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.
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.
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
- May Monthly Status Report (Worksheet PDF); Online Submission Form
- April Monthly Status Report (Worksheet PDF); Online Submission Form
- March Monthly Status Report (Worksheet PDF); Online Submission Form
- February Monthly Status Report Worksheet PDF; Online submission form
- January QIA Contact Reporting: Online Submission Form
January 2018 RCA Outcomes PDF
CROWNWeb Home Training Data Entry Guide PDF
Seven Step Tracker Flyer PDF
QIA Activity Checklist PDF
2019 National ESRD NCC LAN QIA Call Schedule PDF
MEI's Patient Interest Checklists: 0-30 days PDF > 1 year PDF
Join the On-Line Discussion Group at JENY 2.0
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)
May 14, 2019 3:00pm-4:00pm ET
July 9, 2019 3:00pm-4:00pm ET
September 10, 2019 3:00pm-4:00pm ET
November 12, 2019 3:00pm-4:00pm ET
March 12, 2019 Transitional Care Unit Recording
- Be able to describe a Transitional Care Unit (TCU).
- Identify two forms of home patient education.
- Discuss the importance of including staff/team, how to include family/support systems and why it’s important.
- Discuss method for RCA, and then create the plan/PDA based on the findings.
January 15, 2019
Home Hemodialysis | View Recording
- Identify 2 benefits of more frequent hemodialysis.
- Name 3 factors that make for a good home hemodialysis candidate.
For more information:
Quality Improvement Coordinator
Monthly HT QIA Newsletters:
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
7) Patient begins home modality training