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Welcome to the April 10 issue of the Quality Insights Renal Network 4 e-newsletter. In this issue, we bring you information about patient education features, our quality improvement activities, upcoming events, National Healthcare Safety Network (NHSN) updates, CROWNWeb updates, continuing education opportunities,  resources and much more. We encourage you to  contact us with any questions, concerns or suggestions.  
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Treatment Options
We will be providing a Network 4 Patient Education Sheet each month in 2018. These documents are also located on  our website. Please provide all of your patients with this education sheet this month.   Also, we ask that you please encourage your facility's Patient  Representatives to pass out this educational information as well. 
Effective April 30, 2018, CMS will distribute program updates and other important communications exclusively via the End-Stage Renal Disease Quality Incentive Program (ESRD QIP) listserv. This listserv will replace current email blasts from the ESRD QIP mailbox. Signing up is easy. Create your ESRD QIP listserv account by selecting the option for the ESRD Quality Incentive Program. CMS will use the online listserv to distribute communications about changes to ESRD QIP policy and process to the ESRD QIP stakeholder community of providers, facilities, and other interested parties. You will need to create a user account to receive future communications from the listserv. If you have any additional questions or concerns, please contact the ESRD QIP team using the ESRD QIP Q&A Tool.
QIAsQuality Improvement Activities (QIAs)

Network 4 Quality Improvement Activities (QIA)
The Centers for Medicare & Medicaid Services (CMS) has set a five-year target to improve the health of all people in the United States living with End-Stage Renal Disease (ESRD).  Specifically, CMS goals will focus on the following. 
Transplant Waitlist
  • Increase the percentage of ESRD patients on the transplant waitlist from 18.5 percent (the 2016 national average) to 30 percent by 2023 
  • Promote early referrals to kidney transplant and assist patients and providers in improving referral patterns by addressing barriers identified as the patient moves through the waitlist process
Home Dialysis 
  • Increase the number of ESRD patients dialyzing at home from 12 percent (the 2016 national average) to 16 percent by 2023 
  • Promote referral to home dialysis modalities, identify and mitigate the barriers to timely referrals, and determine the steps patients and providers can take to improve referral patterns 

Increasing Patient Participation in network 4's quality improvement activities through Subject Matter Experts 
Many patients with kidney disease face barriers in completing the necessary steps required to be on the transplant waitlist. Studies show that peer support is effective. As a result, Network 4 - in consultation with its patient subject matter experts (SMEs) - is in the process of developing guidelines for a Patient Advocacy Initiative focused on improving the patient transplant waitlist status and home dialysis training initiations. Our goal is to build a pipeline of patients helping patients. Patient Advocates will be available for patient-to-patient sharing of experiences. The goal is to encourage/guide patients as they move through the processes of transplant evaluation and home therapy initiation. We currently have three SMEs partnering with four facilities.

Network 4 Subject Matter Experts (SMEs)

We will also be featuring our patient stories in upcoming newsletters. 

UpcomingEventsUpcoming Events

April is Organ Donation Awareness Month
Join the Renal Support Network (RSN) in encouraging your friends and family to register as organ, eye and tissue donors and to honor those who have saved lives through the gift of donation.

The Need
  • Over 118,000 people are waiting for transplants. The demand for organs far exceeds the supply.
  • More than 20 people die each day while waiting for a transplant.
  • Another person is added to the national transplant waiting list every ten minutes.
  • One organ donor can save up to eight lives.
  • Kidneys are needed more than any other organ.
The Facts
  • Anyone can become an organ donor, no matter your medical history or how old you are.
  • Organs and tissues that can be donated include: heart, kidneys, lungs, pancreas, liver, intestines, corneas, skin, tendons, bone, and heart valves.
  • After you have registered, tell your family so they understand and can communicate your decision when you cannot.
  • 95% of U.S. adults support organ donation, but only 54% have registered as donors.
Nine common myths about organ donation, accompanied by the truth. Don't let these misconceptions deter you from registering as a donor. Learn more about Organ Donation Awareness Month. 
Webinar Opportunity to share with your patients: Job Fair Tips and Tricks
My Employment Options will present an April 12, 2018 webinar on Job Fair Tips and Tricks.  The webinar will cover the following topics: 
  • How to Put Yourself in the Recruiter's Shoes
  • Tips on Navigating the Chat Software
  • Job Fair Etiquette Tips
  • What to Do after the Job Fair
  • Many other topics!

