Promote Appropriate Home Dialysis
Quality Improvement Activity (QIA)
For questions or technical assistance, please contact:
Sarah Keehner,
Quality Improvement Director
(203) 285-1214

Heather Camilleri, CCHT
Quality Improvement Coordinator
(203) 285-1224
QIA Facilities:
List of facilities included in the Promote Appropriate Home Dialysis QIA
Please be aware of due dates associated with each activity.

PROVIDE: Input Key Facility Staff Contact Information in the Home Therapies QIA collection tool by Friday, February 2, 2018. One contact form per facility.

WATCH: View the "Five Whys Jefferson Memorial Example" Video (<2 minutes)

DISCUSS: Talk with dialysis team members and patients to identify root causes of barriers to increasing utilization of home dialysis.

COMPLETE: Answer questions in the Home Therapies QIA Root Cause Analysis (RCA) Reporting Tool by Friday, February 9, 2018. One assessment per facility.

ATTEND: Join us for the Home Therapies QIA Kick-Off Webinar to be held on Tuesday, February 6, 2018 from 1:00-1:30 PM.  Project requirements, activities to augment current process, and Q&A session will be available during this webinar. 
Click here to register.
Dear Provider,
IPRO End Stage Renal Disease (ESRD) Network of New England would like to notify facilities of a national initiative from the Center for Medicare & Medicaid Services (CMS) 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.

A priority of the Network is to serve as a resource to both dialysis patients and professionals throughout project activities.  Open communication about existing processes, barriers, and successes is encouraged.  Network staff members are interested in supplementing resources for what is working in your facility, not adding additional burden. However, in order to assess barriers, and identify how the Network can effectively meet needs of the community, completion of the ACTION REQUIRED activities (to the left) is essential for success of the project.
CMS Inclusion Criteria
Your facility has been selected to participate in this QIA. The Network will be working with 30% of the facilities in the Network area.
Project Goals
Participating facilities shall demonstrate a 10% increase in patients who utilize an appropriate home therapy by October 2018.
Project Activities
* Perform a Root Cause Analysis of barriers
* Appoint a Home Therapy Patient Ambassador
* Promote peer-to-peer mentoring
* Facility participation in NCC LAN events
* Track and monitor patent progression through the seven step process
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.