Project Guidelines

IPRO ESRD Networks are tasked by the Centers for Medicare & Medicaid Services (CMS) to work with facilities to increase the utilization of home therapies. Home dialysis modalities are underutilized in the USA with only 8% of patients utilizing home dialysis versus 92% being treated at in-center hemodialysis facilities[1]CMS has set a 5-year target to improve the health of all people in the United States living with ESRD.  This goal for 2023 is to increase the number of patients dialyzing at home to 16%.  (The 2018 NY State average was 7%)

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. 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

Criteria: Include ALL facilities in Network service area
Goal: Using the ABC(tm) model, the Network shall increase the rate of patients utilizing Home Therapies (PD and HHD) in the Network service area by at least 2.5% by evaluation based on data available in October, 2019 by working with incident patients, prevalent patients, and dialysis facilities. 
Baseline Data: October 2019 CROWNWeb data (Treatment Setting = "Home").
Re-Measurement Data: 

Goal 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). Final re-measure will be September 2020 data.

7 Step tracking will be reported to CMS monthly. (the number of patients at each stage of the process as the patients are successfully moved to the next step to home therapies utilization) NOTE: DCI, DVA and FMC facility data will be automatically reported to CMS monthly. 

QIA Reporting to Network

  • February 2020 QIA bi-Monthly Feedback Worksheet PDF; Online Reporting Form (Due February 15, 2020)
  • ALL QIA Facility Contact Form and RCA Barriers   Online Form (Due January 15, 2020)
  • RCA/PDSA Worksheet  PDF (Barriers to be reported on QIA Facility Contact Form)
 

Tools and Resources

Resources:
CROWNWeb Home Training Data Entry Guide PDF
Seven Step Tracker Flyer PDF
PDSA Temaplate PDF

Education Station
Education Station Sign PDF
Best Practices Tip Sheet (Updated 2019) PDF

Webinars

2020 QIA Overview Webinar: This recording provides an overview of Network QIAs, timelines, resources and activities.
RecordingSlides

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
Crossword Puzzle: PD The Needle Free Option PDF

Word Searches: 
PD Word Search 
PDF
HHD Word Search
PDF

PAC Speaks Patient Newsletter:
Overcoming Needle Fear PDF
Home Hemodialysis PDF

National ESRD NCC Webinars (free CE to registered attendees):

2020  ESRD NCC Home Therapies LAN Calls (Registration Page)
One Continuing Education Credit Opportunity for each NCC webinar/recording

Recordings: Recording Page
Click 
here if you are already registered in the Learning Management Center (LMC).
Click here to register for the LMC and then access the course.

Home Hemodialysis | View Recording

National Resources

Medical Education Institute (MEI)/Home Dialysis Central (HDC)

MEI Patient/Care Partner Tool:  My Life/My Dialysis Choice webpage
HDC Staff Tool: Method to Assess Treatment Choices for Home Dialysis (MATCH-D) webpage

 

For more information:

Anna Bennett
Quality Improvement Coordinator
516-209-5474
anna.bennett@ipro.us

CMS has defined seven steps leading to home dialysis utilization: 

1) Patient interest in home dialysis

2) Educational session to determine the patient’s preference of 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

FINAL GOAL:

7) Patient begins home modality training