Volume 3 Ed. 3 | September 2019
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- Network Updates
- Patient Services and Patient Care
- Network Quality Improvement (QIA) Highlights
- Data Management
- Upcoming Events and Webinars
- Important Links
- Network Staff Directory
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From the Executive Director
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Greetings!
Amazing! We are three quarters of the way through 2019, school is beginning, and the Network is finishing up its project year.
Throughout 2019, Network 15 has actively reached out to facilities and built strong, collaborative relationships to map our future. You’ve been a part of changes to our activities, webpage, and outreach methods. If you haven’t visited it recently, I encourage you to visit our webpage at
https://www.hsag.com/en/esrd-networks/esrd-network-15/ to find new and exciting resources, such as the video,
Who is Network 15?, our new podcast series,
The Dialysis Life, and other valuable tools found on the QIA page.
Of course, we are already thinking about the next project year and encourage you to share your ideas on how to make our 2020 activities even better. It is because of you that we were able to make so much progress in 2019, and we hope to continue improving with your assistance. Please feel free to send any comments and/or suggestions on how to better our QIAs to me at
vbrantley@nw15.esrd.net.
Thank you!
Vicki Brantley, MSN, RN
Executive Director
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Role of the Network: Clinical Guidelines and Standards of Care
A primary goal of the Network is to improve the quality of healthcare services provided to end stage renal disease (ESRD) patients. To that end, the Network, with the assistance of the Medical Review Board, annually reviews and updates the Clinical Performance Guidelines and Standards of Care, which provide guidance for dialysis care providers.
Guidelines are developed in partnership with the Centers for Medicare & Medicaid Services (CMS) and clinics in the service area. The Network then uses a federally-mandated Standards of Care rubric to ensure appropriate care and facility requirements and clinical outcome goals are met. This combination of guidelines and standards assists your facility to provide high-quality treatment to all ESRD patients.
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Patient Services and Patient Care
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Help Patients With Medicare Part D Benefit Review and Open Enrollment
Understanding Medicare coverage can be confusing for your patients, especially figuring out what treatments and medications are covered by which part. Medicare open enrollment is just around the corner (October 15–December 7, 2019). Take just a few moments to review the available Medicare options with your ESRD patients, especially their Part D benefits, before they have to make their Medicare plan decisions during the open enrollment period.
It is important that your ESRD patients understand that making the right choice is critical; they may not be able to change their insurance plan as easily (or perhaps, not at all) as Medicare beneficiaries who don’t have ESRD.
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The Importance of the Influenza Vaccination for Patients and Staff
People with ESRD have decreased immunity due to their kidney disease and are, therefore, at higher risk for contracting influenza (the flu) than the general population. Your ESRD patients are also more likely to develop serious complications from the flu, such as infections, dehydration, pneumonia, and even sepsis. Encourage all of your ESRD patients to get the vaccinated.
Then, turn your attention to your facility staff, both for their protection and the protection of your patients. The Advisory Committee on Immunization Practices (ACIP) recommends that all healthcare personnel (HCP) be vaccinated annually against influenza. And, you must report on immunizations for healthcare personnel at the facility-level in the National Healthcare Safety Network (NHSN). The reporting period for
immunization of healthcare personnel for the 2019–2020 flu season is 10/1/2019–3/31/2020.
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Network Quality Improvement Activity Highlights
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Bloodstream Infection (BSI) Reduction:
Days Since Last Bloom
Poster
The
Days Since Last Bloodstream Infection Poster,
developed by the CDC,
is designed to raise awareness about infections for direct patient care staff, patients, and patient family members. The poster was created to help reduce BSIs
by tracking the days that have passed since the last BSI in a clinic. Use the poster to start discussions and provide education about the importance of preventing BSIs.
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Treatment Options and New ESRD Technologies: Transitional Care Units
Transitional care units offer patient-centered, four-week educational programs for all patients initiating dialysis who may be candidates for other treatment modalities. During transitional care, patients learn about all aspects of renal replacement therapy, including modality selection, access information, transplant options, as well as the impact of the nutritional and psychosocial aspects of the disease. This program enables patients to make truly informed decisions regarding their care.
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Learning and Action Network Highlight: Transplant Best Practices
The ESRD National Coordination Center (ESRD NCC) has held three QIA Learning and Action Network (LAN) calls on the topic of Transplant in calendar year 2019. During these LAN calls, the following interventions were identified as LAN best practices:
- Use a transplant tracker to monitor patients through the transplant process.
- Develop a communication process/relationship with the transplant centers.
- Refer patients to more than one transplant center.
- Provide patient education regarding the steps to transplant including details of what to expect at each step.
- While educating patients, listen to why they are not interested in transplant and talk about their concerns and possible misconceptions.
- Continue to educate patients at their level of readiness and re-educate existing patients that may not have been ready when educated in the past.
- Hold a lobby day that includes peer support and mentorship from a previously transplanted patient.
Mark your calendar to join the ESRD NCC, the Networks, and other ESRD professionals for the upcoming transplant LAN calls on:
- September 17, 2019
- November 19, 2019
Find copies of the slides used to support previous LAN discussions, as well as recordings of the events on the ESRD NCC QIA LAN webpage at
https://esrdncc.org/en/qia/.
