Welcome to the July Issue of ACT IVATION In This Issue   Topics for the September Quality Improvement Activity (QIA) Learning and Action Networks (LANs)    Implementation Rates of May QIA LAN Interventions   National Patient and Family Engagement (NPFE) LAN Affinity Group QIAs  Human Centered Design (HCD) Updates   The Advancing American Kidney Health (AAKH) Initiative Announcement  Forum of end Stage Renal Disease (ESRD) Networks Kidney Transplant Toolkit    The KidneyX: Patient Innovator Challenge  The Role of Healthcare Coalitions in Emergency Response

Quality Improvement

Learning and Action Networks Learning and Action Networks bring together stakeholders from across the continuum of care to promote collective change around shared improvement goals. The ESRD NCC QIA LAN meetings help support achievement of these goals by facilitating communication between healthcare settings and assisting with the rapid identification and spread of best practices.     Below is an overview of the September QIA LAN meetings. The meetings are open to ESRD providers and community stakeholders across all Network service areas. Each meeting provides one continuing education unit.   September 3 Bloodstream Infections (BSIs) For this meeting, a panel of speakers from Portage Dialysis, part of the Maricopa Integrated Health System, will discuss how they were able to successfully reduce BSIs in the facility. The panelists, who include Marek Patyniak, RN, BSN, Jinkee Borja, RN, BSN, CNN, Barry Rubin, BA, RN, and Helen Rosales, RN, BSN, CNN, will provide examples of innovative staff practices and share resources for patient education. Click here to register:  https://cc.readytalk.com/r/ns8d1aynstzk&eom   September 10 Home Dialysis This LAN will feature Wendy Woods, who is Chief Executive Officer of Kidney Kare, Inc. Florida, a provider with services that include peritoneal dialysis, and both staff-assisted and self-care home dialysis. Ms. Woods will review ideas for promoting home dialysis to patients, including ideas for providing targeted education. She will also describe ways to use social media to promote home dialysis.  Click here to register:  https://cc.readytalk.com/r/dot2l88yuq15&eom   September 17 Transplant Join Jennifer Gander, PhD, a clinical epidemiologist with Kaiser Permanente Georgia Regional, as she discusses disparities in transplantation and the types of challenges faced by patients who are pursuing kidney transplant. Ms. Gander will also provide successful strategies to better enable staff explore the option of transplant with patients and family members.  Click her to register:  https://cc.readytalk.com/r/ynn2y0b05ult&eom   Implementation of May QIA LAN Interventions The following table provides an overview of the reported implementation rates for the interventions shared during May's QIA LANs. The data were collected using the post-LAN evaluation question:  “If you attended the May meeting, or listened to the recording, which of the following QIA LAN interventions did you implement?”  Respondents were asked to select all that applied.

Patient and Family Engagement

NPFE-LAN The NPFE-LAN Affinity Groups are tasked with identifying, enhancing, or developing resources to support Network QIAs, with a focus on those that can be tested, spread, and used by the wider renal community. Below is an overview of the NPFE-LAN Affinity Groups and the resources they are developing this year.   BSI Affinity Group The BSI Affinity Group is developing a resource to complement currently exiting materials from the Centers for Disease Control and Prevention (CDC) Clean Hands Count campaign. The resource, Test Your Hand Hygiene Knowledge , is an interactive learning module designed to increase knowledge of proper hand hygiene and demonstrate proper hand washing techniques. The module is mobile-friendly and can be shared through text messaging. Affinity Group Subject Matter Experts (SMEs) will partner with local dialysis facilities during August and September 2019 to hold Lobby Day events that showcase the new module and encourage use and spread.  Home Dialysis Affinity Group The Home Dialysis Affinity Group identified that one of the main obstacles to engaging patients in home treatment modality education is that discussion often consists of staff simply asking the question, “Are you interested in home dialysis?” If the patient response is “no,” the conversation often ends at that point and is documented in the Plan of Care as "educated/not interested." Affinity Group SMEs reported that many patients say "no" when asked because they have not been educated about home dialysis, and therefore, cannot imagine themselves in that treatment setting. To address this barrier, the Affinity Group is developing conversation starter cards titled, Let’s Talk: Home Dialysis , to help patients, caregivers, and healthcare providers initiate and maintain dialogue about home dialysis treatment options. Kidney Transplant Affinity Group The Kidney Transplant Affinity Group is creating a resource designed to facilitate meaningful conversations about dialysis treatment options with the healthcare team. The SMEs noted that when the healthcare team has an established rapport with patients and family members, they will be more likely to share goals about their quality of life. This information can be used by healthcare professionals to better frame conversations about kidney transplant as a treatment option. To assist with establishing this type of rapport, the Affinity Group is developing, Partnering Along the Road to Transplant, a resource detailing five key steps to effective communication between patients and healthcare professionals. Patient-Selected Topic Affinity Group This year NPFE-LAN SMEs participating on this Affinity Group selected improving emotional well-being as the topic of focus. The Affinity Group is developing Goal Setting: Getting Back to Me, a workbook to support patients who identify a goal and strive to achieve it. The resource is designed to help patients restore their sense of dignity and increase self-esteem through goal setting. The NCC recently hosted a national Kidney Caregiver Peer Connection Call in support of the Affinity Group topic that served as an opportunity for caregivers and family members nationwide to learn directly from individuals who have cared for a loved one diagnosed with kidney disease.

