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Welcome to the July 18 issue of the Quality Insights Renal Network 4 e-newsletter. In this issue, we bring you information about organ stunning while on hemodialysis, webinar materials that are available around the Patient Experience of Care, 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.  
FeedbackPlease provide us with your feedback on last month's Facility-LED PATIENT EDUCATION
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Vocational Rehabilitation
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. 

Though your patients may want to return to the workforce, they may not know where to start. The Ticket to Work program will help connect your patients to employment (ages 18-64). 
OrganStunningorgan stunning on hemodialysis: what is it and what can you do? 
Check out this article from Home Dialysis Central on the concept of organ stunning and how it affects patients on hemodialysis. If your clinic now tells you water can only be removed at a certain rate, this article can help you understand why.
PEOCLanMaterialsPatient Experience of Care lan materials now available 
On June 27, the ESRD National Coordinating Center hosted a Patient Experience of Care Learning and Action Network (LAN) webinar on Relationship-Centered Communication. The featured presenter was Laura Cooley, PhD, of the Academy of Communication in Healthcare. Webinar materials are now available: 
BSIGroupESRD NCC Bloodstream Reduction affinity group recommends cdc brochure 
Members of the ESRD National Coordinating Center (NCC)  Bloodstream Infection (BSI) Reduction Affinity group, which is comprised of dialysis patients and caregivers, has recommended the distribution of the CDC Clean Hands Count brochure. Please consider printing and placing copies of this brochure in your lobby area and/or distributing them directly to your patients.
Quality Insights Renal Network 4 recently completed two new educational outreach pieces around the topic of choosing home dialysis. These resources explore the benefits of peritoneal dialysis and home hemodialysis. Check out the new tri-fold brochureCheck out the new poster
DCI2DCI Eastgate Demonstrates how Care of the Patient is Tied to patient experience  
Check out the article on page 4 in the June issue of OUTReach, a publication of Reach Kidney Care. 
QIAsQuality Improvement Activities (QIAs)

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. 

"stitches of hope" campaign encourages getting on transplant waitlist 
One of Network 4's four Quality Improvement Activities (QIA) is focused on increasing the number of patients on the Transplant Waitlist and there are currently 100 Network 4 facilities participating. As a creative way to keep track of patients who are waitlisted during the project period, Network 4, in consultation with our patient/caregiver subject matter experts, is creating a "Stitches of Hope" quilt. Imagine if 100 facilities are able to assist at least 10 patients each to get on the transplant waitlist. We could exceed CMS' goal! One of our caregivers has drafted a design and will make the quilt. 

Featured Patient Testimonial: 
Houa's Story

Check out an inspirational story from Houa Yang, a caregiver for several family members who suffered from kidney disease. Houa knows the benefit of kidney transplant first hand through experience with her mother and siblings. Read Houa's story

Learn more about the "Stitches of Hope" quilt campaign.

UPDATE: We recently received 10 quilt patches from a facility! This means facility staff have assisted 10 patients in getting on the transplant waitlist. We look forward to continued responses from project facilities. Please remember to mail all quilt patches along with signed patient consent forms and any unused patches to Network 4 in the included self-addressed envelope by September 28, 2018 (or as soon as you have recorded information on all 10 patches).  
UpcomingEventsUpcoming Events
rsn announces 16th annual essay contest
The Renal Support Network's (RSN) Annual Patient Essay Contest provides an outstanding opportunity for people who have chronic kidney disease (CKD), including people on dialysis and kidney transplant recipients, to make a valuable contribution to society by expressing their ideas, views, and most importantly, hope. This year, the theme asks the writers to "Tell us about someone (Doctor, Nurse, Family member, Friend, Patient, Pet) who has inspired, encourage or educated you on how to live well with kidney disease."  All submissions must be written by someone who has been diagnosed with CKD.

Contest winners will receive cash prizes: 
  • First Place, $500
  • Second Place, $300
  • Third Place, $100

The submission deadline is August 10, 2018. Winners will be announced on September 20, 2018, and winning essays will be featured in RSN's new magazine Live & Give and on Learn more

NHSNUpdatesNHSN Updates

nhsn dialysis team to host webinars on dialysis event surveillance
The National Healthcare Safety Network (NHSN) Dialysis Team will be providing four live webinars in August for new and experienced NHSN users. The Centers for Disease Control and Prevention (CDC) subject matter experts will be available to answer your questions about NHSN Dialysis Event Surveillance during the webinars.

