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:
- Patient fear of performing dialysis at home
- Lack of staff education
- 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:
- Implement a tracking tool to monitor and refer patients who are interested in a home modality to the Home Therapy Coordinator
- Provide education to all staff members on modality options available for patients
- 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:
- Age (65 and older vs. 18-64)
- Ethnicity (Hispanic vs. Non-Hispanic)
- Facility Location (Rural vs. Urban)
- Gender (Female vs. Male)
- 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.