Learn more and register today 

UPMC to host "the big ask: the big give"
The University of Pittsburgh Medical Center (UPMC), in partnership with the National Kidney Foundation (NKF), will host "The Big Ask: The Big Give," on Friday, April 20 from 10:00 a.m. to 2:00 p.m. at the UPMC Montefiore, 3459 5th Avenue, Pittsburgh, PA 15213. The program is designed to provide patients who need kidney transplants and their family members and friends with information and training needed to identify and recruit potential living donors. Register today. For more information, please contact Cherie Peters, Program Director, at the National Kidney Foundation office in Pittsburgh by calling (412) 261-4115 ext. 759 or by emailing
Network 4 Executive Director to Present at CKD Conference
Quality Insights Renal Network 4 Executive Director Chris Brown will be a presenter at the upcoming Update on Chronic Kidney Disease, coordinated by Penn State College of Medicine and The Kidney Foundation of Central PA. The conference will take place on Tuesday, April 24, 2018 from 7:00 a.m. to 4:00 p.m. ET at the Hotel Hershey, located at 100 Hotel Road, Hershey, PA 71033. Brown will present about lessons learned from Hurricanes Irma and Maria. The event is designed to update nephrologists, physicians, physician assistants, certified registered nurse practitioners, dialysis nurses and technicians, renal social workers, renal dietitians, and other interested health-care professionals on recent medical advances in the care of patients with chronic kidney disease (CKD). The conference will help practitioners attain the knowledge and skills to maintain competency in the management of patients with CKD. Continuing Education credits may be available. Cost to attend is $85 per person. Registration cost includes instruction, all meals, online handout materials and refreshments. Download the conference brochure to learn more and register
28th Annual Transplant Surgeon Designee Symposium for CKD Professionals
The Renal and Pancreas Transplant Division at Saint Barnabas Medical Center is hosting the 28th Annual Transplant Surgeon Designee Symposium for Chronic Kidney Disease (CKD) Professionals  
on Thursday, April 26, 2018 at the Pines Manor in Edison, New Jersey. T
his symposium is designed to provide the necessary knowledge and skills for renal health professionals who wish to broaden their knowledge of renal and pancreas transplantation. It is designed for dialysis nurses, patient care technicians, social workers and dietitians. All participating RNs will be certified as 2018 Transplant Surgeon Designees according to the guidelines established by The Renal and Pancreas Transplant Division at Saint Barnabas Medical Center. 

Contact Hours
  • For Social Workers - This course, The 28th Annual Transplant Surgeon Designee Symposium for Chronic Kidney Disease Professionals, Approval #182401-0705, provided by Saint Barnabas Medical Center Renal & Pancreas Transplant Division, is approved for continuing education by the New Jersey Social Work Continuing Education Approval Collaborative, which is administered by NASW-NJ. CE Approval Collaborative Approval Period: February 16, 2018 through August 31, 2018. Social workers will receive five and three-quarter (5.75) continuing education hours for participating in this course, divided as follows: one (1) clinical; one and a quarter (1.25) ethics and non-clinical; three and a half (3.5) non-clinical."
  • For Nurses & PCTs - This activity has been submitted to American Nephrology Nurses' Association for approval to award contact hours. American Nephrology Nurses' Association - Approver is accredited as an approver of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.
  • For Dietitians - This activity has been submitted to the Commission on Dietetic Registration (CDR) for approval to award contact hours to dietitians. 
Register hereFor more information, please contact Christina Psathas at (973) 322-2285 or download the symposium brochure
NHSNUpdatesNHSN Updates

Reminder: Data for CMS Quality Reporting Programs Due Soon
All outpatient dialysis facilities providing in-center hemodialysis and/or a home modality should report their data to the Healthcare Patient Safety component in order to comply with the ESRD Quality Incentive Payment (QIP) requirements for reporting the clinical measure Healthcare Personnel Influenza Vaccination Reporting Measure. 

Please make sure at least one individual at your facility can access NHSN via SAMS and has been assigned appropriate user rights in NHSN so they may enter and view the facility's data. To ensure your data have been correctly entered into NHSN, please make sure to verify that: 1) your monthly reporting plans are complete, 2) you've entered appropriate summary and event data or checked the appropriate no events boxes, and 3) you've cleared all alerts from your NHSN facility homepage. For additional guidance on ensuring your data are accurately sent to CMS for Quality Reporting purposes, please visit the CDC website and navigate to the appropriate section(s) for your facility type.

As we approach the May 15 submission deadline for the 2017-2018 influenza season, CDC has outlined some guidance to help facilities check their HCP vaccination data. 

