Project Guidelines

IPRO ESRD Networks are tasked by the Centers for Medicare and Medicaid Services (CMS) to work with facilities to increase the use home therapies.

Home dialysis modalities are underutilized in the USA with only 8% of the dialysis patients undergoing renal replacement therapy at home versus 92% being treated with center hemodialysis[1].

As a result, the following AIM with a 5-year target has been set to guide national health promotion and management to improve the health of all people in the United States living with ESRD: by 2023, to increase the number of ESRD patients dialyzing at home to 16% from the 2016 national average of 12%.

The intent of the Home Dialysis QIA is to promote referral to home dialysis modalities, identify and mitigate the barriers to timely referral, and determine the steps patients and providers can take to improve referral patterns. The Networks shall increase the number of patients on a home modality by participating in the ESRD NCC Home Dialysis LAN, and assisting dialysis facilities in the implementation of interventions to support patients through the process of training to dialyze at home.

[1] Thinking outside the box—identifying patients for home dialysis. Brigitte Schiller, Hayley Munroe, and Andrea Neitzer

Goal: 10 percentage point increase in home therapies training over baseline.

Timeline: Facilities are selected and notified of their participation in January. The Network will work with the facilities to implement interventions.  Facilities will be notified in October if they have met the goal to graduate or will continue in the project during the next year. Facilities not meeting goal should continue to implement interventions and strategies regardless of the measurement period to maximize their ability to graduate in future years.

Facility Selection: 30% of all Network Service area chronic out patients dialysis facilities that treat in-center hemodialysis patients. (stand alone home therapy facilities are excluded)

Baseline Data: The QIA baseline data was provided by the ESRD National Coordinating Center (NCC) from the facility submitted information available in CROWNWeb.

Re-Measurement Data: Data for this QIA will be extracted from facility monthly CROWNWeb data, and will be provided to the Network by the ESRD National Coordinating Center (NCC.)

Network Calendars:

June 2018 Printable PDF
May 2018 Printable PDF
April 2018 Printable PDF
March 2018 Printable PDF
February 2018 Printable PDF

QIA Tools and Resources

February Data Collection Tool: Online Submission Form (Due March 5th)

Printable Patient Education Materials

Flyer: What are my treatment choices?   PDF
Booklet: Considering your treatment choices  PDF
Booklet: Know the Facts about Home Dialysis Choices PDF


February 5, 2018
National ESRD NCC Home Therapies LAN Event
Featured Presenters: Mark Shapiro, MD, DaVita; Eduardo Zanatta, MBA, DaVita

January 31, 2018
Home Therapies QIA Kick-Off Webinar 
Review project timelines, report root causes to low home therapies training, and review project interventions for 2018.  Slides; RecordingPost Assessment

January 17, 2018
RCA 5 Whys Tutorial
Reviewing Root Cause Analysis and how to perform the 5 Whys
 Worksheet; Recording Slides Evaluation Form


Lean Resources

Institute for Healthcare Improvement (IHI) Resources

IHI PaperGoing Lean in Healthcare

IHI Video Activity: A comparison LEAN and QI

For more information:

Michelle Lewis
Quality Improvement Coordinator