Human Centered Design

Increase Access to Transplant and Reduce the Kidney Discard Rate During 2018, the NCC, the Centers for Medicare & Medicaid Services (CMS), and Accenture conducted research with patients, providers, and other renal stakeholders, to uncover root causes of behavioral factors impacting kidney transplant and discard rates. During June 2019, a second phase of the project was initiated with a focus on organization procurement organizations (OPOs) and transplant centers. The second phase serves as a complementary effort to improve transplant and discard rates. During July 2019, the NCC conducted interviews in collaboration with Networks 2, 4, 11, and 15.

Increase the Use of Home Dialysis Modalities in the ESRD Community During June 2019, the NCC began conducting research related to strategies for increasing the use of home dialysis modalities in the ESRD community. Initial research for the project included a literature review and actor mapping session, which is used to identify stakeholders that are both directly, and secondarily, involved or reached by the project.   During July 2019, the NCC conducted visits with best practice facilities in collaboration with Networks 6, 16, and 17. The visits, which included interviews with patients and staff, were conducted in person to allow for observations of the surroundings and a better understanding of the context in which the interview was taking place. Additional visits are planned for August in collaboration with Network 8.

Develop a Patient Social App  The NCC is currently completing its synthesis of the ideas and feedback collected from the May 2019 ideation session for the Patient Social App development. The 250 ideas generated by participating patients, caregivers, CMS, and facility staff, including a nephrologist, nurse, social worker, and dietitian, are being used to inform the HCD-driven development of an app that will increase patient empowerment and activation. The ideas are currently being synthesized to identify patterns and themes which, based on preliminary analysis, include social interaction, medication and appointment reminders, and educational resources. The NCC will use final synthesis findings to inform next steps for the project.

Communication and Coordination

NPFE-LAN SMEs Attend Advancing American Kidney Health Initiative Announcement On Tuesday, July 10, 2019, the Advancing American Kidney Health Executive Order was signed. The order aims to improve detection, diagnosis, and treatment of kidney failure, with a goal to reduce the number of ESRD patients by 25 percent by 2030. Other components of the order focus on living kidney transplant donors and raising public awareness about chronic kidney disease.  Prior to the signing, several ESRD NCC NPFE-LAN SMEs attended an announcement about the initiative, including Nieltje Gedney, a SME for Network 5, Derek Forfang, a SME from Network 17, Mary Baliker, a Network 11 SME, and Precious McGowan, a Legacy member of the NPFE-LAN and Network 14 SME. Ms. McGown called attending the announcement an “epic experience,” stating, “I truly appreciate the political acknowledgement and action to improve the quality of life for us that are living with kidney disease.”   Ms. Baliker said, “I never thought in my lifetime I would see the focus come to light with kidney care. It was a privilege and honor to be one of the patients representing the kidney community at the event. I am excited that there will be a focus on increasing living and deceased organ donation, early detection, and cutting-edge treatments.”

Kidney Transplant Toolkit for Healthcare Professionals K idney transplantation is the best treatment and preferred treatment for ESRD. To help more patients receive a kidney transplant, the Forum of ESRD Networks created a toolkit to support healthcare professionals in meeting the needs of patients who want a kidney transplant. The resource is intended to serve as a reference tool for dialysis facility staff, providing information about the transplant referral process and guidance to help patients prepare for receiving a kidney transplant. The toolkit addresses the following and more: Selecting patients to be referred to a transplant center. Deceased donor transplantation. The role of the dialysis unit beyond education. The toolkit can be used as a standalone resource or to complement existing facility interventions. Download the Kidney Transplant Toolkit at https://bit.ly/2LUFHnl .