Data Verification in NHSN 

NHSN does not provide a confirmation e-mail to facilities once they have submitted their data. CDC assists with routinely verifying HCP influenza vaccination summary data during the first year of data reporting for a CMS program as a courtesy to facilities. After the first year, facilities should follow the steps below to verify data. Facilities should also maintain printed copies or screenshots of their data entry for their records. 
  1. Ensure that your facility is enrolled in NHSN as the correct facility type. You can view this information on the Facility Information page for your facility in NHSN. For example, if your facility is an ambulatory surgery center, it should only be enrolled in NHSN as "AMB-SURG - Outpatient Surgery Facility." If you have questions about your NHSN facility type, please contact for assistance. 
  2. Ensure that the correct facility CMS Certification Number (CCN) and CCN effective date have been entered into the "Facility Information" page of NHSN. View specific guidance on adding/updating the facility CCN and CCN effective date within NHSN. 
  3. Run a CMS Line Listing Report to ensure that data have been correctly entered into NHSN. Directions on how to run these reports are located by facility type under the "CMS Reporting" heading on the CDC website. This line listing shows what data for your facility will be shared with CMS. 
As long as your facility is enrolled as the correct facility type, your CCN and CCN effective date are correct, and your data appear in the CMS Line Listing for the current reporting period, no further action is required on your part. Your data will be shared with CMS following the reporting deadline established by CMS for your facility type. Also, please note that some facilities are required to report HCP influenza vaccination summary data not only to NHSN to meet CMS reporting requirements, but to other entities, such as their state or city. For non-CMS reporting requirements, facilities will need to determine if reporting through NHSN is sufficient to meet these requirements, or if data must be transmitted via another mechanism. For your reference, more information about reporting requirements, along with a data submission checklist is now available online.
Required Dialysis Event Surveillance Training
CMS requires that at least one person from each outpatient dialysis facility that is eligible to report positive blood cultures (PBC), IV antibiotic starts, and pus, redness and swelling (PRS) to the National Healthcare Safety Network (NHSN) in 2018, complete the Annual NHSN Dialysis Event Surveillance Training. Eligible facilities include:
  • Facilities that provide in-center hemodialysis to at least 11 in-center hemodialysis patients
  • Facilities that have a CMS Certification date prior to January 1, 2018 

Learn more about eligibility.

Starting in 2018, Network 4 must verify, track, and report to CMS on a monthly basis the number of facilities completing this training for 2018. Please complete the following steps as soon as possible. 

  1. Complete the training and attestation no later than September 28.
  2. Print the certificate of completion. 
  3. Attest to completion of the training.

Dialysis Event Training/Re-training is available:  

New Instructional Guidance on the re-Consent Process

The National Healthcare Safety Network (NHSN) team has published some informational guidance to assist users with completion of the updated NHSN Agreement to Participate and Consent. A 5-minute video informs users of the new Consent purposes and the simple process for accepting the Consent electronically. Furthermore, a step-by-step guidance document provides detailed instructions and screen shots for what Facility Administrators and Primary Contacts can expect to see when they begin the re-consent process in the NHSN application. A link to the video and the guidance document can both be found in the FAQs About NHSN's Agreement to Participate and Consent. As a reminder, the deadline for accepting the updated Consent is April 14, 2018, for all components except Long-term Care, which has a deadline of June 15, 2018. If you have any questions about the re-consent process, please email the NHSN helpdesk.
NHSN 8.8.1 Introduces Updated Agreement
The January 23 release of the NHSN 8.8.1 application introduced an updated NHSN Agreement to Participate and Consent for current NHSN facility users who enrolled in NHSN prior to December 2, 2017.  Facilities that enrolled in NHSN on or after December 2, 2017, have already accessed this new Consent and will not need to accept it again if they have already done so.  Primary Contacts or Facility Administrators should agree to this updated Consent form for each component your facility participates in (Dialysis and/or Healthcare Personnel) by April 14th, 2018, or risk losing access to NHSN.  The Consent form became available on January 23rd and an alert appeared on all NHSN component home pages. Primary contacts and facility administrators also received an email notification.  Additional information, including Frequently Asked Questions and the updated NHSN purposes, are available on CDC's NHSN website.  If you have any questions, please send an email to with the subject line "NHSN Reconsent."
CMSUpdatesCMS Updates
April 2018 CROWNWEb Newsletter now available
The April 2018 edition of the CROWNWeb Newsletter is now available online. The CROWNWeb Newsletter focuses on user-specific topics, such as training, account management, use of the CROWNWeb system, and tips and tricks, as well as key technical aspects of CROWNWeb.

This month's featured stories include:
  • CROWNWeb and the Medicare Beneficiary Identifier (MBI)
  • Using the EDI process to submit CROWNWeb Data
  • CROWNWeb Clinical Corner
  • Clinical Closures
Webinar opportunity: cms emergency preparedness final rule
The International Association of Emergency Managers (IAEM) USA Healthcare Caucus is excited to announce its second webinar in partnership with Centers for Medicare & Medicaid Services (CMS) on the Emergency Preparedness Final Rule. The webinar will be held on Tuesday, April 24, 2018 from 1:00 to 2:00 p.m. EST. Please join Caecilia (Cece) Blondiaux with the Quality, Safety & Oversight Group (QSOG) from CMS. Ms. Blondiaux will provide a recap and updates on the final rule.  Ms. Blondiaux will also highlight and discuss key areas where CMS is seeing an increased number of deficiencies as related to the final rule. There will be approximately 20-25 minutes allotted for a question and answer session at the end of the webinar. For efficiency and to answer as many questions as possible, IAEM asks that you submit questions in advance to, no later than April 16, 2018. Register today.  
CEUOppsCEU Opportunities

The Lankenau Kidney Transplant Program presents Updates in Transplantation Care, which will be held Friday, April 27, from 8:00 a.m. to 4:00 p.m. at the Lankenau Medical Center at 100 East Lancaster Avenue, Wynnewood, PA 19096. 

