The IPRO End Stage Renal Disease (ESRD) Network of New York is contracted by the Center for Medicare & Medicaid Services (CMS) to launch Quality Improvement Activities in the Network Service area. 30% of dialysis facilities have been targeted in New York state to improve the Utilization of Home Therapies. (Peritoneal Dialysis and Home Hemo Dialysis)
Facilities in this QIA are targeted to increase the number of patients utilizing appropriate home dialysis by 10% during this project period. Ultimately, CMS has a goal to increase the national average of patients utilizing home dialysis to 16% in 2023 from just 12% in 2016.
CMS has a developed a seven step methodology to track patient progression through the process of changing modality from in-center hemodialysis to an appropriate home
modality. The seven steps are as follows:
- Patient interest in home modality
- Educational session to determine the patient's preference of home modality
- Patient suitability for home modality determined by nephrologist, with expertise in home dialysis therapy
- Assessment for appropriate access placement
- Placement of appropriate access
- Patent accepted for modality training
- Patient begins home modality training
In collaboration with the National Coordinating Center (NCC) and dialysis facilities the Network will track and monitor patient progression through these seven steps. The Network will assist facilities with identification with root cause(s) that may impede patient progression. Facilities will participate in a bi-monthly Learning and Action Network (LAN) presented by the NCC to facilitate that sharing of best practices to promote appropriate home dialysis.