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Welcome to the May 30 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.  
FeedbackPlease provide us with your feedback on last month's Facility-LED PATIENT EDUCATION
Please take this short survey to let us know what you thought about last month's facility-led patient education topics
Dialysis Facility Compare (DFC)
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. 
CostArticleA more cost effective, clinically sound approach to hemodialysis treatment  
Check out this article recently featured on talking about a new financial approach to hemodialysis treatment. 
NetworkMeetingsave the date: network 4 annual council meeting  
Please join us for the Network 4 Annual Council Meeting. This meeting is MANDTORY for all facilities to attend. Please ensure that at least one representative from your facility attends this meeting and shares the presented information with your staff.

Please note: This will be an INTERACTIVE meeting with required polling, so please clear your schedule so you can provide 100% attention to the information being shared.

Date: June 6, 2018
Time: 1:00 p.m. EDT

  • 2018 Quality Improvement Activity Update
  • Patient Engagement Activity Update
  • Update on Emergency Management Requirements

Please register prior to the event by clicking here

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.
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 version 8.9 released
National Healthcare Safety Network (NHSN) version 8.9 was released on April 28. Highlights of the changes to the Dialysis Event Component are included below. There were no changes made to the Healthcare Personnel Safety Modules.
  • Working Days Calculator for Denominators for Dialysis Event Surveillance Form - A new calculator has been created to help users determine the first two working days of the month when reporting Denominators for Dialysis Event Surveillance. Check it out

  • Dialysis rate tables and run charts have been updated with 2016 aggregate data. 
  • 'TAP Report - Bloodstream Infection (BSI) Data' has been renamed to 'Excess Infections - Bloodstream (BSI) Data' and updated to allow group users to view the number of excess infections grouped by summary year (summaryYr), summary quarter (summaryYQ), and summary half year (summaryYH).
  • Clinical Document Architecture (CDA): Dialysis summary for AKI location that contains all zeroes may be a valid entry or import. Note - CDA DE-summary is required to contain value for "# of patients for whom dialyzers are reused."
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:  

Deadline extended for re-Consent Process
The Centers for Disease Control and Prevention (CDC) announces a deadline extension for completing the online National Healthcare Safety Network (NHSN) Agreement to Participate and Consent form, referred to as the Consent in this announcement. The new deadline for completing the Consent, June 15, 2018 , applies to ALL facilities currently enrolled in NHSN regardless of their CMS participation. The deadline for Long-term Care Facilities remains June 15, 2018.

The Consent is accessible to only the NHSN Facility Administrator or Primary Contact user. The new deadline provides additional time for each facility's NHSN Facility Administrator or Primary Contact to complete the online Consent and avoid any interruptions in access to the NHSN application, including access for purposes of submitting data to meet local, state, or federal reporting requirements. Please be informed that if the Consent is not completed by the new deadline, access to NHSN will be temporarily suspended. Additionally, users will receive an error message when they attempt to log into NHSN redirecting them to the Facility Administrator or Primary Contact.

CMS quality reporting deadlines for NHSN measure reporting are not affected by this extension.
NHSN is pleased to assist with any questions or concerns you may have regarding the Consent process. Learn more on how to complete the NHSN Agreement to Participate and Consent process. You may also direct questions to
CMSUpdatesCMS Updates
esrd qip and dfc updates
The Centers for Medicare & Medicaid Services (CMS) has completed its April refresh of the facility data in Dialysis Facility Compare (DFC).  Learn more. The newly updated DFC database and current five-star facility ratings can be found here.  

CMS also recently updated its web page on Technical Specifications for ESRD QIP Measures to include the CY2018 ESRD PPS Final Rule, and links to Technical Measure Specifications through PY2021.   

The Centers for Disease Control and Prevention (CDC) also recently updated its web page on NHSN and CMS ESRD QIP Rule and its page on the Nine Core Interventions that they recommend for reducing bloodstream infections (BSI). 
May 2018 CROWNWEb Newsletter now available
The May 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: 5 Years Strong
  • EQRS 1.2 - CROWNWeb Enhancements
  • CROWNWeb New User Training
  • Clinical Closures
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)

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:
  • Recommended Immunization Schedule for Adults

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  May 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.
podcast: reducing infections and changing culture - A Personal Perspective on Conquering infections in outpatient dialysis  
Sally Hess has many years of experience as an infection preventionist, and in 2008, she was responsible for surveillance of bloodstream infections throughout her health care system. There had been a drop in central line-associated bloodstream infections within the intensive care units (ICUs); however, there were still a lot of positive blood culture results sent to her on a daily basis. Where were they coming from? She began investigating, and what she found out may be a surprise to you. This 11-minute podcast is an account of challenges and successes around engaging dialysis care teams to focus on "Zero Preventable Infections" in outpatient dialysis facilities. Listen to the podcast. Learn more about the Making Dialysis Safer for Patient Coalition
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. ESRD4-052418