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

Spring 2006 - Quality Improvement Projects: 2006 through 2009

Fistula First! (Performance-Based Project)

This is an on-going project to increase the usage of arteriovenous fistulae in incident (new) and prevalent (existing) patients. The Centers for Medicare & Medicaid (CMS) has set goals for Network # 12 to reach!

• By March 2007 Network # 12 as a whole must reach 44.1% AVF
• By March 2007 Non-large dialysis organization (LDO) facilities as a whole must reach 47.4%
• In March 2005, CMS set a new national “stretch” AVF goal of 66%, with a target date of June 2009. (For more information visit: www.fistulafirst.org)

Cannulation Camp

There has been a great deal of interest expressed by facility staff members in the “buttonhole” technique for arteriovenous fistulae. Tentatively, cannulation training is planned for January 2008.

Project: “Cath Out!”

Starting in the summer of 2007, this project will focus on reducing the usage of catheters as primary vascular accesses. Patients that have another option for a vascular access should utilize that option. Catheters should only be utilized as an access of last resort. Tracking catheter usage, permanent access planning, and removing catheters before the 90 day mark will be the primary goals of the project. The project will be kicked off in St. Louis, Missouri. If successful, the project may extend through 2009.

Mission: “Referral”

Focusing on patient evaluation for kidney transplantation, this quality improvement project will begin with ten Network-selected facilities. Beginning in 2006, data will be gathered to determine the following:

• Are patients being referred to the transplant surgeon for kidney transplant evaluation?
• Do the patients understand whether or not they are eligible for transplant?
• Is there evidence in the medical record that the patient was evaluated for transplant?
• What are the barriers to transplantation?
• Does someone other than the transplant surgeon (proxy signature) sign the long-term care plan?

Clinical Performance Measures (CPM)

This is an ongoing annual data collection project that the Network assists the Centers for Medicare & Medicaid in performing. Data is requested from a 5% sample of hemodialysis (HD) and peritoneal dialysis (PD) patients. The pediatric and Veterans Administration patients are sampled 100%. Clinical indicators include anemia management, vascular access, nutrition, and adequacy of dialysis. Look for the familiar blue (PD) and yellow sheets (HD) this summer.

Operation: “Protein Power”

Increasing serum albumin is difficult! Many factors affect the nutritional status of ESRD patients. This project will provide facilities with tools that were proven to be effective in other ESRD Networks (#1 and #15). This quality improvement project will rollout in the spring of 2007.

Operation: “Clot Not!”

This project will begin in the summer of 2007, and may extend into 2008. The focus of the initiative will be to raise the awareness of the need to monitor arteriovenous grafts for stenosis. Preventing clotting episodes improves the adequacy of dialysis, reduces hospitalization, and prevents patient pain and suffering. Disruptions to the facility schedule caused by declotting procedures and rescheduled dialysis treatments are minimized.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

© 2008 End-Stage Renal Disease (ESRD) #12 Network Coordinating Council, Inc. dba Heartland Kidney Network
This resource was (created, developed, compiled, etc.) while under contract with Center for Medicare and Medicaid Services, Baltimore, Maryland. Contract #HHSM-500-2006-NW012C. The contents presented do not necessarily reflect CMS policy.