In an effort to improve the IPRO ESRD Network Program's ability to ensure educational materials and public announcements get the right information, to the right people, at the right time, we need your help.

Certain firewall and intrusion prevention security programs can interfere (or block) email coming from Constant Contact (the Network’s service for email communication). You can tell your security program that content from Constant Contact is okay to view by putting Constant Contact's domains or IP addresses on a safelist (formerly referred to as a whitelist).

ACTION: Search on the web page of your security program for instructions to find out how to locate and add "safe senders" or contact your IT department directly. You'll need to add Constant Contact's URLs or IP addresses to the safe sender list.

If your program allows website URLs, copy the following Constant Contact URLs and add them to your safelist:

If your program allows IP addresses, add this Constant Contact IP Ranges to their safelist:

The formatting (CIDR notation) above signifies a range or IP addresses which is equivalent to 208.75.123.* and 205.207.106.*

Note: Some security programs will prompt you to restart your computer, to allow the changes to take effect.

Patient and Family Engagement (PFE) is an integral part of a successful healthcare team. Acknowledging the positive impact of empowering patients, the IPRO ESRD Network Program aims to increase the numbers of patients and family members representing dialysis facilities through the recruitment of Patient Facility Representative (PFR), previously known as the Network’s Patient Advisory Committee (PAC) members.

Throughout 2021, the IPRO ESRD Network Program will be supporting dialysis facilities and PFR members by providing them with training, resources, interventions, and educational tools to utilize at the facility level. PFE in healthcare is essential to achieve successful outcomes at the facility. PFR members should be incorporated into the Quality Assurance Performance Improvement (QAPI) to provide the patient perspective. This would allow the Network and facility staff to evaluate how PFE has impacted quality measures and patient satisfaction.

ACTION: Facilities are asked to identify and nominate a PFR member (more than one can participate) to help facilitate quality improvement activities. All patients interested in becoming PFR members must have a Patient Facility Representative (PFR) Application and Confidentiality Agreement completed by facility staff.

If your facility already has an existing PAC member that wishes to continue to serve as the PFR, please contact Danielle Andrews, MPH, MSW, GCPH, Community Outreach Coordinator, at 516-209-5549 or danielle.andrews@ipro.us to confirm their ongoing participation with the Network.

The Centers for Disease Control and Prevention (CDC), Making Dialysis Safer Coalition, is working to characterize end-stage renal disease (ESRD) patients on maintenance dialysis who are diagnosed with SARS-CoV-2 infections after being fully vaccinated.

CDC is requesting healthcare providers who work with patients with ESRD on maintenance dialysis to report SARS-CoV-2 infections that meet the following criteria:

ACTION: If you have any cases to report, please email CDC’s Dialysis Coalition email box dialysiscoalition@cdc.gov using the subject line: “Breakthrough cases”. Include in your email*:

The heat and humidity may cause heat stress during outdoor exertion or extended exposure. Extreme heat can cause illness and death among the at-risk population who cannot stay cool.

ESRD Networks have been tasked by the Center for Medicare & Medicaid Services (CMS) to decrease the rate of infections in peritoneal and venous catheters used for dialysis and the amount of blood transfusions given to ESRD patients dialyzing in a nursing home, keeping with our focus of improving health outcomes and access to care in vulnerable populations. The IPRO ESRD Network Program has organized both of these goals into one overarching quality improvement activity (QIA) due to the close nature and overlapping focus areas. The Network will be closely monitoring dialysis programs providing home modalities to patients residing in a nursing home. QIA initiatives include:

The Network recognize that dialysis in the nursing home is not a widespread practice at this time. However, with the advent of the pandemic there was a noted interest in home therapies for nursing home residents and it is anticipated this form of home therapy will continue to grow. For the next five years, CMS has provided a unique opportunity for the Network to be involved the initiation of a new quality improvement project and the IPRO team has been working diligently to identify barriers, and gather educational resources to help dialysis facilities and nursing home staff improve the quality of care and outcomes for this population. 

