Project Guidelines

IPRO ESRD Network of the South Atlantic is tasked by the Centers for Medicare and Medicaid Services (CMS) to collaborate with 30% of the dialysis facilities in the Network service area to support the efforts of increasing the rates of patients dialyzing at home.

As a result, a 5-year target goal has been set by the Centers for Medicare and Medicaid Services (CMS) to guide national health promotion and management to improve the health of all people in the United States living with ESRD: by 2023, 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.

Timeline:

Facilities were selected and notified of their participation in December 2018. The Network will collaborate and assist dialysis facilities with implementing interventions. Facilities will be notified in October 2019 if they have met the goal to graduate or will continue in the project during the next option 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.

Baseline Data:

The baseline data for dialysis facility inclusion was provided by the ESRD National Coordinating Center (NCC) from the facility submitted information available in CROWNWeb.

Facility Selection:

The Network identified thirty (30) percent of all Network Service area chronic out patients dialysis facilities that treat in-center hemodialysis patients. ( ONLY acute units are excluded, all others are included even if the facility does not have an on-site Home Dialysis Program)

Goal:

Demonstrate a 2 percent point improvement in the natural trend of patients using a home modality and start home dialysis training by evaluation of each option year based on the data provided by the ESRD National Coordinating Center (NCC) from the baseline period of October of 2013 - September of 2018. (This baseline data was extracted from the CROWNWeb database)

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:

 

Quality Improvement Webinars:
  • 2019 Home Dialysis QIA Kick-Off & Continuation Webinar (1/10/2019) Slides; Recording 
ESRD NCC Home Modality LAN Call Webinars:
Patient Education Resources:
Provider Resources:

 

For More Information, Please Contact:

Michelle Lewis
Quality Improvement Coordinator
919-463-4510
mlewis@nw6.esrd.net

Network QIA Calendars:

February 2019 QIA Calendar PDF