Fall 2019
Fall is a beautiful reminder of how wonderful change can be. As we look forward to a fast approaching new year, we hope everyone will embrace growth and change in a way that will continue to improve the quality of care we provide to our patients. We look forward to our continued partnership with each and every one of you, and hope we can be an on going source of information and resources that will help to better the way kidney care is delivered in our Network.
Your ESRD Network 16 Team
Quality Improvement
2020 Quality Improvement Activities Launching Soon!
Stay tuned for information on projects for 2020. We are excited to tell you all about our new project goals on a call that will be planned for mid December. Dates and time TBA.  
Are you Hip to QIP?
There are several changes to the ESRD QIP program for calendar year 2020. We will be hosting a call on Thursday, December 12, 2019 to discuss changes in more detail. Stay tuned for details. In the meantime, we have shared some of the highlights for you below:
  • Percentage of Prevalent Patients Waitlisted - Percentage of patients at each dialysis facility who were on the kidney or kidney-pancreas transplant waitlist averaged across patients prevalent on the last day of each month during the performance period. Exclusions include patients over 75 years old and patients admitted to a skilled nursing facility or on hospice.
  • Medication Reconciliation - The percentage of patient-months for which medication reconciliation was performed and documented by an eligible professional (physician, nurse, ARNP, pharmacist). CROWNWeb will be the source of this data.
  • Standardized Transfusion Ratio has moved from a clinical measure to a reporting measure.
  • NHSN - Facilities will be able to receive partial credit for the NHSN reporting measure.
Many other measures still exist including standardized hospitalization ratio (SHR), standardized readmission ration (SRR), ICH CAHPS, adequacy, vascular access, hypercalcemia, ultrafiltration rate, and clinical depression screening and follow-up.
ESRD QIP measures change every year and we recommend using the ESRD PY specific Technical Specification to keep you and your staff up to date. Those Technical Specifications can be found here:  https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/ESRDQIP/061_TechnicalSpecifications.html
Opioid Awareness
By teaching patients about pain and how to manage it daily, we hope they will be less likely to look to opioids as the first line of defense. If you would like to support your patients to take a more active role in their pain management, this toolkit allows them to choose their own path: physical activity, mood and mindset, sleep, nutrition, and tapering. Each area includes a video, handout and tracking sheet. Available in English, Spanish, Russian, Vietnamese and Mandarin. https://www.oregonpainguidance.org/resources/patient-education-toolkit/
Diabetes Self-Management
Many of our patients not only have to manage their kidney care, but have to manage diabetes as well. Kidney patients already have so many dietary guidelines to follow, and a diagnosis of diabetes only complicates this. We know in order for our patients to live as healthy a life as possible diabetes must be properly managed. Help your patients manage their diabetes by ensuring they understand the diagnosis and understand what steps they need to take to live the healthiest life possible. Please review these resources and share them with your patients: https://www.cdc.gov/diabetes/ndep/people-with-diabetes/index.html

Patient Services
Managing Patient Expectations 
Ensuring that your patients know what to expect from your unit/staff on a daily basis can help to create a calm and conflict free treatment environment. One way to do this is by following the treatment schedule as closely as possible. We often get calls about patients being upset when they are not put on treatment as soon as they arrive to the unit. We have seen many situations where patients are arriving early and being put on early, but become very angry when they have to wait till their actual scheduled on time. Unfortunately, when we don't follow the schedule, we often set up an expectation that will lead to conflict when that expectation is not met. Following the schedule not only ensures our patients have a realistic expectation of when they will start treatment, which helps them to plan their day, but also helps to ensure patient safety by properly spacing out put on times. We suggest conducting an internal audit of your put on times. Make sure staff are following the schedule and provide your patients their put on times in writing to eliminate any confusion. 
Dialysis Patient Depression Toolkit
The National Forum of ESRD Networks would like your help in spreading the word about their new Dialysis Patient Depression Toolkit. This toolkit was developed by kidney patients in an effort to help other patients who may be dealing with depression. Here are a few ways you can share this great resource:
Patient Newsletters
Please visit our website to download and share the latest version of our Patient Newsletter with the patients and care partners in your clinic.
Keeping Patient Information Up to Date
If a patient’s address is not accurately reported and updated in CROWNWeb in a timely manner, it could lead to some negative consequences for the patient, and extra work for the facility:
  • Patients will be difficult to track during an emergency or disaster. By keeping the address current in CROWNWeb, you and any of your teammates will be able to quickly run the Patient Roster Report and mark your patients as safe or direct help to their address.
  • Patient will not receive the mailed New ESRD Patient Orientation Packet, where they learn valuable information about treatment options and the role of the ESRD Network. If this Packet does not reach the patient the facility will be notified by the Network to make the correction within a mandatory due date, or the facility will be mailed the Packet(s) to distribute to the patients themselves.
  • Your facility will have a difficult time identifying the nearest home modality facility or transplant center or support group to your patient’s address, in order to refer them. A small mistake in the address could cause a significant deficit in the patient receiving their best care possible.

Question: How do we admit a patient into CROWNWeb if they do not have a Social Security Number (SSN)?
 Answer: If your facility is having trouble admitting a patient into CROWNWeb, please complete the " Request to Review Possible Duplicate and Admit Form ” and the Network Data Team will admit the patient for you! Do not leave any field blank, and do not email this Form, which is located on our CROWNWeb Resources page.

Emergency Preparedness
Interruption in Service
Please notify the Network anytime you have an interruption in service using this form: http://www.esrdnetwork18.org/machform/view.php?id=44393
Make sure to let us know if you need any assistance.  
 New Resource
The Kidney Community Emergency Response Coalition (KCER) is pleased to announce its new resource, Emergency Disconnect Procedure for In-Center Hemodialysis Patients.
The one-page instruction sheet shows in-center hemodialysis patients how to disconnect from dialysis during an emergency situation in three steps.  We encourage you to use this tool to help educate your patients about emergency procedures and to have it available chair side as a guide should an actual emergency occur.
KCER Newsletter
We would also like to encourage you to sign up for the KCER Newsletter. To do so please visit the KCER website: https://www.kcercoalition.com/en/resources/kcer-watch/
Changes in Facility Personnel

When your facility has staff join or leave your team, be sure to notify the Network so we know who to reach out to at the facility for important information including: emergency preparedness, new resources for facilities and patients, upcoming events and deadlines, MAH password changes, CROWNWeb cleanup, and other outreach efforts.
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Contact us

Questions? Feel free to give us a call at 206-923-0714
Do not include any PHI/PII in the email

Comagine Health: ESRD Network 16
Phone: 206-923-0714
Fax: 206-923-0716