The Network will be providing more information in the coming months as educational tools are developed.

Every year 37% of ESRD patients are hospitalized. One in three will be readmitted in 30 days for the same condition as the initial visit. Patient outcomes deteriorate with each hospital and emergency room visit, with the greatest negative impact to those patients greater than 65 years of age.

The Centers for Medicare & Medicaid Services (CMS) has tasked ESRD Networks to collaborate with facilities to improve patient outcomes by reducing hospitalizations, unplanned hospitalizations and Emergency Room (ER)visits.

Your Network Quality Team will be working closely with a small intervention group (community coalition) and regional hospital quality and leadership membership to effect this change. The Network Service Area will also be provided all resources and interventions to implement. This quality improvement activity (QIA) aligns with the Quality Initiatives Program (QIP) metrics. Therefore, by improving patient outcomes your facility may reduce payment reductions.

Safely and effectively transitioning patients to and from the hospital and receiving patients from the hospital are fundamental to reducing subsequent readmissions and emergency room visits. Obtaining timely patient information after patients return to dialysis from hospitalization has always been a major area of concern. An effective communication process is essential to ensure a safe patient hand-off between healthcare settings and should require the active participation of both a sending provider and a receiving provider.

Establishing a good system of communication between healthcare settings is the key to successful care transitions. Here's an immediate action your facility can take to improve communication aimed at reducing hospitalizations, ER visits and readmissions:

ACTION: An Immediate action your facility can take to reduce hospitalizations, ER visits and readmissions:

The choice of home modality has been shown to enhance a patient’s quality of life and improve patient outcomes with better blood pressure control and fewer hospitalizations.

Network communications with current in-center hemodialysis patients has identified the need for additional patient and staff education on home modalities. Educating your facility staff on home modality options is essential to providing patients with clear consistent messaging when discussing peritoneal and home hemodialysis. Each staff member should have enough understanding of these modality options to answer basic questions while providing encouragement and guidance to their patients. Staff should understand the steps to home utilization and provide contact information to area home programs to interested patients and family members. Facility home modality educational policies should include educational materials, testing competencies, and communication guidance with emphasis on empathy, listening, and patient preference to ensure consistent messaging on this topic and ultimately appropriate patient modality selection.

The ESRD National Coordinating Center (NCC) Home Dialysis Universal Staff Education Course will give dialysis staff an educational option and provide 1.5 CEs (applies to RNs, MSWs, RDs, and technicians) upon completion of the following modules. Please share the link with all facility staff members.

Good communication between dialysis facilities, transplant centers and patients has been a key best practice that leads to patients successfully moving through the transplant process and eventually obtaining a kidney transplant. However, communication with transplant centers has often been described as a challenge that dialysis providers experience. To improve communication, providers have sometimes developed internal tracking systems or processes that would help them support the patient through the transplant process. Some dialysis providers have access to communication softwares that facilitate bidirectional communication with the transplant center. To learn more about some of these softwares and how it can work for your facility, please watch the recorded demos for:

ACTION: If your organization does not have access to a tool that streamlines communication with transplant centers, the Network encourages facility leadership discussion of these and other possible alternatives to consider for implementation.

All Medicare certified dialysis facilities are required to report in the National Healthcare Safety Network (NHSN) and track vaccination status for:

Part of the ongoing initiatives of the Network is to work with providers that have low vaccination rates for both patients and staff.

ACTION: Please start reviewing the facility's vaccination planning during QAPI and know your vaccination rates, barriers, and share your success stories with the Network. Network staff will be reaching out to facilities to discuss vaccination planning, processes, and overall rates. Remember, if you are part of a Large Dialysis Organization your corporation delivers clinical data via batch submission weekly (for COVID-19 NHSN) and monthly for EQRS/CROWNWeb. If the facility is not using batch upload for submitting data, make sure staff is reporting accurately for the clinic, and that the facility is prepared for the upcoming flu season.

