March 2019
Announcements & Updates
National Kidney Foundation (NKF) Patient Education Symposium

Join the NKF for a FREE patient and family learning workshop about what you need to know about kidney transplantation.
Wednesday, March 18, 2020
6:00 - 8:00 PM
31 Seymour Street, Hartford, Connecticut
4th Floor Conference Rooms 1 & 2

Please register by March 13, 2020 by calling 203-623-0165 or emailing marcia.hilditch@kidney.org.
ESRD Quality Incentive Program (QIP) Calendar Year (CY) 2020

T he Centers for Medicare & Medicaid Services (CMS) administers the End-Stage Renal Disease Quality Incentive Program (ESRD QIP) to promote high-quality care in renal dialysis facilities. The program changes the way CMS pays for the treatment of ESRD patients by linking a portion of the payment directly to facilities’ performance on a core set of quality measu res. Facilities that do not meet or exceed performance standards will be subject to a payment reduction of up to two percent depending on how far their performance deviates from the standards. These standards and measures will be made public for people to compare facility performance when choosing dialysis centers. The following is a list of tools and resources to help dialysis facility staff and patients understand the ESRD QIP.

Emergency Preparedness Patient Pledge

People living in New England can experience different types of emergencies. These situations can lead to increased emergency department visits, hospitalizations, and an increase in death rates. Dialysis patients are at an even greater risk than most of the population in the event of an emergency—especially if they are caught unprepared. IPRO ESRD Network of New England encourages dialysis facilities to talk to patients about emergency policies and procedures, along with inviting patients to pledge to have a strong “take-charge” approach in their own personal preparedness.

Learning and Action Networks (LANs)
The  End Stage Renal Disease (ESRD) National Coordinating Center (NCC) LAN meetings connect stakeholders from across the continuum of care in support of meeting quality improvement and patient/family engagement goals for the ESRD population. The LANs help foster cross-setting communication and collaboration, and provide a platform for sharing and quickly spreading best practices.

Registration is required.  Please select the link for  each  event to register. A registration confirmation will be provided, via email, containing event link, password, and dial-in information.

For more information about ESRD NCC LANs, including upcoming events and recordings, visit  https://esrdncc.org/en/qia/.

Who Should Attend?
These  mandatory  webinar presentations are appropriate for all facility staff, including directors of operations, regional managers, facility administrators, clinic managers and coordinators, nurses, social workers, and patient care technicians, transplant directors and coordinators, patients, and caregivers.

Continuing Education Unit (CEU) Provided
One CEU will be provided  by the NCC  for attending. Please include your license number when registering to receive CEU credit or certificate.
Bloodstream Infection (BSI) LAN
March 3, 2020 - 3:00 pm to 4:00 pm EST
Featuring  Jonathan Segal, MD , a nephrologist at the University of Michigan. Dr. Segal will discuss his recently published article describing why some dialysis facilities have high rates of fistulas despite having patients with many comorbid conditions.
Also featuring Maria Regnier, RN, MSN, CNN,  the Senior Director for the upper Midwest Enterprise Dialysis programs at Sanford Health. Ms. Regnier will discuss how she has empowered nurses to evaluate fistulas and collaborate with the vascular surgeons to shorten the time a patient has a catheter.
H ome Dialysis LAN
March 10, 2020 - 3:00 pm to 4:00 pm EST
Featuring  Tushar Chopra, M.D., FASN , a medical director of the University of Virginia Staunton Dialysis unit in Staunton, Virginia. Dr. Chopra is also an assistant professor of medicine, division of nephrology at the University of Virginia Health System, and serves on the National Kidney Foundation of Virginia Medical Advisory Board.
Transplant LAN
March 17, 2020 -  3:00 pm to 4:00 pm EST
Featuring  Robin Taylor, MSW, LSW, a renal social worker and Kidney Smart Modality Educator for the DaVita Hackensack Dialysis facility in Maywood, New Jersey, where she has worked for the past twenty five years. Ms. Taylor will share how their facility uses a multi-disciplinary approach to educate the patients and staff about kidney transplant.
Quality Improvement Initiatives
Bloodstream Infection (BSI) Reduction

The Centers for Disease Control and Prevention (CDC) audit tools and checklists are intended to promote CDC-recommended practices for infection prevention in hemodialysis facilities. The audit tools and checklists can be used by facility staff and patients to help guide their practices.  Encouraging patients to take an active role in infection prevention has proven to result in better clinical outcomes!

