December 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 patient 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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Change happens at the local level. Dialysis facility Quality Assurance and Performance Improvement (QAPI) meetings are the perfect place to start. Giving interdisciplinary team (IDT) members a copy of this change package for review allows them to identify and prioritize opportunities to increase the number of patients educated, referred, trained, and utilizing home dialysis modalities. The change ideas presented serve as “tests of change” that drive performance improvement and quality improvement programs.
About QAPI: QAPI merges quality assurance (QA) and performance improvement (PI) into a comprehensive approach to quality management. QA is the process of meeting standards and ensuring care reaches an acceptable level. PI is the proactive, continuous study of processes with the intent to identify opportunities and test new approaches to fix the underlying causes of persistent, systemic problems. Data-driven QAPI programs may be customized to facility needs. Key steps include:
- Identifying the problem and defining the goal
- Deciding on a measurement to monitor improvement
- Brainstorming solutions based on barriers and root causes
- Planning an intervention
- Using Plan, Do, Study, Act (PDSA) to implement the improvement project
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Quick Start QAPI Guide
This document provides general guidance for incorporating patients into your facility QAPI activities. It provides a brief description of QAPI and some of the standardized quality tools and methods, as well as several checklists to help you get started.
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Goal Setting
Help your patients thrive by setting Specific, Measurable, Achievable, Relevant, and Time bound (SMART) goals and checking in on progress at appropriate intervals. Download the worksheet.
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PDSA Cycle
This short video can help your staff feel confident on how to complete a Plan, Do, Study, Act (PDSA) cycle when implementing a new quality improvement activity in your clinic. Successful clinics have shared time and again that involving the entire team in an action plan makes a positive difference in the outcome!
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Foster Physician Support of Home Dialysis |
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Strengthen Nephrologists' Comfort Level With Dialysis at Home |
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Home Dialysis Toolkit
This toolkit for healthcare providers and practitioners is a reference tool that gives information about overcoming barriers to starting or growing a home dialysis program.
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NKF Home Dialysis Study
The National Kidney Foundation (NKF) presented the study about the “Perceptions of Home Dialysis Training and Experience Among US Nephrology Fellows”. This study reviews the training that a nephrology fellow receives about home dialysis. The conclusion of this study suggests there is a need to renovate the nephrology fellowship training on home dialysis.
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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Improve Primary Care and Specialty Physician Awareness and Education |
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CKDintercept
CKDintercept is a groundbreaking initiative from the National Kidney Foundation (NKF) to improve chronic kidney disease testing, recognition, and management in primary care. This website also includes information about online education modules that review treatment choices for advanced CKD and ESRD patients.
Action Step: Review this website with your rounding nephrologists so that they are aware of resources that are available for primary care providers.
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Adopt a Mindset That Home Dialysis is Possible |
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Consider All Paitents, Widely Refer Patients, and Explore Options Before Declining Patients for Home Modalities |
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My Choices: Home Dialysis
This video features dialysis patients who talk about how their choice of home dialysis has changed their lives. It also shows that regardless of their age, ethnicity, or their stage in life, home dialysis is a possibility for a lot of patients.
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Home Treatment Options
In this video, two home dialysis patients share the challenges they faced moving to a home treatment, the benefits of using a home therapy, and why they encourage other patients to talk to their healthcare team about home dialysis.
Developed by the National Patient and Family Engagement-Learning and Action Network (NPFE-LAN) Home Dialysis Affinity Group, this video helps support the Advancing American Kidney Health goal of getting more patients to use a home dialysis therapy.
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Home Dialysis is Possible! |
The Network has created a resource for in-center hemodialysis staff members that informs them about ways to identify a potential home modality candidate. This resource includes a space to fill in the information about the closest home dialysis unit and also the name of a facility staff member that would be able to help guide staff and patients thru the home modality referral process.
Action Step: Review resource with the interdisciplinary team and come up with a plan to encourage staff members to participate in the initiative to increase the use of home modalities.
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Frequently Address Misconceptions and Promote Benefits
Among Staff Members and Patients
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Action Step: Address in-center hemodialysis (ICHD) staff misperceptions about home dialysis openly and educate on home frequently and one-on-one. Disseminate “Myth and Fact” sheets to address and confusion about home dialysis.
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Home Dialysis
Myth Busters
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Uncovering Myths About
Home Dialysis
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How to Overcome Home
Dialysis Barriers
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Home Dialyzors United has created this video entitled “How to Overcome Home Dialysis Barriers” that reviews possible barriers that some patients may have while on home dialysis and includes ways to overcome these barriers.
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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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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 use this link to tell us all about what your facility does to increase the use of home modalities.
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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. 20.Q-ESRD.10.140
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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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