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 at least 30% of facilities in Network service area
Goal: 2 percentage point increase in natural trend in home therapies utilization over baseline
Baseline Data: 5 year average trend of patients utilizing Home Therapies (10/2013 - 9/2018)
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). Final re-measure will be September 2019 data.

Tools and Resources

Reporting Forms:

Resources:

January 2018 RCA Outcomes PDF
CROWNWeb Home Training Data Entry Guide PDF
Seven Step Tracker Flyer PDF
QIA Activity Checklist PDF
MEI's Patient Interest Checklists:   0-30 days PDF     > 1 year PDF
PDSA Temaplate PDF
Join the On-Line Discussion Group at JENY 2.0

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

Webinars

Network Webinars:

June 25, 2019
Webinar: Mid-Point Transplant and Home Therapies QIA Review
Slides PDFRecordingPost-test
On this webinar, we reviewed : QIA Activities and Goals; Transplant Champions; Home Therapies Champions; Promising Practices; Network Treatment Options QIAs Materials; Common Barriers; Tips to Engage Patients

January 10, 2019
Webinar: 2019 Combined Home Therapies QIA  and Transplant QIA Kickoff
Slidesrecording and posttest/affirmation (link).

Printable Patient Education MaterialsFlyer: 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: (new 5/90)
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):

Printable 2019 National ESRD NCC LAN QIA Call Schedule PDF

2019 ESRD NCC Home Therapies LAN Calls
One Continuing Education Credit Opportunity for each NCC webinar/recording

Upcoming Dates: (Registration Page)
September 10, 2019 3:00pm-4:00pm ET 
November 12, 2019 3:00pm-4:00pm ET

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.

July 9, 2019 
In-Center Hemodialysis to Peritoneal Dialysis Conversions| Recording TBD

June 18, 2019
PFE LAN: Quality Assessment and Performance Improvement (QAPI)
View the PowerPoint slides; Listen to the recorded webinar (Once you click the link, scroll down and hit the play button to start the webinar recording.)

May 14, 2019 
Telemedicine and Home Dialysis: Our Future Together | View Recording

March 12, 2019 
Transitional Care Unit | View Recording

January 15, 2019 
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
abennett@nw2.esrd.net

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