Possible New QIP Measures

CMS is in the process of deciding which new measures to add to its Quality programs. For the ESRD QIP, measures under consideration include in-center patient Coronavirus vaccination coverage, health care personnel Coronavirus vaccination coverage, and Standardized Hospitalization Ratio. For details see https://www.cms.gov/files/document/measures-under-consideration-list-2020-report.pdf – suggested new ESRD measures are summarized on p.82. Measures under consideration are being sent to the National Quality Forum’s Measure Applications Partnership (https://www.qualityforum.org/map/). After the “MAP” has evaluated them, measures still under consideration will be published in the Federal Register for public comment sometime after February 1, 2021.

AAKP Seeks CCPD Patient/Caregiver Input

AAKP is supporting a research initiative with Relavo, a medical device company aiming to make peritoneal dialysis safer and more accessible by reducing the risk of peritonitis, which hospitalizes 15% of PD patients annually.  Relavo is a recent winner of the KidneyX Innovation Accelerator Phase 2: Redesign Dialysis Competition, and of the KidneyX Patient Innovator Challenge.  AAKP and Relavo are seeking patients and caregivers with CCPD experience that are over 18, currently live in the US, and read/understand English, to participate in an online survey.  The results will be used to ensure that a Relavo device, the PeritoneX, addresses what matters most to patients and caregivers.  Learn more about PeritoneX, which disinfects CCPD tubing during treatment set-up, at https://relavomedical.com/.  Find the survey at https://www.surveygizmo.com/s3/5787206/Relavo-Device-Survey.

RSN Podcasts on Hospitalization, Emotional Balance

RSN KidneyTalk has published two new podcasts on:

• COVID-19 and Staying out of the Hospital discusses the most common causes of hospitalization in people requiring dialysis and what to do to stay safe.  Find it at https://www.rsnhope.org/kidneytalk/covid-19-and-staying-out-of-the-hospital/.

• Maintaining Emotional Balance in an Unbalancing Time looks for the right words for dialysis clinic personnel when people are suffering from loss, and describes coping mechanisms to help alleviate anxiety and make tough life decisions.  Find this one at https://www.rsnhope.org/kidneytalk/maintaining-emotional-balance-in-an-unbalancing-time/.

4/2+ ASN COVID-19 Webinars on Hospitalization and Home

ASN will present an April 2, 2020 webinar on Hospital Care and Treatment Options for COVID-19 Positive Patients with ESKD and AKI that will address key areas of concern in the management of COVID-19 positive patients receiving RRT in the hospital setting, including treatment options, staffing, and safety.  Register at https://register.gotowebinar.com/register/4478274981960155148.

There’s no link yet, but ASN has also promised an April 9 webinar on Considerations in the Home Dialysis Setting. 

Recordings of the two previous ASN COVID-19 webinars are available at:

• COVID-19 Information for Providers of Dialysis Services (March 11, 2020), https://www.asn-online.org/ntds/resources/Webcast_2020_03_11_COVID-19.mp4.
• CDC Recommendations and Policy Updates for Current Challenges in the Dialysis Setting (March 26, 2020), https://www.asn-online.org/ntds/resources/Webcast_2020_03_26_COVID-19.mp4.

September Is Sepsis Awareness Month

In a new Safe Healthcare blog post at https://blogs.cdc.gov/safehealthcare/sepsis-awareness-month-why-each-person-matters/, CDC’s Dr. Denise Cardo highlights efforts to protect patients from #SEPSIS and how CDC’s partners in healthcare have impacted this work.  Dr. Cardo also includes many links to useful resources for combatting sepsis.  Join the conversation on Twitter or on the Safe Healthcare blog itself, and spread the word.  It could save a life.  #SAM2019

Diabetic Foot Care

A recent study published in the American Diabetes Association’s (ADA) journal Diabetes Care (http://care.diabetesjournals.org/content/early/2019/05/28/dc19-0296) using 2000-2015 USRDS data has shown that the rates of nontraumatic lower-extremity amputation (NLEA) among adults with ESRD and diabetes fell 44% between 2000 and 2013 from 7.5 to 4.2 NLEA per 100 person-years, while NLEA among ESRD patients without diabetes declined 31% over the same period, from 1.6 to 1.1 per 100 person-years.  Both reductions were highly statistically significant.  However, both rates flat-lined after 2013.

We want to stress the importance of improving patient and staff education on diabetes self-management and preventive foot care, in order to resume the reductions in these rates.  CDC’s recommendations on diabetic foot care can be found at https://www.cdc.gov/features/diabetesfoothealth/index.html.  The ADA’s input is at http://www.diabetes.org/living-with-diabetes/complications/foot-complications/foot-care.html in English and http://www.diabetes.org/es/vivir-con-diabetes/complicaciones/el-cuidado-de-los-pies.html in Spanish.