This educational symposium will address emerging issues in kidney transplantation, including impacts of the opioid crisis and hepatitis C epidemic on availability of quality donor organs and clinical implications of increased-risk organ transplantation. Safe pain management in patients with failing kidneys, prior opioid use and obesity risks in kidney transplantation, indications for kidney-pancreas transplantation, and special needs of patients with delayed graft function also will be reviewed. The program will include presentations by members of the organ transplant teams at Lankenau Medical Center and Thomas Jefferson University Hospitals, as well as personal accounts from a panel of individuals who have undergone kidney transplantation and living kidney donation at Lankenau Medical Center. Those encouraged to attend include nurses, social workers, dialysis center staff, transplant professionals, and other health professionals involved in the care of patients before and after kidney transplantation. For more information on objectives, agenda and the speakers, please download the symposium brochure. Registration is required for the symposium. Call (866) 225-5654 to register. 

This activity has been submitted to the American Board for Transplant Certification, American Nephrology Nurses Association, and Pennsylvania State Board of Social Workers to award 5.0 CEUs for nurses, social workers, and dialysis patient care technicians. The Pennsylvania State Nurses Association is accredited as an approver of continuing nursing education by the American Nurses  Credentialing Center's Commission on Accreditation.
Advanced Renal Education
This educational site provides CEU credits for anyone who completes a course. Register to gain access and complete a course.
American Kidney Fund
The American Kidney Fund offers several online courses that provide free CEs for health care professionals. Learn more
Armstrong Institute for Patient Safety and Quality
The Armstrong Institute for Patient Safety and Quality is now offering short, interactive samples of courses to get a feel for how it creates engaging learning experiences that are relevant and applicable to your work improving patient safety. Samples are now available for the following cours es:
  • Patient Safety Certificate Program
  • Human Factors for Patient Safety
  • Becoming a Patient Safety Hero
  • Foundations of CUSP
These samples will work on mobile devices; however, for the best experience use on a laptop or desktop computer. Browse the course catalog for details on all courses, including continuing education credits, learning objectives and costs.
Centers for Disease Control and Prevention (CDC)

The CDC has new free continuing education opportunities available through its Tune In for Safe Healthcare webinar series. Webinars include: 

  • Empowering Nurses to Protect Themselves and Their Patients: The Importance of Collaboration between Nurses and Environmental Services
  • Infections in Dialysis Centers: Understanding what Matters to Patients
  • Empowering Nurses for Early Sepsis Recognition
Morbidity and Mortality Weekly Report (MMWR) and Medscape
CDC's Morbidity and Mortality Weekly Report (MMWR) presents a FREE continuing education activity on the following topics:
  • Cancer and Obesity
  • Invasive Cancer
  • Recommendations on the Use of Seasonal Influenza Vaccines

In support of improving patient care, Medscape, LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. If you are not a registered user on Medscape, please register for free or login without a password and get unlimited access to all continuing education activities and other Medscape features.

ESRDResourcesESRD Resources
Latest edition of KCER Watch is Now Available  
The  March 2018 issue of KCER Watch , the monthly environmental scan that provides timely and pertinent information related to emergency preparedness, is now available. The goal of KCER Watch is to facilitate the exchange of information, sharing of resources, and advancement of knowledge and expertise among ESRD and emergency management stakeholders. 
Check out the ESRD NCC Information Exchange
The ESRD Network Coordinating Center (NCC) provides centralized coordination and support for the Medicare ESRD Network program. Each month, the ESRD NCC distributes an e-newsletter, known as the Information Exchange, that compiles the most important information from numerous ListServs and publications related to renal health. To sign up to receive this informative newsletter, please contact the ESRD NCC at or visit the ESRD NCC website

Executive Director
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King of Prussia, PA 19406 
(610) 265-2418 
(800) 548-9205 (patients only) 
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This bi-weekly e-newsletter will serve as our primary method of communicating important news and updates. We encourage you to visit our Web site for the most up-to-date information or to contact us with questions, comments or suggestions.
This material was prepared by Quality Insights Renal Network 4 under contract with the Centers for Medicare & Medicaid Services (CMS). The contents do not necessarily reflect CMS policy.

Publication No. ESRD4-040918b