February Home Dialysis Change Package Newsletter |
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This change package supports dialysis facilities and End Stage Renal Disease (ESRD) Networks to increase the number of patients using home dialysis modalities, including peritoneal dialysis (PD) and home hemodialysis. Collected from top-performing dialysis facilities, the package includes an intervention menu of actionable change ideas options for facility implementation. Please view the Home Change Package in its entirety.
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Foster Physician Support of Home Dialysis |
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End-stage renal disease (ESRD) affects more than 500,000 Americans, and many of these patients receive dialysis therapy. Recognizing the importance and centrality of this therapy to physician training and patient care, the American Society of Nephrology (ASN) Dialysis Advisory Group developed a comprehensive curriculum for trainees and nephrologists, the "ASN Virtual Mentor Dialysis Curriculum." This curriculum spans a substantial portion of what trainees need to understand—and what nephrologists may want to refresh—about the provision of dialysis care, from machinery to preventive health and from drug dosing to peritoneal dialysis in special populations.
Action Step: Share resources with nephrologists during monthly meetings. Encourage nephrologists to use this as a training tool for renal fellows and new nephrologists.
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Adopt a Mindset that Home Dialysis is Possible |
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Home Dialysis Central offers several different patient stories about their journey with ESRD and their treatment choice of using a home modality, either home hemodialysis or peritoneal dialysis. The differences in age and activity levels prove that the use of a home modality can be appropriate for most patients. |
Change Ideas
- Explain to in-center hemodialysis (ICHD) staff the quantity and quality of education that patients get in training, specifically for patients on home hemodialysis (HHD), to minimize the potential of sharing misinformation.
- Do not ask, “Is this patient a home dialysis candidate?” Instead ask, “Why shouldn’t this patient be on home dialysis?”
- Provide layers of education on home dialysis in different settings at numerous times with different healthcare team members.
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Elevate Home Program Collaboration and Refine Operations |
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The American Association of Kidney Patients (AAKP) has created a resource that provides education for patients and caregivers about treatment choices in ESRD. This resource identifies the members of the healthcare team along with their roles in patient care. By identifying the healthcare team it promotes the idea that patients are not alone. |
Change Ideas:
- Respect that each member of the interdisciplinary team (IDT) is “one piece of the puzzle” and that all are needed to deliver excellent patient care.
- Ensure discussion of home dialysis has a permanent place on the ICHD Quality Assurance and Performance Improvement (QAPI) agenda, in weekly staff meetings, and during informal staff huddles.
- Implement the quality improvement process (plan-do-study-act) to address metrics not moving toward goals or trends moving in the wrong direction.
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Educate and Support Patients and Caregivers Throughout the Continuum of Care |
The fear of the unknown is natural. Many patients and families contemplating home dialysis may have legitimate concerns about their ability to be successful. Effective home programs blend empathy and education to empower patients to be successful at home. |
Change Ideas:
- Provide monthly education to caregivers and patients to sustain home dialysis. Create a curriculum with recommended topics for each month, with available materials in a variety of media, such as written, verbal, and video.
- Create or use a standardized home dialysis training manual for education. Make the education hands-on and create modules for open discussion, nurse demonstration of home dialysis, and patient practice under observation. Create a checklist for training to ensure patients understand all aspects of their education.
- Ensure all training, education, and patient interactions are upbeat and encouraging.
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Engaging Patients and Families |
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Be On The Lookout for a Home Dialysis Hero!
Do you know a Home Hero? A home dialysis hero is a home patient who has the ability and desire to share their experience with others to encourage them to consider a home modality. Please review the suggested criteria for a Home Hero, discuss and brainstorm with your team considering home patients and/or current patients that may benefit.
As part of our National Kidney Month activities, we want to recognize Home Heroes. Email a picture to Network 10 or Network 12 and tell us about your Home Hero and why they deserve a shout out.
Suggested Criteria for a Home Dialysis Hero
- Performs peritoneal or hemodialysis at home
- Proud of transitioning to home dialysis and eager to share their story to inspire Dialysis Peers to choose a home treatment option that’s right for them
- Familiar with the terms, process, and benefits of home dialysis
- Well-adapted to the challenges faced by Dialysis Peers
- Effective communicator with empathy skills
- A desire to support Dialysis Peers in their journey with kidney disease
- Schedule flexibility to be available for their Dialysis Peer by telephone or other virtual ways, or in-person if program participants are located near each other and it is safe to meet in-person
- A trusted confidant for their Dialysis Peer
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Action For Kidney Health Calendar |
February’s Action for Kidney Health calendar topic is Speak Up and Share, focusing on providing information about the grievance process and on ways patients can share their ideas, time and talents through volunteering.
This month’s Action for Kidney Health for home is: “Ask about doing your own set up and/or needle sticks. Self-care can make you more confident about doing home dialysis”.
Download and print the calendar for your patients and encourage them to take all the actions for their kidney health.
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March’s Action for Kidney Health Calendar topic is Caring for My Kidneys, focusing on National Kidney Month-Shout OUT for Kidney Health!, National Nutrition Month and National Save Your Vision Month. |
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In Case You Missed It!
The Network presented a webinar entitled “The Possibilities of Dialysis in a Nursing Home Setting”. The webinar included information about the importance of dialysis in a nursing home resident, the advantages of onsite dialysis, the CMS requirements and NDAC standards, and the benefits of care transitions and improving outcomes.
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Sharing a Common Goal!
We would like to hear your current practices on the initiative to improve the use of home modalities! The processes that you have in place may benefit another facility and we would love to share these ideas.
Please tell us all about what your facility does to increase the use of home modalities using the link below.
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Calling All Home Dialysis Nurses!
We are looking for nurses that are passionate about improving the quality of life of our ESRD population! We want to hear from you! We want to know about your experiences with home modalities, barriers you have faced or are facing now, and any innovative ideas on how we can further improve the way things are being done. Please contact Roma Heater, RN, BSN Quality Improvement Manager.
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This newsletter was prepared and distributed by Qsource ESRD Networks, under contract with the Centers for Medicare & Medicaid Services, an agency of the U.S. Department of Health and Human Services (contract number HHSM-500-2016-00010C and HHSM-500-2016-00012C). The contents presented do not necessarily reflect CMS policy. 21.Q-ESRD.02.027
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ESRD Network 10: 317-257-8265 | Patient Line: 800-456-6919 | Website
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ESRD Network 12: 816-880-9990 | Patient Line: 800-444-9965 | Website
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