January Home Dialysis Change Package Newsletter |
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This change package supports dialysis facilities and End Stage Renal Disease (ESRD) Networks to increase the number of patients using home dialysis modalities, including peritoneal dialysis (PD) and home hemodialysis. Collected from top-performing dialysis facilities, the package includes an intervention menu of actionable change ideas options for facility implementation. Please view the Home Change Package in its entirety.
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Elevate Home Program Collaboration and Refine Operations |
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Promote a Culture of Teamwork and Build Strong Relationships |
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Patient-centered home dialysis care requires a strong team dedicated to making this modality work for patients and their caregivers. Recognizing this need, successful facilities create a culture of learning and hire the right staff for home dialysis. |
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ESRD NCC Universal Staff Education |
The End-Stage Renal Disease National Coordinating Center (ESRD NCC) has developed Universal Staff Education modules that are designed to improve awareness and understanding around home dialysis options. There are three modules, and each module will take approximately 30 minutes. At the completion of the third module, completing the course evaluation, staff will be able to receive 1.5 continuing education units (CEUs).
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Action Step: Share this resource with in-center hemodialysis staff so that they can better understand the benefits, misconceptions, and ways to encourage the use of home modalities. Consider incorporating the education modules in new hire orientation.
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Measure, Monitor, And Assess Program Metrics to Drive Success and Continued Improvement |
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Home dialysis programs are complex and require continuous quality improvement to maintain success and growth. Effective teams identify, track, and share metrics at regularly scheduled meetings. They also create a safe environment, looking to improve rather than blame.
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Educate and Support Patients and Caregivers Throughout the Continuum of Care |
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Provide Consistent Patient and Caregiver Education and Training While Honoring Individual Needs |
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The fear of the unknown is natural. Many patients and families contemplating home dialysis may have legitimate concerns about their ability to be successful. Effective home programs blend empathy and education to empower patients to be successful at home. |
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Change Ideas:
- Create or use a standardized home dialysis training manual for education. Make the education hands-on and create modules for open discussion, nurse demonstration of home dialysis, and patient practice under observation.
- Create a checklist for training to ensure patients understand all aspects of their education.
- Communicate with patients that they will always have other treatment options if home dialysis does not work for them.
- Assign a home patient to the same nurse for training to build a relationship and ensure continuity of training.
- Modify the time needed for training to meet patient and caregiver needs and to accommodate the patient’s ability.
- Manage training schedules and patient assignments to be flexible for more time with a patient who needs it.
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Identify and Proactively Address Barriers in the Patient's Home |
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Helping patients maintain success at home is an important outcome. To retain patients, successful programs develop strong patient relationships to continually educate patients and caregivers as well as identify and solve issues that could prevent patients from continuing home dialysis.
Change Ideas:
- Collaborate with the patient and family to identify and proactively address potential issues regarding the home environment.
- Collaborate with the patient and family to resolve barriers to home dialysis or clinic visits.
- Be proactive in assessing possible barriers by observing a patient’s body language, tone of voice, if he or she is acting in a way different from his or her typical manner, and responses to non-clinical questions. Ask follow-up questions to investigate.
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Recognize and Support Patient and Family Psychosocial Needs |
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Psychosocial issues are a significant barrier to home dialysis use. These may include fear, anxiety, financial living conditions, availability of storage space, stress, layoffs, relocation, divorce, loss of caregiver support, and burnout. These matters affect patients and caregivers alike. Strong home programs recognize and implement proactive person-centered strategies with involvement of experienced social workers to support patients and caregivers.
Change Ideas:
- When speaking with a patient receiving ICHD who seems depressed or angry, bring up the possibilities and benefits of home dialysis.
- For patients receiving ICHD, instill hope that they can be successful on home dialysis and can lead their best life.
- Schedule new patients to have additional time with the social worker to address emotional needs related to adjustment to dialysis.
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Engaging Patients and Families
The Network is providing a new Action for Kidney Health Calendar to encourage patient engagement in their care by taking different actions for their kidney health in 2021. January’s Action for Kidney Health calendar topic is Active and Healthy Living focusing on encouraging active and healthy habits to improve their overall health. This month’s Action for Kidney Health for home is: “Talk to a home patient about how doing dialysis at home helps them remain active.”
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- Download and print the calendar for your patients and encourage them to take all the actions for their kidney health.
- Work with your home department and/or the nearest facility with a home program to identify a patient who would be good to share their story with others.
- Share articles, podcasts and/or videos where patients share their stories.
- Visit the Network website for patient stories and patient newsletters
- Home Dialysis Central
- ESRD NCC: Home Dialysis Peer Connection Call recordings
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The Possibilities of Dialysis in a Nursing Home Setting
Qsource will be presenting a webinar to educate long-term care facilities and administrative staff about the possibilities of dialysis in a nursing home setting. If you would like to attend, please register using the link below and download the flier to share this information with medical directors or long-term care facility staff members. |
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Sharing a Common Goal!
We would like to hear your current practices on the initiative to improve the use of home modalities! The processes that you have in place may benefit another facility and we would love to share these ideas.
Please tell us all about what your facility does to increase the use of home modalities using the link below.
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We want to hear from you!
Below is a survey that will give us information about what kind of training your facility is using for staff, patients, and caregivers. The information you provide will help us identify best practices that can be used to help create a training process that would work for everyone.
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This newsletter was prepared and distributed by Qsource ESRD Networks, under contract with the Centers for Medicare & Medicaid Services, an agency of the U.S. Department of Health and Human Services (contract number HHSM-500-2016-00010C and HHSM-500-2016-00012C). The contents presented do not necessarily reflect CMS policy. 20.Q-ESRD.10.148a
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ESRD Network 10: 317-257-8265 | Patient Line: 800-456-6919 | Website
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ESRD Network 12: 816-880-9990 | Patient Line: 800-444-9965 | Website
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