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CROWNWeb
CMS-2728 and 2746 Forms
The CMS 2728 ESRD Patient Medicare Entitlement and/or Patient Registration form serves as the Medicare enrollment and patient registry form for all ESRD and kidney transplant patients in the U.S. and U.S. territories. The forms are completed and submitted directly to CMS via CROWNWeb
and should be submitted within 10 business days, but no later than 45 days from the first chronic treatment at an outpatient dialysis facility. For example, if a patient started chronic dialysis treatments on 1/1/2019, the CMS-2728 form should be submitted by 1/11/2019 and would be considered late after 2/15/2019. The original signed CMS-2728 is provided to the Social Security Administration (SSA) if a patient is applying for ESRD Medicare benefits.
The CMS-2746 ESRD Death Notification form must be completed when a patient passes away. It is due in CROWNWeb within 14 days of a patient’s date of death.
Copies of a patient’s printed and signed CMS-2728 form, as well as the printed CMS-2746 form, as appropriate, should be kept in the patient’s medical record.
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CROWNWeb Clinical Closure Dates
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Clinical Months
June 2019
July 2019
August 2019
September 2019
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Date for Closure of Clinical Submissions
September 3, 2019 at 11:59 p.m. PT
September 30, 2019 at 11:59 p.m. PT
October 31, 2019 at 11:59 p.m. PT
December 2, 2019 at 11:59 p.m. PT
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National Healthcare and Safety Network (NHSN)—Quarterly Data Checks
Upcoming Deadline for NHSN Reporting
Facilities must follow NHSN Dialysis Event Surveillance Protocol and reporting requirements for CY 2019/Payment Year (PY) 2021 for compliance with the ESRD Quality Incentive Program (QIP). The quarterly reporting deadline for April–June 2019 data is on or before
September 30, 2019.
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The ESRD QIP
CMS provides several resources to ensure you understand and can comply with all of the ESRD QIP requirements. Find what you need to know for CY 2019/PY 2021 in:
- The ESRD QIP Q&A Tool, which provides immediate answers to commonly asked questions and has a robust search engine that allows users to quickly locate information based on keywords or phrases and provides a convenient summary of relevant answers. There is an overview of the tool in the right-hand “Resources” menu on the ESRD QIP QualityNet home page.
There is also a brief tutorial, found at
ESRD QIP Q&A Tool tutorial, that guides users to create an account within the tool, which will enable CMS to communicate directly with them.
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Dialysis Facility Compare (DFC)
Dialysis Facility Compare,
https://www.medicare.gov/dialysisfacilitycompare/, is a Medicare website that provides patients and ESRD professionals with information on more than 7,000 dialysis facilities throughout the country. It is a tool that can be used to compare characteristics, services, and performance on quality measures among dialysis facilities.
Facilities have the opportunity to review their performance data before it is posted on DFC via their Quarterly Dialysis Facility Compare (QDFC) Reports on dialysisdata.org during established preview periods. Dialysisdata.org also contains a list of frequently asked questions found at:
https://www.dialysisdata.org/content/faq.
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Upcoming Events and Webinars
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Reducing Bloodstream Infection LAN Event
Date: September 3, 2019
Time: 1–2 p.m. MT
Increasing Rates of Patients Dialysis at Home LAN Event
Date: September 10, 2019
Time: 1–2 p.m. MT
Increasing Rate of Patients on a Transplant Waitlist LAN Event
Date: September 17, 2019
Time: 1–2 p.m. MT
Patient Experience of Care (PEOC) LAN Event
Date: September 25, 2019
Time: Noon–1 p.m. MT
DPC:
Diabetes and Kidney Disease
Date: September 26, 2019
Time: Noon–1 p.m. MT
DPC:
Decisions You Need to Make About Your Transplant Choice
Date: October 17, 2019
Time: Noon–1 p.m. MT
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Please give us your feedback!
As part of our ongoing efforts to give you the information that you need at the time that you need it, we request that you complete this short survey about our Provider eNewsletter.
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UNOS
Find patient transplant resources on the United Network for Organ Sharing (UNOS) website.
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Visit the In-Center Hemodialysis Consumer Assessment of Providers and Systems (ICH CAHPS) website for up-to-date information on his important patient survey.
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CROWNWeb Online Help
Learn about CROWNWeb and its implementations, resources, terminology, and requirements.
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NHSN
Track bloodstream infections and important healthcare process measures, such as healthcare personnel influenza vaccine status and infection control adherence rates.
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Dialysis Facility Compare
Compare dialysis facilities based on the quality of patient care they provide.
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Patient and Family Engagement
The Network's patient and Family Engagement web page provides
resources that will help all participants on the healthcare team to fully engage in the process of care for end stage renal disease (ESRD) patients.
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ESRD
National Coordinating Center (NCC)
The ESRD NCC provides resources for patients and providers that support:
Better care for the individual through beneficiary and family centered care.
Better health for the ESRD population.
Reducing costs of ESRD care by improving care.
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Kidney Community Emergency Response (KCER) Program
KCER Provides technical assistance to the kidney community to ensure timely and efficient disaster preparedness, response, and recovery in the event of disaster.
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Vicki Brantley, MSN, RN
Executive Director
303.831.8818
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Amy Carper, LCSW, CCM, NSWC
Quality Improvement Director
720.697.7916
650.389.1083
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Justin Carr, MSW, LCSW
Patent Services Director
813.865.3457
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Susan Moretti, BSN, RN
QI Nephrology Nurse
720.697.7914
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Debbie Buchanan
Project Coordinator
720.697.7915
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This material was prepared by HSAG: ESRD Network 15, 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. Publication Number: OK-ESRD-15G024-08302019-01
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