Promote Appropriate Home Therapies
Quality Improvement Activity (HT QIA)
For questions or technical assistance, please contact:
Anna Bennett
Quality Improvement Coordinator
(516) 209-5474

Jeanine Pilgrim
Quality Improvement Director
(516) 209-5365  
QIA Facilities:

List of Facilities 

included in the Promote Appropriate Home Dialysis QIA

ACTION REQUIRED:
Please be aware of due dates associated with each activity.

Review : Match D Tool.  If possible schedule a lunch and learn for staff to review the tool.
Report:  Due 5/31
April Data, 
Barriers/Successes and Feedback.
DISCUSS: Speak with your staff, patients and administration about how your facility's treatment options education process is sustainable. Is it sustainable?  
Innovations/Best Practices
Home Therapy (HT) Innovations Reported in April: (are any of these possible at your dialysis facility?)


Home Therapies Bulletin Boards/Education Stations!  (Please send us pictures of your bulletin boards!!)


PD CD/DVDs
 

In house Education (Staff working with Patients)
 

Outside Educators (vendors and guest presenters)
 

Lunch and Learn
 

Home Dialysis Staff Follow up
 

Kidney Care Advocates
 

Review of New Materials: Match D

 HT Open House
 

HT Lobby Days
 

Treatment Options Orientation (New Patients)
 

LPN dedicated to walking the patients through the process.

May 2018 Updates

TO: All HT QIA Facility Staff, Patient SMEs and Stakeholders

May is a very exciting month for the Home Therapies QIA.  At the Network's 2018 Annual Meeting on May 17th, in Garden City,  Dr. Rachid Daoui will be speaking and demonstrating via live stream DCI Rubin Center's Innovative Remote Home Dialysis Monitoring. Remote monitoring can help overcome the barriers of not having a partner. 
 
May is the fifth month of the QIA, we are almost half way through this year's cycle.  We are still working closely with the NCC to ensure that the data we receive is trending accurately.  Last month, we shared baseline and goal data with facility leads. 
 
Although LDOs (DaVita, DCI and FMC) are providing 7 step data to the Network monthly via the ESRD NCC, please continue to report your successes, barriers and feedback so that this QIA can continue to meet the needs of your patients and staff.

Thank you for all of your efforts in this QIA. 
May Activities
Discuss: Sustainability - is your facility's process for educating patients, family members and staff sustainable?  Is it an ongoing process?  Do you report on treatment options education at your monthly QAPI meeting?

Review: ESRD NCC LAN recommended MATCH-D  as a resource for staff training.  The non-profit Medical Education Institute, Inc., developed the Method to Assess Treatment Choices for Home Dialysis (MATCH-D) to help nephrologists and dialysis staff identify and assess candidates for home dialysis therapies (PD and HHD). It is designed to sensitize clinicians to key issues about who can use home dialysis. Please note that there is a companion patient tool from MEI: My Life, My Dialysis Choice this is an online decision making tool that patients and family members can use when deciding on modalities.

Consider reviewing the Match D tool with your staff as part of their education process, and take a look at the My Life, My Dialysis Choice Tool - it helps to organize questions about how a modality can fit into a patient's lifestyle. Maybe you can review both as part of a Lunch & Learn session with your staff? And recommend the My Life, My Dialysis Choice website to patients and family members.

Report:  (Due 5/31/2018) Based on feedback, we have re designed our Monthly Reporting form to make it easier to report feedback. 

All Facilities MUST report feedback, but you ONLY need to report 7 step data if your facility is NOT part of an LDO (DaVita, DCI, FMC).
Past Activities
QIA Education Materials Feedback
Flyer: What are my treatment choices? PDF
Booklet: Considering your treatment choices PDF
Booklet: Know the Facts about Home Dialysis Choices PDF

April Successes:
A patient was accepted for solo home training!

April Barriers:
Patient Lack of Interest
Past HT Failures (PD and HHD)
Hernia
Transportation
Surgeon's availability
Failed catheter

Materials Available:  April National Home Modality LAN
 
Topics covered:
Education strategies that build and/or strengthen relationships between staff and patients to overcome barriers.

Patient-centered activities that identify gaps between patients' goals and current quality of life.

Strategies for overcoming barriers that impact a patient's perceived suitability for home modalities.
 
Approaches that decrease home admission wait time through collaboration between regional home programs.
We Want to Hear from YOU!
Please contact the Quality Improvement Department if you have questions, comments, or specific barriers that you would like to address.  Let us know if you have identified any best practices that you would like to share with the community.
About the 2018 Home Therapies QIA
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:
  1. Patient interest in home modality
  2. Educational session to determine the patient's preference of home modality
  3. Patient suitability for home modality determined by nephrologist, with expertise in home dialysis therapy
  4. Assessment for appropriate access placement 
  5. Placement of appropriate access
  6. Patent accepted for modality training
  7. 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.