6/25 CMS Seeks Comment on Rural Hospital Payment Changes

CMS has proposed that they improve their payments to rural hospitals, in an effort to improve rural health in the US.  While this isn’t directly relevant to ESRD, it will certainly be relevant whenever a kidney patient needs services at a hospital in a rural area.  Find the Proposed Rule and Request for Comment at https://www.govinfo.gov/content/pkg/FR-2018-05-07/pdf/2018-08705.pdf, and a Notice of Corrections at https://www.govinfo.gov/content/pkg/FR-2018-06-20/pdf/2018-13152.pdf.  Comments are due by June 25, 2019.  For background information see https://www.cms.gov/blog/putting-our-rethinking-rural-health-strategy-action and https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/FY2019-IPPS-Proposed-Rule-Home-Page-Items/FY2019-IPPS-Proposed-Rule-Regulations.html?DLPage=1&DLEntries=10&DLSort=0&DLSortDir=ascending.

6/12+ Infection Control Tools

• In mid-June 2019 a series of presentations on Infection Control, offering free CME/CE credits to physicians, nurses, and pharmacists, will expire.  CDC and Medscape produced them in 2017 with the intention that they’d be valid for two years.  The six presentations include Risk Recognition, Environmental Services, Medical Equipment, Nonsterile Gloves, Hierarchy of Controls, and Injection Safety.  Find them at https://www.cdc.gov/infectioncontrol/training/cme-info.html.

• The Joint Commission Speak Up series includes a poster and short video in English and Spanish on Infection Prevention.  Find these tools and many more at https://www.jointcommission.org/topics/speak_up_infection_control.aspx.  The Speak Up series also includes resources on Five Ways to Be Active in Your Care at the Hospital for dialysis and diabetes patients, on Avoiding a Return Trip to the Hospital, on Depression, on Organ Donation, on Pain, and many other topics.  Find them all at https://www.dropbox.com/sh/3e5uml0tk6myy4s/AAB0a91UJK8p8-VkokWD0q2Ga?dl=0.

• The Oregon Patient Safety Commission suggests giving your facility a Patient Safety Culture Survey, such as those provided by the HHS Agency for Healthcare Research and Quality (AHRQ).  While they don’t have a Survey specifically for dialysis facilities, most of the questions on any of their surveys are directly applicable or can easily be adapted.  For details see https://oregonpatientsafety.org/news-information/patient-safety-alerts/add-patient-safety-culture-surveys-to-your-prevention-toolbox/945/.

• AHRQ will present a June 12, 2019 webinar on Best Practices for Web-Based Surveys on Patient Safety Culture; register at https://westat.webex.com/mw3300/mywebex/default.do?nomenu=true&siteurl=westat&service=6&rnd=0.14765443759873476&main_url=https%3A%2F%2Fwestat.webex.com%2Fec3300%2Feventcenter%2Fevent%2FeventAction.do%3FtheAction%3Ddetail%26%26%26EMK%3D4832534b00000004055fc9090fc824db69d4fc807faaa82be8a7e2f6b039075465c816eb25f825d0%26siteurl%3Dwestat%26confViewID%3D123809633363065597%26encryptTicket%3DSDJTSwAAAARxY3pJMqWtIxlWNZjpy6DEzK3qsti–1Bsvb7DlIp51Q2%26#utm_source=SOPSanc&utm_medium=Email&utm_campaign=20190422.

• The CDC Safe Healthcare Blog makes a good frequent reminder about the ever-present danger of infection, and how to respond to it effectively.  It’s post for this week is titled Clean Hands Count to Keep Patients Safe from Healthcare Associated Infections.  Find the post and the Blog at https://blogs.cdc.gov/safehealthcare/clean-hands-count-to-keep-patients-safe-from-healthcare-associated-infections/.

More Care Transitions Resources

The ESRD National Coordinating Center has prepared a list of “Key Messages” for National Care Transitions Week, which you can find at https://s3-us-west-2.amazonaws.com/nwrn.org/files/N/NCC/NCC.NCTA.Keys.pdf.  Other useful materials on the ESRD NCC website include:

• Care Transitions 201: CMS Webinar at https://esrdncc.uat.hsag.com/en/resources/professionals/care-transitions/care-transitions-201-cms-webinar/.
• Questions about You (and your hospital stay) at https://esrdncc.uat.hsag.com/contentassets/8bcc6caabcc74d48bb23802fa99dce95/nw15_sitdontstand-questions-about-you_final_508.pdf.
• We’re Not Being Nosy – We Care (so we want to know all about your hospital stay) at https://esrdncc.uat.hsag.com/contentassets/72339be2095d4906ba06b538680d531c/nw15_notbeingnosy_final_508.pdf.

4/9 QIP Webinar on SHR Measure

CMS will present an April 9, 2019 Quarterly Measures webinar on the ESRD QIP SHR Standardized Hospitalization Ratio measure.  For details see https://register.gotowebinar.com/register/6298808943011603459.