QAPI is a combined approach of two mutually reinforcing aspects of a quality management system: Quality Assurance (QA) and Performance Improvement (PI). QAPI takes a systematic, comprehensive, and data-driven approach to maintain and improving safety and quality in nursing homes while involving all nursing home caregivers in practical and creative problem-solving.

Similar to virtual support groups, virtual QAPI meetings utilize online applications such as Webex, Zoom, and Google Meets. Creating and conducting virtual QAPI meetings should consist of:

Mental Health is a growing concern in the ESRD community, and with that comes the responsibility to assist patients to improve mental and emotional wellbeing. The dialysis population is culturally diverse and the type of support provided should be culturally appropriate to meet their individual needs.

The Mental Health Technology Transfer Center (MHTTC) Network is hosting online sessions this month for its Culturally Responsive Evidence-Based and Community-Defined Practices for Mental Health Series. Below are two opportunities to expand professional skill set to continue to meet the cultural needs of the people in the ESRD community.

The April 2015 article Potential Impact of Peer Mentoring on Treatment Choice in Patients with Chronic Kidney Disease: A Review, by Dr. Ghahramani, states that Chronic Kidney Disease (CKD) and End-Stage Renal Disease (ESRD) have been directly correlated with increased mortality, morbidity, and overall medical cost. Complexities of a CKD or ESRD diagnosis have created an increased passiveness among new patients that have taken a less active approach in the kidney treatment plan. Additionally, ineffective education of patients and increased passiveness have been associated with increased morbidity and mortality among ESRD patients. According to Dr. Ghahramani, the utilization of a peer mentoring program has the potential to reinforce self-management skills, activities, increase overall patient engagement and improve healthcare outcomes. Moreover, an effective peer mentoring program can be divided into seven model approaches: professional-led group visits, peer-led self-management training, peer coaches, community health workers, support groups, telephone-based peer support, and web- and email-based programs. Dr. Ghahramani noted the success of peer mentoring programs has been attributed to its individualized, patient-centered approach with an emphasis on decision and self-management skills to help improve health outcomes. The relationships built through peer mentoring have the ability to establish trust and recognize individualized healthcare barriers that may have a negative impact on a chronic healthcare condition. These relationships have been correlated with decreased feelings of isolation and increased coping skills among CKD patients. Peer mentoring can equip CKD patients with the necessary skills to combat ongoing anxieties and increase self-awareness.

For more information on Peer Mentoring, please visit the IPRO ESRD Network Program website at https://esrd.ipro.org/patients-family/pfe/peer-mentoring/

The Social Security Administration's Ticket to Work program connects individuals with free employment services to help them decide if working is right for them, prepares them for work, find employment or maintain success for patients who want to continue to work. Services offered include career counseling, vocational rehabilitation, and job placement and training from authorized Ticket to Work service providers, such as Employment Networks (EN) or your State Vocational Rehabilitation (VR) agency.

Each month the Ticket to Work program hosts the Work Incentives Seminar Event (WISE), which are free webinars on vocational rehabilitation services for eligible populations. They are held on the fourth Wednesday of each month. Past WISE webinars can be accessed at WISE on Demand. The next webinar will be held:

When: Wednesday, July 28, 2021

Time: 3:00pm – 4:30pm (EST)

Registration: https://choosework.ssa.gov/wise

Please also visit the IPRO ESRD Network Program website for additional information and resources about vocational rehabilitation.

The IPRO ESRD Data Department provides technical assistance using a customer support system. This is one place for your data submission needs for various systems such as CROWNWeb, NHSN, Dialysis data or Quality Incentive program. In order to meet the needs of our facilities, the new system will provide support:

NOTE: When submitting a request to the Network, you should NEVER include any patient-specific information such as Name, Date of Birth, Social Security Number, Medicare Claim Number, etc. The only patient identifier that can safely be communicated is the Unique Patient Identifier (UPI) from CROWNWeb.

For more information, please visit the Network website.

Email: esrdnetworkprogram@ipro.us  · Website: esrd.ipro.org