Home dialysis Training
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 8.6% of all prevalent dialysis patients in 2015.² In addition, only 11.3% of Network 4’s ESRD patient population utilized a form of home therapy as of December 31, 2016. 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: 
 

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

Monthly Reporting Tool

Toolkit 

• Introduction Webinar
  • Presentation Slides
  • Webinar Recording
  • Provide Feedback
• 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 Testimony
  • Timmy Nelson, Patient
• 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
  • Thinking Outside the Box – Identifying Patients for Home Dialysis
  • Psychosocial Barriers to Home Dialysis: A Literature Review
  • Home Dialysis First: A New Paradigm for New ESRD Patients
• Conditions for Coverage

References

1. ​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.  

2. United States Renal Data System. 2015 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, 2015

Page last updated: 01/25/18