 |
|||
|
|
|||
|
|
|||
 |
|||
 |
|||
 |
|||
  |
|||
 |
|||
 |
|||
|
Visit the Project CROWNWeb Website Today |
|||
|
|
|||
 |
|||
 Visit National Fistula First Web site http://www.fistulafist.org |
|||
 |
|||
 Developed by William Jennings, MD and Lawrence Spergel, MD and hosted by the University of Oklahoma Health Science Center. |
|||
 | |||
 |
|||
 |
|||
| Lists of Renal Related Articles from MedWatch |
|||
 |
|||
| This contains PDF Files. You need Adobe Acrobat Reader to view these files. |
|||
| Download FREE Adobe Acrobat Reader here. | 
|
||
|
|||
|
Contact Us by email at: webmaster@nw13.esrd.net |
|||
| |||
| 4200 Perimeter Center Drive Suite 102 | |||
| Oklahoma City, OK 73112-2314 | |||
| 405.942.6000 1.800.472.8664(For Patients Use Only) |
|||
| Main Fax 405.942.6884, Data Fax: 405.942.6181 Web site Disclaimer |
|||
Quality Improvement
MISSION STATEMENT: "Our goal is to form a dynamic partnership designed to foster an environment of continuous quality improvement and mentoring in ESRD Network 13 facilities. TOGETHER, we will be our best and do our best in the interest of quality patient care." The information provided in this section is to help assist the dialysis and transplant providers to give the best possible care. All documents in this section are printer friendly for your convenience, so please feel free to copy the information as needed.
The information provided in this section is to help assist the dialysis and transplant providers to give the best possible care. All documents in this section are printer friendly for your convenience, so please feel free to copy the information as needed.
ESRD Network 13 is pleased to provide these tools for use or adaptation. If you adapt our material for your organization or personal use, please acknowledge ESRD Network 13 as the source. Please add a citation to your document or web page, include the URL, date accessed, and ESRD Network 13. ESRD Network 13 suggests the following citations.
| The Facility Resource Materials provide updated materials set forth by the Network 13 Medical Review Board (MRB) and helpful information regarding the care of ESRD patients. The information is printer friendly so please feel free to copy materials as needed. |
| The Quality Improvement Tools provide a listing of the current Quality Improvement projects and associated tools from ESRD Network 13. |
| The Dialysis Facility Report (DFR) includes updated quality measures and data that could be useful in quality improvement and assurance activities. |
| The Clinical Tools provides listings of Web sites for clinical calculations. |
The Clinical Performance Measures (CPM) - Annually, the Centers for Medicare & Medicaid Services, with input from the Networks and the renal community, determines the areas to focus Network resources for national quality improvement activities. This activity is known as the "Clinical Performance Measures" (CPM). Each year, the following will be determined: The categories of care to assess, evaluate, and monitor for improvement;
|
FORUM MAC QI Tool Kits - The FORUM of ESRD Networks has developed a series of QI toolkits to address the areas of: |
Quality Improvement Tools
Quality Improvement WorkPlan
Task 1.a., Vascular Access [Fistula First (FF)] QIP - Increasing AVF Utilization Rates for Prevalent Hemodialysis (HD) Patients with Placed AVF’s”
| Tools | |
| Vascular Access (Hemodialysis Patients) |
Task 1.b., CPM Measures QIP – Vascular Access (Catheters) - “Identification & Intervention to Expedite the Placement of Permanent Vascular Access in Catheter-Using Patients Where Permanent Vascular Access is Clinically Feasible”
| Tools | |
Vascular Access (Hemodialysis Patients) |
Task 1.c., Network 13 QIP - “Partnership to Obtain and Subsequently Improve Dialysis Patient Immunization Rates for Influenza, Pneumococcal Pneumonia, and Hepatitis B”
| Tools | |
Immunization (Hep B, Influenza, Pneumcoccal) |
1. Reporting Tool (HD)
5. Handout Patient |
Task 1.d., Facility-Specific QAPI - “Incorporating Basic QI Steps into Existing Facility-Specific QI Projects”
| Quality Improvement | Tools |
| Vascular Access (HD) AVF Functionality |
|
| Vascular Access (HD) Catheter Reduction |
1. 2009 Catheter Reduction Tool (Excel) |
Anemia Management |
Anemia Management Worksheet ( Tools ) |
Adequacy of Dialysis: Hemodialysis & Peritoneal Dialysis |
1. Adequacy Audit Tools (Excel) 2. Instruction |
Updated 9/22/2009
Dialysis Facility Report (DFR)
Changes in Dialysis Facility Report Posted 10/1/2009
Below please find a memo from CMS and the University of Michigan’s Kidney Epidemiology and Cost Center regarding the recalculation of Standardized Mortality Ratios in the 2009 Dialysis Facility Reports.
-
THE RECALCULATION OF THE STANDARDIZED MORTALITY RATIOS (SMRs) ON THE DIALYSIS FACILITY REPORTS
- 2009 Dialysis facility Report - Accessing the Comment Website
Synopisis:
What Will Change in the DFRs?
Only Table 1 and the Dialysis Facility Compare (DFR) Table (page 2 of the DFR) will have new values. None of the other tables in the DFR will change.
In Table 1:
The expected death and SMR measures will be recalculated (items 1d, 1f, 1j-o, 1s, 1u, and 1x-z). The rest of Table 1, including counts of patients and deaths, will not change.
In the DFC table on page 2:
The numbers in the patient survival section will change. The DFC survival classification may also change, although most facilities (95%) will not see a change in the DFC classification. The other DFC measures shown on this table, anemia management and dialysis adequacy, will not change.