During the month of March all facilities should be using the CDC hand hygiene audit tool to perform a minimum of 30 hand hygiene audits. The facility can audit any staff member that enters and exits the treatment area. Administrators, social workers and dietitian should all be practicing good hand hygiene, along with the patient, who must also wash their hands when entering and existing the treatment area. Any staff member can perform these audits.  All audits must be entered in to NHSN by the end of the March.
Long-Term Catheter Reduction

Increasing the number of patients receiving dialysis via arteriovenous fistulas (AVF) and reducing long-term catheter (LTC) use for dialysis access is key to providing optimum care for your patients. A dialysis patient is identified as having a LTC when he or she has been dialyzed with a catheter for 90 days or longer, regardless of whether the catheter has been replaced. The following is a list of tools and resources to help dialysis facility staff with reducing catheters.

Health Information Exchange (HIE)

Utilization of an HIE (or another evidence-based highly effective information transfer system to receive information relevant to positive blood cultures during the transition of care) is vital for communication between dialysis facilities and hospitals. Continuity of care will help keep dialysis patients healthier longer and reduce burden on care providers. All facilities are encouraged to reach out to local hospitals, identify quality assurance staff, and implement a system that ensure timely communication of vital health records between the facility and other care providers.

Please contact the Network Quality Improvement Department at 203-285-1214 for assistance with HIE.
Increasing the Number of Patients Utilizing Home Modalities

Home dialysis modalities are underutilized in the USA with only 8% of the dialysis patients undergoing renal replacement therapy at home versus 92% being treated with in-center hemodialysis. Dialysis facilities should be championing initiatives detailed in the Executive Order on Advancing American Kidney Health (AAKH) by discussing home dialysis as a first treatment option with patients. The following is a list of tools and resources to help dialysis facility staff with promoting appr opriate home dialysis.

Increasing the Number of Patients on the Transplant Wait List

A kidney transplant is a possible treatment option for individuals on dialysis. However, not everyone who wants a transplant can be considered eligible to receive one. Increasing patient interest by providing educational resources and in-center counseling helps to open the lines of communication about the right treatment options for ESRD patients. The following is a list of tools and resources to help dialysis facility staff with increasing the rate of patients on the transplant waiting list.

Peer Mentoring

A peer mentor empowers fellow patients to move forward and cope with their lives after being diagnosed with ESRD. Patients may have family and friends to assist
with their new diagnosis. However, it helps to have someone who has been through the same experience and has a good understanding of all that dialysis involves. Individuals who are succeeding at achieving their treatment goals can
provide insight to help others successfully manage kidney disease. The following is a list of tools and resources to help dialysis facility staff with initiating and maintaining a peer mentoring program at the facility.


After recruitment and confidentiality forms have been submitted, patients can begin peer mentor training.


The Network is available to support dialysis facilities and patients in establishing or maintaining a peer mentoring program. Please call 203-285-1213 for more information.
Patient Services
Access to Care

CMS strives to assure appropriate access to dialysis care for ESRD patients who require life-sustaining dialysis treatment, regardless of modality. Failure to Place can occur when no outpatient dialysis facility is located that will accept an ESRD patient for routine dialysis treatment. Therefore, an involuntary discharge (IVD) or involuntary transfer (IVT) should be rare and preceded by demonstrated effort on the part of the interdisciplinary team to address the problem in a mutually beneficial way. The facility must have written policies and procedures that supports the Conditions for Coverage (CfC), and ensures that physician management encourages patients being maintained in consist dialysis care regardless of patient adherence. The following is a list of tools and resources to help dialysis patients with access to care barriers.


The Network works with dialysis facilities to address issues related to IVD/IVT or difficulties placing or maintaining patients in treatment. Please contact the Patient Services Department at 203-285-1213 for assistance.
Patient Experience of Care

According to the JAMA article, Patient Self-management of Chronic Disease in Primary Care , "Patients are often more satisfied with their care, and express a greater quality of life, when they are able to be active participants in planning and implementation. This level of involvement in their care, and the collaboration, with the rest of their healthcare team, allows them to feel empowered and ultimately leads to improved health outcomes.” The following is a list of tools and resources to help dialysis facility staff with improving the patient experience of care.

Patient and Family Engagement - ESRD Support Groups

Individuals with end stage renal disease may benefit from a support group where they can share information, get advice, and receive comfort from peers . Several national, nonprofit organizations have websites devoted to educating and empowering those interested in starting or participating in a support group. The following is a list of tools and resources to help dialysis facility staff with implementing support gro ups.

Network 1 Staff
Danielle R. Daley, MBA
Executive Director
(203) 285-1212

Sarah Keehner, RN, BSN, CNN
Quality Improvement Director
(203) 285-1214

Agata Roszkowski, LMSW
Patient Services Director
(203) 285-1213

Jaya Bhargava, PhD, CPHQ
Regional Operations Director
(203) 285-1215
TBD
Sr. Program Support Coordinator
@ipro.us
(203) 285-1222

Megan Perras, LPN
Quality Improvement Coordinator
(203) 285-1224

Cheryl Pettway
Community Outreach Coordinator
(203) 285-1223

Krystle Gonzalez
Customer Service Manager
(203) 285-1225