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:

Promote Appropriate Home Dialysis QIA:

Participating Facilities  

QIA Kick Off Webinar:

Home Dialysis QIA Kick Off Webinar conducted on February 6, 2018:




Please be aware of due dates associated with each activity.

DISCUSS: Talk with dialysis team members and patients to develop a facility plan  to increasing utilization of home dialysis.

COMPLETE: Download,
review and complete the Plan portion of the
PDSA Tool and submit via email to:  
Friday, March 2, 2018.
One assessment per facility.

Patient Education is the key to overcoming the patient fear of dialyzing at home. Included in this newsletter is a Myths vs. Reality poster to help educate patient on the common misconception of dialyzing  at home. 

* Home Hemodialysis

* Peritoneal Dialysis  

Disparity Education:

There are many

disparities in healthcare

today. The following

link provides of brief

over view of the dispirited amongst race found in the ESRD population:

Kidney Health Disparities


Dear Provider,

Thank you to all the facilities that have completed the 5-Why's RCA tool. If you have not completed and submitted the RCA tool assessment at this time, please do so as soon as possible.

Based on the RCAs that have been submitted, three common barriers were identified:
  1. Patient fear of performing dialysis at home
  2. Lack of staff education
  3. Lack of referrals from nephrologist
Feedback from the completed RCAs, determined  patients are afraid of a home modality due to insufficient patient education. The RCAs also identified a lack of understanding by healthcare staff on home therapy options. 
Below are three suggestions of how to overcome these barriers:
  1. Implement a tracking tool to monitor and refer patients who are interested in a home modality to the Home Therapy Coordinator
  2. Provide education to all staff members on modality options available for patients
  3. Make modality education a more prominent topic during the patient plan of care
This month the Network is asking facilities to develop a PDSA cycle to help over come facility specific barriers. 

The Network will be tracking and monitoring facility's patient population utilizing home dialysis under the direction of the Centers of Medicare & Medicaid Service (CMS). This will identity any disparities that may be present among home dialysis patients. CMS will focus on the following five disparate categories:
  1. Age (65 and older vs. 18-64)
  2. Ethnicity (Hispanic vs. Non-Hispanic)
  3. Facility Location (Rural vs. Urban)
  4. Gender (Female vs. Male)
  5. Race (Population other than White, including African American, Asian, Native American, Pacific Islander, etc. vs. White)
A priority of the Network staff is to serve as a resource to both dialysis patients and professionals throughout the project activities.  Open communication about existing processes, barriers, and successes is encouraged.  Network staff is providing supplemental resources to assist with educating staff and patients, while not adding additional burden. However, in order to assess barriers, and identify how the Network can effectively meet needs of the community, please complete the ACTION REQUIRED activities located on the left side bar of the newsletter by March 2, 2018. 
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
* Complete PDSA cycle and submit to Network
* Appoint a Home Therapy Patient Ambassador
* Promote peer-to-peer mentoring
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.