Home dialysis utilization
Quality improvement activity (QIa)

Network Project Lead: Kou Kha-Moua

Studies show that patients who participate in home dialysis therapy experience greater independence and are able to dialyze at a slower rate, which is proven to produce a better physiological response. Patients who have home dialysis therapy also benefit from the following¹:

Lower risk of death
Improved blood pressure control
Better quality of life
Better phosphorus control to prevent bone disease
Improvements in neuropathy, less restless leg syndrome
Feel better during dialysis (less “washed out” feelings )
More energy for daily tasks
Better sleep
Boosts independence, responsibility and confidence
Continued employment
Makes travel easier
Fewer and shorter hospital stays

In spite of the benefits of home dialysis therapies, according to the United States Renal Data System (USRDS), home dialysis only accounted for 8.3% of all prevalent dialysis patients in 2016.² In addition, only 11.2% of Network 4’s ESRD patient population utilized a form of home therapy as of December 31, 2017. The long-term goal and impact of improving home modality initiation aligns with CMS’ priorities, and results in better health and lower costs for our patients. Network 4 will assist participating facilities as they guide patients through the 7 step process leading to home dialysis utilization:

Patient interest in home dialysis
Educational session to determine the patient’s preference of home modality
Patient suitability for home modality determined by a nephrologist with expertise in home dialysis therapy
Assessment for appropriate access placement
Placement of appropriate access
Patient accepted for home modality training
Patient begins home modality training

Monthly Reporting Tool

Presentations & Materials

Toolkit

Quality Improvement Videos
- Quality Improvement in Healthcare (11:08 Minutes)
- Root Cause Analysis – Process to Identify Areas for Quality Improvement
  - What is a Fishbone Diagram? (3:08 Minutes)
  - Root Cause Analysis: 5 Whys (4:44 Minutes)
- PDSA Cycles – Process to Achieve Quality Improvement (6:21 Minutes)
PDSA Worksheet
- This worksheet is provided for you to use if you wish to have a hard copy prior to documenting your PDSA work online
Patient Evaluation Form
Patient Testimony
- Timmy Nelson, Patient
Why Should I Choose Home Dialysis?
5-Diamond Patient Safety Program Home Therapy Module
My Life, My Dialysis Choice
- A tool to assess the modality which may best fit the patient’s value
Home Dialysis Articles
Conditions for Coverage
Uncovering the Myths about Home Dialysis: Myth vs. Reality Toolkit
"Best Wishes on the Decision to Dialyze at Home" Certificate Template

ESRD NCC Home Dialysis QIA Learning and Action Network (LAN) Calls

(recordings and presentations to be added)
Please note that these dates are subject to change based on speaker availability. Meeting details, including registration link and call overview, to be provided prior to each call.

DATE (2nd TUESDAYS)	TIME
January 15, 2019	3:00 p.m. – 4:00 pm ET
March 12, 2019	3:00 p.m. – 4:00 pm ET
May 14, 2019	3:00 p.m. – 4:00 pm ET
July 9, 2019	3:00 p.m. – 4:00 pm ET
September 10, 2019	3:00 p.m. – 4:00 pm ET
November 12, 2019	3:00 p.m. – 4:00 pm ET

January 15, 2019

Archived Materials

2018 Introduction Webinar

2018 ESRD NCC Home Dialysis QIA

References

Young BA, Chan C, Blagg C, et al. How to overcome barriers and establish a successful home HD program. 2012. http://cjasn.asnjournals.org/content/early/2012/10/03/CJN.07080712.full.
United States Renal Data System. 2018 USRDS annual data report: Epidemiology of kidney disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2018

Page last updated: 04/10/19