Quality Improvement Projects (QIP)

Quality improvement projects (QIP’s) are to be accomplished in the areas of focus as determined by Centers for Medicare and Medicaid Services. Those areas are inclusive of adequacy of dialysis, anemia, vascular access, and preventive health care (immunizations, mammography, etc.). Projects have been historically and will continue to evolve from basic evaluation of current processes to gauge need (opportunity) for improvement in the development of intervention strategies which will foster change as applicable, and ultimately lead to the measurement of efforts. The challenge throughout this process is to document all of the activities in a reportable, user-friendly format. Projects will be evaluated on the following items:

• NEED
• FEASIBILITY
• POTENTIAL IMPACT ON THE ESRD PATIENT POPULATION
• PROJECT DESIGN
• COST EFFECTIVENESS
• TIMELINESS

The first QIP accomplished within Network 13 was in the area of hemodialysis adequacy. Adequacy of Hemodialysis: Prescription and Delivery was successfully completed with 10 facilities. As a result of this activity, the Network developed and distributed a continuing education self-study known as “Adequacy of Hemodialysis: Prescription & Delivery”. This educational material has been approved for 2.0 contact hours via ANNA.

Our second QIP was “Early Detection of Venous Stenosis in Arterio-Venous Grafts”. The immediate goal of this project was to stimulate early detection of venous stenosis, coupled with intervention, which may prevent AVG failure and may impact hospitalizations for graft related events. Unfortunately, we had to discontinue this project for reasons outside our immediate control.

Our current QIP is “Improving the Adequacy of Hemodialysis Delivered to Patients with Catheter Vascular Access”. The immediate clinical outcome to be addressed is to increase the percent of hemodialysis patients for whom vascular access is a catheter who receive adequate hemodialysis therapy (URR > 65%) from < 60% to at least 80% by December 2001.

The Network is also collaborating with Quality Improvement Organizations (QIOs) in the areas of Diabetic Foot Care in ESRD Facilities (Oklahoma QIOs) and Immunizations (Louisiana PRO).

Updated 3/7/2003