Project Overview

Home dialysis modalities are underutilized in the USA with only 8% of dialysis patients undergoing renal replacement therapy at home versus 92% being treated with in-center hemodialysis. The Executive Order on Advancing American Kidney Health on July 10, 2019 recognizes this inequity as seen here in the following link. The ESRD Network supports all CMS goals and initiatives detailed in the Executive order including the goal to improve kidney health by having 80% of new ESRD patients in 2025 either receiving dialysis at home or receiving a transplant.

The ESRD Network of the South Atlantic is tasked by the Centers for Medicare and Medicaid Services (CMS) to collaborate with dialysis providers in the entire Network service area to support the efforts of increasing the rates of patients dialyzing at home.

The intent of the Home Dialysis Quality Improvement Activity (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 ESRD Network of the South Atlantic will assist dialysis providers with increasing the rate of patients on a home modality by promoting the participation in the bi-monthly CMS established and ESRD National Coordinating Center (NCC) hosted Home Modality LAN Calls and assisting dialysis facilities with the implementation of interventions to support patients through the process of training to dialyze at home.

Timeline

 The home dialysis QIA measurement period will be from January 1, 2020 through September 30, 2020 and includes all dialysis facilities in the Network service area.

Baseline Data

The baseline data was provided by the ESRD National Coordinating Center (NCC) from the facility submitted information available in CROWNWeb. Facilities will be selected for their level of participation according to a tiered approach based upon their October 2019 baseline data. All dialysis facilities will be notified in December 2019 once this data is analyzed. 

Facility Selection

Only acute units are excluded from the 2020 Home Dialysis QIA, all others are included to participate, even if the facility does not have an on-site Home Dialysis Program.

Goal

Increase the rate of patients on a home modality by 2.5% in the Network Service Area, by working with incident and prevalent patients. (Dialysis facilities will be given individual goals according to their baseline rate as of data received from the National Coordinating Center-NCC).

Re-Measurement Data

Data for this Quality Improvement Activity (QIA) will be extracted from the facility monthly CROWNWeb data, and will be provided to the Network by the ESRD National Coordinating Center (NCC).

7 Steps Leading To Home Dialysis Utilization

1.  Patient interest in home dialysis (after assisting the patient to determine modality options that fit the patient's lifestyle) 

2.  Educational session about home modality

3.  Patient suitability for home modality determined by a nephrologist with expertise in home dialysis therapy

4.  Assessment for appropriate access placement

5.  Placement of appropriate access

6.  Patient accepted for home modality training

7.  Patient begins home modality training (Counts towards Goal)

 

QIA Tools and Resources

ESRD NCC Home Modality LAN Call Webinars
Home Dialysis Toolkit resources:
  • Flyer: What are my treatment choices?  PDF
  • Booklet: Considering your treatment choices  PDF
  • Booklet: Know the Facts about Home Dialysis Choices  PDF
Patient Education Resources:
  • NW6 Home Hemodialysis (HHD) Word Search Puzzle PDF
  • NW6 Peritoneal Dialysis (PD) Word Search Puzzle PDF
  • My Choice, Home Hemodialysis Myths vs. Reality PDF
  • My Choice, Home Peritoneal Dialysis Myths vs. Reality PDF
  • Uncovering Myths About Home Dialysis PDF
  • Home Dialysis Central - Patient Videos About Home Dialysis 
  • NKF - Have you thought about Dialysis at Home? PDF
  • NKF - What you need to know - Peritoneal Dialysis (PD) English; Spanish
  • Flyer: What are my treatment choices?  PDF
  • Booklet: Considering your treatment choices  PDF
  • Booklet: Know the Facts about Home Dialysis Choices  PDF
  • My Life My Dialysis Choice
  • Home Dialyzors United
Provider Resources:

For More Information, Please Contact:

Michelle Lewis
Quality Improvement Coordinator
919-463-4510
Contact Me