Home Dialysis Central has published a Dialysis Fluid Restriction Calculator to answer the question, “How much can I drink between dialysis sessions?” individualized for each patient. For the Calculator and discussion, see https://homedialysis.org/news-and-research/blog/265-a-new-dialysis-fluid-restriction-calculator.
The CROWNWeb training session on Attestation, and the new clinical measures for Ultrafiltration, and Number of Dialysis Sessions, has been rescheduled for February 1, 2018. Find more information and register at http://mycrownweb.org/pcw_lems/february-1st-attestation-ultrafiltration-and-number-of-dialysis-sessions-training-event/.
CMS has published the 2o17 edition of the CMS ESRD Measures Manual, which details how the PY2017 (CY2017) QIP and October 2017 DFC Star Ratings are calculated. The Manual includes information on the new Kt/V and NHSN QIP measures, TPS calculation, PY2020, and changes to DFC and Star Rating calculations. Find a copy of the CMS press release, which includes links to the Manual and supporting material, at https://s3-us-west-2.amazonaws.com/nwrn.org/files/QIP/CMS%2CQIP.061617.pdf .
CMS is advising dialysis facilities that PY2017 PSCs will be available for download starting December 15, 2016. Facilities will be able to access their PY2017 PSCs until the start of the PY 2018 Preview Period next summer. Please retain the PDF file containing your PSCs so that you cam generate a replacement paper copy as needed throughout 2017. Facilities must post their PSC in a prominent patient area throughout 2017.
Final PSRs will be available for download after the first of January. CMS will notify facilities once they have confirmed the availability date.
CMS has identified over 100 facilities who do not currently have a point of contact (POC) designated in the QIP system. CMS urges those facilities to establish a POC as soon as possible. It is the POC who will be authorized to access Final PSRs on the ESRD QIP system on behalf of their facility. System users are required to change their passwords every 60 days in order to keep their accounts active. Users whose accounts become inactive will need to contact the QualityNet Help Desk for assistance in reactivating those accounts.
If you have questions or concerns regarding use of the ESRD QIP system, please contact the QualityNet Help Desk at firstname.lastname@example.org or (866) 288-8912 from 5am to 5pm PST Monday through Friday.
Due to high volume of use on the ESRD QIP application, you may experience some delays in retrieving your reports. Once you request a report, please allow two hours for the system to generate your report. If your requested report is not retrieved within two hours, then submit a helpdesk ticket providing your CCN and the desired report name.
Finally, CMS has published a memo outlining its methodology for monitoring changes in access to dialysis. Find it at https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/ESRDQIP/09_MonitorandEval.html . The page also includes Fact Sheets for anemia, bone and mineral disease. vascular access. and URR.
CMS has published changes to DFC, detailed at https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-10-28.html . ICH-CAHPS, Standardized BSI Ratio (SIR), and Pediatric PD Kt/V have been added to DFC, but not to the Star Ratings. Changes have been made to the way the Star Ratings are calculated, and adjustments have been made to the way the Vascular Access, Kt/V, Standardized Readmission Ratio (SRR), and Hypercalcemia components of the Star Ratings are measured. All of these changes are included in the DFC update made October 28, 2016.
The Mid-Atlantic Renal Coalition, ESRD Network 5, has developed a program for training dialysis patients to be mentors and mentees, and a test of the program has successfully reduced the number of missed dialysis treatments. Missed and shortened treatments can result in fluid management problems, unhappy patients, and unnecessary hospitalizations. The program is briefly described in Nephrology News & Issues, at http://www.nephrologynews.com/peer-mentoring-reduces-missed-dialysis-treatments/ . Network 5 has made all of the materials for the program, which they call Peer Up!, available for free download, at http://esrdnet5.org/Peer-Up!-Program-Toolkit.aspx . The Peer Up! Toolkit includes six sections: Background and Overview, Program Management, Recruitment and Retention, Mentor Training, Patient Support Resources, and Assessment and Evaluation. Both mentees and mentors reported improvements in psychosocial and physiological factors.
We’ve added a video called “Teachable Moments” to our For Clinical Staff web page at http://www.nwrenalnetwork.org/staff.htm#home. The video coaches in-center dialysis staff on how to help take advantage of “teachable moments” (moments when a patient is listening and likely to hear and understand a communication) to educate patients about home dialysis and other topics. Instructions for obtaining continuing education credits can be found at the end of the video; use authorization number CEP16217.
The brochure – including agenda and location – for the Annual Network Conference is now available, at http://www.nwrenalnetwork.org/misc/NW_Renal_Network_Provider_Meeting_Agenda.pdf. Topics include a Network update, emerging treatments, fluid dynamics, risk, infection, patient engagement, communication, palliative care, ethics, and home dialysis. CEs will be provided to nurses, social workers, techs, and dietitians. Register from our home page at http://www.nwrenalnetwork.org/.
We’ve added a link, to an article from ASN Newswise called “Depressive Symptoms and Pain May Affect Adherence and Health Outcomes in Dialysis Patients,” to the resources list for the Missed Treatments QI Project on our Learning and Action Network page at http://www.nwrenalnetwork.org/QI/LAN/LAN.htm#miss.
We’ve added new resources to the Missed Treatments section of our Learning and Action Network web page, including a root cause form for patient adherence, and Module 10 on Getting Adequate Dialysis from the Medical Education Institute’s Kidney School. The latter is available in printed, online, audio, and Spanish versions. Find them all at http://www.nwrenalnetwork.org/QI/LAN/LAN.htm#miss.