (HHS) National Quality Strategy (NQS) is a national effort to align public- and private-sector stakeholders to achieve better health and healthcare for all Americans. It was developed “through a transparent and collaborative process with input from a range of stakeholders. More than 300 groups, organizations, and individuals, representing all sectors of the health care industry and the general public, provided comments.”

The Centers for Medicare & Medicaid Services (CMS) contracts with End Stage Renal Disease (ESRD) Networks to implement the NQS principles and HHS Secretary’s priorities in the ESRD community. Starting in December 2017, Networks will launch a set of new quality improvement activities, data reporting requirements, and educational programs that reflect updated priorities and goals.

HHS Secretary’s Priorities

  1. Reform, Strengthen, and Modernize the Nation’s Health Care System
  2. Protect the Health of Americans Where They Live, Learn, Work, and Play
  3. Strengthen the Economic and Social Well-Being of Americans Across the Lifespan
  4. Foster Sound, Sustained Advances in the Sciences
  5. Promote Effective and Efficient Management and Stewardship

CMS Goals

  1. Empower patients to make decisions about their health care
  2. Usher in a new era of state flexibility and local leadership
  3. Support innovative approaches to improve quality, accessibility, and affordability
  4. Improve the CMS customer experience

Addressing Patient Placement Challenges: 30 Day Trial Period

In 2016, the IPRO ESRD Network of New York introduced an innovative program to help facilities accept patients who had been previously involuntarily discharged from their dialysis facility.  As reported in the April 6, 2016 issue of Nephrology News and Issues, through the program prospective dialysis units are offered a 30-day trial period during which they may accept a patient for treatment as if he or she is a “transient” patient. The unit accepts the patient with the understanding that there is no commitment to continue treatment after 30 days; should the patient cause excessive disruption to the unit or exhibit threatening or violent outbursts. Participating units agree that if the patient refrains from these behaviors, the unit will accept the patient as permanent after the 30th day or the 12th treatment. In 2017 the program continues to help patients who have been involuntarily discharged from their dialysis facility, with five patients being accepted permanently in a new dialysis facility, to date.  This program helps those patients who have been involuntarily discharged from their unit receive a second chance.  Through this second chance, the patient and facility get to know one another and the patient has an opportunity to gain a sense of stability and reliable access  to the treatments needed to stay healthy and to survive.

Click here, to read the complete article, An innovative approach in addressing dialysis patient placement challenges.

Beyond Patient Centered Care: Self Care

Over the past 20 years, health care as a whole has been moving toward the patient-centered care-end of the spectrum. What’s the next step? Care that is truly delivered by patients themselves.” In the dialysis unit, staff members can promote patient self-management techniques, from hand washing to self-cannulation and self-management.   A recent Harvard Business Review article,  The Value of Teaching Patients to Administer Their Own Care, includes an example of a self-care dialysis program at the Central Texas Nephrology Associates (CTNA) clinic in Waco, Texas.  Below are a few excerpts from the article, and links to videos and additional information on the Institute for Healthcare Improvement’s website, http://www.ihi.org.

  • “In 2016, nearly 40% of CTNA’s 751 patients performed their own dialysis while experiencing fewer hospitalizations and a lower mortality rate than patients receiving dialysis the conventional way.  Patients delivering their own dialysis experienced better outcomes and the health system minimized costs by avoiding unnecessary hospital visits.”
  • “Providers’ role changed from performing every step of the process to serving as coaches and supporters of patients doing their own care.  The resulting redeployment of staff resources led to higher productivity throughout the clinic.”

Regardless of the setting, a successful approach to patient-administered self-care requires the following :

  • “Patients (or caregivers…) must be prepared and willing… Care organizations need to develop a standard process for training patients… Practitioners must be trained to support patient-administered care … to see themselves as coaches and the patient as an integral partner. …[to] recognize that patients’ capabilities to provide their own care may differ and evolve over time, and …to connect with the patient…”
  • “A standard protocol should be developed [including] …methods for distributing equipment, supplies, and medication … [and] how patients and providers should respond to adverse events. …easy access to outpatient and inpatient services to address any needs that arise.”
  • “A care organization that has a value-based-payment system will have a much easier time adopting the self-care model …Patient-administered care realizes savings by avoiding spending in the first place; in a fee-for-service model, this is lost revenue.”