Patients, Families, and Caregivers Invited to Submit Ideas for the KidneyX: Patient Innovator Challenge Funded by the National Kidney Foundation, the KidneyX: Patient Innovator Challenge is a new prize competition to inspire people to brainstorm ideas and innovations to improve the lives of individuals with kidney disease. Key submission areas include: Ways to relieve treatment symptoms. Successful diet and fluid regimens. Methods to help sustain family and social life. While anyone may submit an idea for the competition, kidney patients, families, and caregivers are specifically encouraged to participate. Acknowledging the critical role patients, families, and caregivers serve in advancing their own care, the competition focuses on ideas that offer a solution or fix to challenges faced during daily experiences, including ways to: Improve health. Relieve symptoms. Make daily life easier. The Patient Innovator Challenge will award winners in two different categories: Solutions in Practice, which include solutions that have already been tried or used. New Ideas, which are solutions that have not yet been created or tried. Twenty-five winners will be awarded prizes of either $2,000 or $4,000 . Submissions are being accepted August 1–September 16, 2019. For detailed rules and to apply visit: https://bit.ly/2NXHhHP.

Mark Your Calendar

NCC Event Calendar Click here to view the August 2019 event calendar. The calendar displays dates and times for the QIA and Patient Experience of Care LANs, National PFE LAN and Affinity Group meetings, Community of Practice calls, and Forum of ESRD Networks meetings.  Upcoming Health and Safety Observances August 1–31, 2019, National Immunization Awareness Month (NIAM) National Immunization Month organizers hope to raise awareness about vaccines and share strategies to increase immunization rates. For CDC immunization materials to use in outreach and education efforts during NIAM, visit https://www.cdc.gov/vaccines/partners/index.html .  September 1–30, 2019, National Preparedness Month National Preparedness Month (NPM) is recognized each September and provides an opportunity to remind us that we all must prepare now and throughout the year. Visit the NPM website to check out topics and ideas to promote preparedness. September 8–14, 2019 Nephrology Nurses Week Celebrate Nephrology Nurses Week to thank, honor, and recognize these highly-dedicated members of the medical community. Visit ANNA , the American Nephrology Nurses Association, for resources to help you recognize and celebrate the nephrology nurses who provide kidney patients with life-saving—and life-changing—care. This year's theme is “Nephrology Nurses Aspire to Excellence.” September 17, International Patient Safety Day International Patient Safety Day is a campaign for all stakeholders in the healthcare system to work together to improve patient safety. The focus of this year’s International Day is, "Safety Culture at All Levels." Visit www.patient-safety-day.org to learn more. September 17, National Get Ready Day Prepare yourself because September 17 is Get Ready Day . The American Public Health Association’s Get Ready campaign helps Americans prepare themselves, their families, and their communities for all disasters and hazards, including pandemic flu, infectious disease, natural disasters, and other emergencies. September 29, World Heart Day Cardiovascular disease is the world’s number one killer. World Heart Day encourages and empowers people to be heart healthy. On September 29, make a promise for your heart. Visit the World Heart Federation for more information.

KCER National Exercise—November 9, 2019

The Role of Healthcare Coalitions (HCCs) in Emergency Response HCCs play an integral role in satisfying the ESRD facility requirements of the Centers for Medicare & Medicaid Services (CMS) Emergency Preparedness Rule. Successful adoption of these requirements will enable all providers, wherever they are located, to: Anticipate and plan for emergency needs. Respond swiftly as a facility. Integrate with local public health and emergency management agencies and HCC response activities. Recover rapidly following a disaster. HCCs are groups of individual healthcare and response organizations that collaborate to ensure each member has what it needs to respond to emergencies and planned events. They plan and conduct coordinated exercises to assess the healthcare delivery system's readiness. There is value in participating in HCCs for strategic planning, information sharing and resource coordination, and dialysis facilities are encouraged to engage with their area HCC to explore these integrated opportunities. HCCs do not coordinate individual facility exercises, but provide an opportunity for many provider types to participate in an exercise. HCCs should communicate exercise plans with local and state emergency preparedness agencies to benefit the entire community’s preparedness. Facilities should actively engage with their HCC, as well as local and state emergency agencies, to identify potential opportunities, as appropriate, to not only assess their emergency plan, but also better understand how they can contribute to, coordinate with, and integrate into the broader community’s response during an emergency. HCCs also provide a collective forum for assessing facilities' communications plans to ensure they have the appropriate contacts and understand how best to engage and communicate with state and local public health and emergency management agencies and other relevant partners during an emergency. Take a moment to review the HCC listing by state on the KCER website at https://bit.ly/2Gh1h1B and provide any updates that you may be aware of! Feel free to contact the KCER team with any HCC updates or questions at KCERinfo@hsag.com .

Don’t forget to ‘ Like’ the ESRD NCC on Facebook.

‘ Follow’ us @ESRDNCC on Twitter.

WEBSITE  |  EVENTS  |  RESOURCES

This material was prepared the End Stage Renal Disease National Coordinating Center (ESRD NCC) contractor, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy nor imply endorsement by the U.S. Government. FL-ESRD NCC-7N1T02-08022019-01.