As of September 30, the new reports will be available on the Dialysis Reports Secure Web site: (www.dialysisreports.org) Paper copies of the DFRs will not be mailed to facilities. Facilities will need to log on to the Web site using the email address they previously selected as their username and their password to view the new DFR for their facility. We encourage all facilities that have never logged on to the Web site to create an account and log on before September 30 to ensure that their usernames and passwords are working correctly. Only 11% of facilities have created individual user accounts at this time so we anticipate a high volume of new account creation.
Action:
If you have not already logged in to the www.DialysisReports.org secure website, you will need to refer to the first page of your 2009 Dialysis Facility Report which was forwarded to Medical Directors and Administrators from the Network on 7/24/09. It will provide you with the Master login credentials for your facility so that an individual user account can be created. A sample copy of that first page is attached to this email to assist you in locating the appropriate paper copy.
To Reiterate: To view or download the newly calculated SMR information you will need to create a user account by accessing the Dialysis Reports Secure Website master user account for your facility using the information provided on the original 2009 Dialysis Facility Report. Please make sure you do so prior to September 30th.
Please contact UM-KECC with any questions regarding the recalculation, the Web site, or the process for transition. The UM-KECC staff can be reached at 998-9823 (phone) or keccdfr@umich.edu.
What is the Dialysis Facility Report?
Guide to 2009 Dialysis Facility Reports: Overview, Methodology, Interpretation
Network 13 Dialysis Facility Report Cover Letter
The Dialysis Facility Report is conducted each year by the University of Michigan Kidney Epidemiology and Cost Center (UM-KECC) with funding from the Centers for Medicare & Medicaid Services (CMS). The Report is based on data from Medicare dialysis and hospitalization claims, Medical Evidence Forms (CMS-2728), Death Notification Forms (CMS-2746), Annual Facility Survey Reports (CMS-2744), other CMS data and Social Security Administration data.
It includes updated quality measures that were posted on the Dialysis Facility Compare (DFC) website in November 2008 and information that was sent to your State Survey Agency (SSA) in September 2008 for the State’s use in survey activities.
Please note that these data could be useful in quality improvement and assurance activities. The information contained in this report facilitates comparisons of patient characteristics, treatment patterns, transplantation rates, hospitalization rates, and mortality rates to local and national averages.
Accessing your facility’s Dialysis Facility Report
Your dialysis facility’s Dialysis Facility Report (DFR) is available online via a secure website which requires authentication as an authorized user. The credentials for your facility are found on the first page of the hardcopy report you received from Network 13 in late July (click here for copy of the cover letter). If you are unable to locate that information, please feel free to contact the Network office (405) 942-6000 and that information will be provided to the appropriate individuals.
Posted 3/20/2009
Clinical Tools
GFR CALCULATOR FOR CHILDREN AND ADOLESCENTS UP TO 18 YEARS OLD
Schwartz and Counahan-Barratt Methods
by Stephen Z. Fadem, M.D., FASN and Brian Rosenthal
http://www.kidney.org/professionals/kdoqi/gfr_calculatorPed.cfm
Clinical Practice Guidelines - Published/Uncer development KDOQI Guidelines
Translated Guideline in Russia and Arabic
http://www.kidney.org/professionals/KDOQI/guidelines.cfm
Clinical Performance Measures (CPM)
Annually, the Centers for Medicare & Medicaid Services, with input from the Networks and the renal community, determines the areas to focus Network resources for National quality improvement activities. Historically this activity was known as the "Core Indicator Project." With the advent of NKF-DOQI and clinical practice guidelines, this activity is now known as the "Clinical Performance Measures" (CPM). Each year, the following will be determined: s The categories of care to assess, evaluate, and monitor for improvement;
- The targeted ESRD patient population to study;
- The clinical performance measures on which data will be collected to describe the targeted patient population and care practices.
During each year of the contract, categories of care with clinical performance measures will be selected for review. The following information is as of 2001:
| Category of Care | Clinical Performance Measures (Examples) |
| Adequacy of Dialysis: Hemodialysis & Peritoneal Dialysis |
Pre and Post BUN Levels Utilized Dialyzer (HD) Prescription (PD) Delivered time on hemodialysis Pre and Post Patient Weights Times per week dialyzed (HD) Delivered time on dialysis (HD) Delivered BFR @ 60 minutes (HD) URR and/or Kt/V Kt/V Methodology |
| Anemia
|
Hemoglobins |
|
Vascular Access (HD)
|
Type of access in use for study timeframe Reason for catheter, if applicable Catheter used for > 90 days Routine stenosis screening? Methods of access monitoring Type of access in use for first hemodialysis Date access placed Type of access in use after 90 days |
Nutrition |
Albumin Levels Lab method utilized for obtaining albumins |
Facility abstraction is done on selected patient records for the clinical performance measures for the specified time period . The patient sample is a random selection, via CMS, of patients who were on incenter hemodialysis or peritoneal dialysis during the last quarter of the year.
Each April, the Network forwards CPM data collection forms and instructions, patient sample, and fax response sheet to each facility selected to participate. Each facility abstracts data from patient records and submits forms to the Network office. Each fall, the Network QI staff performs a Data Validation Study (DVS) for the CPM activity. A random patient/facility sample is selected by CMS and then the Network requests patient records be submitted to the Network office for Network data abstraction.
CMS and the Network then analyze performance measures which should be monitored or investigated for opportunities to improve outcomes of care.
CMS Web site - Clinical Performance Measures (CPM) Project - Measures and Data Collection