QIA Guidelines

The intent of this QIA is to assist ESRD patients with seeking gainful employment and/or returning to work.

The Social Security Administration (SSA) administers the Ticket to Work Program. Under this free and voluntary program, eligible beneficiaries between the ages of 18 and 55, who are blind or have a disability and receive Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits are entitled to sign up with an Employment Network (EN) or a State Vocational Rehabilitation (VR) agency of their choice. These approved service providers coordinate and provide appropriate services to help eligible beneficiaries find and maintain employment. Appropriate services may include training, career counseling, vocational rehabilitation, job placement, and ongoing support services necessary to achieve a work goal.

Collaboration: the Network shall identify a minimum of five (5) Employment Networks and/or the State Vocational Rehabilitation (VR) agency that serves the recruited patient population and educate patients regarding the researched and identified EN and/or VR resources.

Facility Selection: The Network shall include in the QIA, at least 10% of the dialysis facilities within the Network’s service area. 

Inclusion Criteria: The ESRD NCC will provide to the Network, based on CROWNWeb, the number of patients reported as receiving EN and/or VR services to be used as the numerator and to be used for the denominator, the number prevalent patients between the ages of 18 and 55

Goal: The Network shall demonstrate at least a ten (10) percentage point increase in referrals to the identified EN and/or VR in by September 30th of the contract year. The Network shall demonstrate at least a five (5) percentage point improvement in the number of patients receiving EN and/or VR services in closed CROWNWeb data by September 30th of the contract year.

Baseline Data:  The baseline for this QIA shall be the number of patients identified in CROWNWeb as working in the patient demographics,  October 2017 – June 2018.

QIA Newsletters (Interventions and Updates)

May (Unconditional Teamwork)
April (Boundrilessness)
March (Innovation)
February (Customer Focus)


(All reporting is due on the last day of the month)

May Monthly Summary Report (MSR) Worksheet PDF; Online Submission Form
April Monthly Summary Report (MSR) Worksheet PDF; Online Submission Form
March Monthly Summary Report (MSR) Worksheet PDF; Online Submission Form

2019 QIA Activity Timeline/Checklist PDF

RCA/PDSA Worksheet PDF (to be completed by facility staff)

QIA Facility Contact, RCA Outcomes, and PDSA plan (Reporting Worksheet PDF); Online submission form (Resubmit by 2/28/2019)


How to Review and Update VR Record in CROWNWeb PDF
MEI's Patient Interest Checklists:   0-30 days PDF     > 1 year PDF
New York State Vocational Rehabilitation Resource Centers  PDF
Printable Word Search PDF
Vocational Rehabilitation: Answers to Your Questions: English  PDF; Spanish PDF

Ticket to Work: Choosing the service provider that's right for you  PDF
The Share Approach PDF

HDC's Working on Dialysis: What Staff Should Know  PDF

Important Links:

NY State: How to apply for VR Resources webpage
SSA Ticket To Work Program webpage
New York State Disability Employment Initiative webpage

Network Webinars

June 18, 2019 from 2:00-3:00 PM
2019 Best Practices Midpoint Webinar
Register here

Past Network Webinars

February 14, 2019 
2019 Support Gainful Employment Kickoff Webinar
During this webinar the requirements of the entire project will be reviewed.
Slides; Recording; Post-test

April 26, 2018
Webinar:  Vocational Rehabilitation QIA April Webinar

Review Root Cause Analysis results, Project Interventions, and progress of the QIA.

January 8, 2018
Webinar: Vocational Rehabilitation QIA Kick-Off Webinar
Review project requirements, timelines, and project interventions for 2018.


ESRD NCC LAN Webinar Recordings

One Continuing Education Credit per recording:
Click here if you are already registered in the Learning Management Center (LMC).
Click here to register for the LMC and then access the courses.

April 16, 2019
Helping Patients Work Using SSA Work Incentives |Slides;  View Recording
Presentation Objectives:  Describe ways to identify dialysis patients on Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) that can return to work without losing income from Social Security.

Explain various work incentive programs including:

  • SSDI Only Work Incentives
  • SSI Only Work Incentives
  • Identify Social Security work incentives.
  • SSI & SSDI Work Incentives
March 7, 2019
Ticket to WorkView Recording
Presentation Objectives:
  • Highlight Social Security disability benefits.
  • Provide overview of Social Security's Ticket to Work program.
  • Identify Social Security work incentives.
  • Discuss attendees' employment team options.
  • Highlight Ticket to Work success stories.
Patient and Healthcare Team

Network QIA Lead

Anna Bennett
Quality Improvement Coordinator
Emergency Manager
(516) 209-5474

Newsletters (Interventions, & Reporting)

February (Customer Focus)
March (Innovation)
April (Boundrilessness)
May (Unconditional Teamwork)

QIA Referral Steps

1. Assess patient needs
2. Discuss Quality of Life (QOL)
3. Set goals for QOL
4. Refer to VR/EN If and when patient is ready or requests
5. UPDATE Patient VR Record in CROWNWeb (how to PDF)
6. Reassess when needed or at Annual Plan of Care

QIA Activities (to date)

Contact your local Independent Living Center
Review Your Education Station
Identify patients (18-54) who need to schedule an appointment with a VR Counselor or attend an orientation session

Share Ticket to Work Information
Patient Involvement in QAPI
Attend National LAN Webinar (or listen to recording)
Utilize MEI's Patient Interest Checklists:
0-30 days PDF
> 1 year PDF
Launch Facility Education Station/Visual Display Project
Launch Patient Knowledge Assessment
Perform QIA RCA and Begin PDSA cycle
Attend QIA Kickoff Webinar (or listen to RecordingPost-test)
Complete QIA Contact Form