Promoting and facilitating high quality care standards for dialysis and kidney transplant patients
in Iowa, Kansas, Missouri and Nebraska.
Main phone (816) 880-9990
Patient toll free (800) 444-9965
Main fax (816) 880-9088
Data fax (816) 880-1775
7505 NW Tiffany Springs Pky. Suite 230 Kansas City, MO 64153
Hot Topics and Heads Up
January 2006 - Network Clinical Performance Measure (CPM) 2005 Goal Reminder
Adequacy of Hemodialysis
It is not enough just to provide dialysis treatments three or four times a week for several hours – there must be a measurable way to ensure that the dialysis treatment that is given is thoroughly cleansing the blood.
Are at least 95% of your patients reaching a mean Kt/V > 1.2 or a URR > 65%?
Vascular Access
The Medicare program spends billions of dollars annually on ESRD patients who are hospitalized for vascular access related conditions. Keeping patients out of the hospital improves their quality of life and of course saves the Medicare program money!
- Do at least 50% of your new patients have arteriovenous fistulas (AVF) as their access?
- Do at least 40% of your current patients have an AVF as their access?
- CMS has set a stretch-goal of 66% AVF by 2009. Will your facility be ready?
- It is the Network12 goal is that 100% of patients with an arteriovenous graft (AVG) will be monitored for Stenosis. Is your facility meeting that goal?
- Is your facility removing temporary catheters before 90 days? Be sure to plan for permanent access placement for your catheter patients when at all possible! Talk about this during your Quality Improvement meetings.
- The Network 12 goal is that is 10% or fewer patients would have to use catheters as their dialysis access. How does your facility rank?
Anemia Management
As a Network we need to remember to focus on ESRD anemia management and how it affects the quality of life for the patient. The various vendors that manufacture products for anemia management offer resources that can assist the dialysis facility in educating staff and patients about topics relating to the management of anemia.
Do at least 85% of the patients dialyzing in your facility have a mean Hgb > 11g/dL?
Serum Albumin
Malnutrition is a major risk factor for morbidity and mortality in the ESRD population. Unfortunately, uremic patients sometimes do not have good appetites and may have other problems (i.e. ill-fitting dentures) that make eating difficult. Creativity becomes of paramount importance in the dialysis center. Think of ways to encourage patients to improve their food intake and try to address other problems relating to eating! Some facilities have “Protein Fairs” in which they try different protein supplements that are available. Recipe sharing, dietary intervention/consultation, and even medically addressing the presence of underlying clinical depression could be possible ways to begin to look at this problem.
How many of your patients are reaching a mean serum albumin > 4.0/3.7 g/dL (BCG/BCP)?