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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.

Facility Resource Materials

The Facility Resource Materials provides 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.

 

Clinical Tools

MDRD GFR Calculator (with SI Units)
by Stephen Z. Fadem, M.D., FACP, FASN
http://www.kidney.org/professionals/kdoqi/gfr_calculator.cfm

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 EPO Utilization Iron Utilization & Iron Studies
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

 

Quality Improvement Tools

 

Quality Improvement	Tools
Vascular Access (HD)	1. AV Intervention   2. Fistula First 11 Concepts ToolKits
Vascular Access (HD)   Stenosis Monitoring	Arteriovenous Grafts (AVG’s) /   Monitoring for Stenosis
Vascular Access (HD)   Catheter Reduction	Catheter Reduction Tool (Excel)
Vascular Access (HD)   AVF Functionality	AVF Functionality Tool (Excel)
Anemia Management	Anemia Management Worksheet   ( Tools )
Adequacy of Dialysis:   Hemodialysis & Peritoneal Dialysis	Adequacy Audit Tools (Excel)   Instruction for Adequacy Audit Tools       (PDF)
Nutrition

Updated 6/12/2007