Introduction to the NHSN Dialysis Event Surveillance Protocol 
NHSN Dialysis Event Surveillance reporting is required for Centers for Medicare & Medicaid Services (CMS) End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP) rule. This session will provide a complete introduction to the NHSN Dialysis Event reporting requirements and the surveillance definitions necessary to complete accurate monthly reporting.
  • Tuesday, August 7 from 3:00 - 4:00 p.m. EDT
    Pre-registration is requiredListen-only audio will be available through your computer speakers. 
    • Participant Dial-In Number: (303) 248- 0285
    • Access Code: 6393927
  • Wednesday, August 8 from 3:00 - 4:00 p.m. EDT
    Pre-registration is required. Listen-only audio will be available through your computer speakers.
    • Participant Dial-In Number: (303) 248-0285
    • Access Code: 6393927
Advanced NHSN Dialysis Event Surveillance Reporting and Introduction to NHSN Reports
Learn how to apply National Healthcare Safety Network (NHSN) Dialysis Event Surveillance definitions through case studies that address common reporting questions. The session also will include an introduction to running and interpreting the most popular NHSN reports so you can review your facility's data, including Dialysis Event bloodstream infection rates.
  • Tuesday, August 14 from 3:00 - 4:00 p.m. EDT
    Pre-registration is required. Listen-only audio will be available through your computer speakers.
    • Participant Dial-In Number: (303) 248-0285
    • Access Code: 6393927
  • Wednesday, August 15 from 3:00 - 4:00 p.m. EDTPre-registration is required. Listen-only audio will be available through your computer speakers.
    • Participant Dial-In Number: (303) 248-0285
    • Access Code: 6393927
Please contact the NHSN helpdesk if you have any questions at
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:  

June 2018 NHSN newsletter now available
The June 2018 edition of the NHSN newsletter is now available. This edition includes the following topics: 
  • NHSN Healthcare Associated Infection (HAI) Checklists: The Wait is Over!
  • Incorrectly Entered CLABSI Events and VAD field clarification
  • Information for Group Users
  • NHSN Surveillance Case Studies published in AJIC and more

Download the newsletter

CMSUpdatesCMS Updates
Save the Date: July 23 webinar to focus on esrd qip system
The Centers for Medicare & Medicaid Services (CMS) has published details on the July 19, 2018 QIP webinar that will be repeated on July 23, 2018. The webinars will provide the basics of how to use the ESRD QIP system, including how to effectively submit a clarification question and a formal inquiry, if needed, prior to the end of the Preview Period. 

Learn more and register:
Save the date: August 7 - ESRD QIP Quarterly Measures webinar on ultrafiltration
CMS will present an August 7, 2018  ESRD QIP Quarterly Measures Webinar on Ultrafiltration, covering both the clinical and performance measurement aspects of the QIP Ultrafiltration Rate (UFR) Measure.  Learn more and register
Py2019 QIP preview period
The PY2019 Preview Period for the ESRD Quality Incentive Program (QIP) will begin on July 23, 2018, and end on August 23, 2018. The Preview Period provides an important opportunity for each facility to review and pose questions about its ESRD QIP scores and any potential payment reductions that may result. During the Preview Period, facilities will be able to access a Performance Score Report (PSR) to learn about how their estimated Total Performance Scores were calculated. CMS updated this year's Preview PSR to provide more-streamlined reporting of facility performance.

In preparation of the PY 2019 Preview Period, CMS encourages all facilities to review and update their authorized users in accordance with the updated password requirements for EIDM accounts as applied to EQRS. Learn more . Each facility also must designate a point of contact (POC) in EQRS; facilities without a POC will not be able to access their Preview PSRs, nor will they be able to submit clarification questions or a formal inquiry . If your facility has not established authorized users and a POC, CMS encourages you to do so as soon as possible.

Visit the QualityNet ESRD QIP Resources page to learn more and access tools. Bring questions or concerns about use of the ESRD QIP system to the QualityNet Help Desk at, or call (866) 288-8912 Monday-Friday between 5:00 a.m. and 5:00 p.m. PDT.
July 2018 CROWNWeb newsletter now available
The July 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:
  • The Data Quality Scorecard
  • CROWNWeb Reports: Forms
CEUOppsEducation and CEU Opportunities
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)

Tune In for Safe Healthcare Webinar Series
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 topic:
  • Prevention of Tetanus, Diphtheria and Pertussis with 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.

renal physicians association e-Learning portal offers new course
The Renal Physicians Association (RPA) has an eLearning portal that offers a wide variety of courses. The newest course, 2018 Fundamentals of Nephrology Coding and Billing, is now available online. This course will provide a better understanding of the federal and regulatory requirements for proper nephrology coding, billing and documentation. 
ESRDResourcesESRD Resources
Latest edition of KCER Watch is Now Available  
The  June 2018 issue of KCER Watch , the monthly environmental scan that provides timely and pertinent information related to emergency preparedness, is now available. Kidney Community Emergency Response (KCER) reviews available literature from peer-reviewed journals and emergency and disaster related trade publications; social media postings; and stakeholder websites to identify news and events in the emergency management field that are beneficial to the ESRD community.  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. The Network encourage you to share KCER Watch with your colleagues and patients. 
new dialysis fluid restriction calculator available  
Home Dialysis Central has published a Dialysis Fluid Restriction Calculator to answer the question, "How much can I drink between dialysis sessions?" The calculator is individualized for each patient.  Learn more
Latest edition of The Express is Now Available  
The latest edition of the Technical Resources, Assistance Center, and Information Exchange (TRACIE) newsletter, The Express, is now available. 
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
Quality Improvement Director
Quality Improvement Coordinator
Quality Improvement Coordinator
Patient Services Coordinator
Data Manager
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610 Freedom Business Center,  
Suite 102 
King of Prussia, PA 19406 
(610) 265-2418 
(800) 548-9205 (patients only) 
(610) 783-0374 (fax) 
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. ESRD4-071218