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2015 Quality Improvement projects

Healthcare-Associated Infections

The Centers for Medicare & Medicaid Services (CMS) AIM 1, “Better Care for the Individual through Beneficiary and Family Center Care” continues to encourage progress toward reducing Healthcare-Associated Infections.  This initiative focuses on the observation and feedback from infection control audits by facility patients/staff.  Interventions are CDC-developed tools, toolkits and educational resources located on the CDC Web site.  Bloodstream (BSI) prevention materials and other helpful guidelines and educational materials may be found here. To directly access the CDC-developed tools, visit this page.

For more information about HAI QIA, view the Healthcare-Associated Infections Quality Improvement Activity (HAI QIA) presentation given by QIRN 4.

Vascular Access Management

CMS continues to encourage progress toward ensuring every hemodialysis patient has the most appropriate type of access. To this end, CMS has set goals of 68% AVF and <10% long term (>90 days) catheter usage, each to be achieved by January 1, 2016. Several facilities are involved with Quality Insights Renal Network 4 Vascular Access Management Improvement projects.

For more information about the vascular access quality improvement project, view this presentation

Increasing Transplant Referrals

Quality Insights, under the direction of CMS, assists dialysis and transplant facilities in improving the quality of care they provide to End Stage Renal Disease (ESRD) patients. Kidney transplantation offers advantages over dialysis for most ESRD patients in both quality of life and survival. 

National research indicates that women have a lower chance of receiving hemodialysis and kidney transplant than men, but they constitute the majority of living kidney donors.* Within the Network 4 community, the female transplant referral rate is 37.2% compared to the male referral rate of 51.7%.**

The purpose of this campaign is to focus attention on improving the transplant referral rates of women in Network 4. Facilities will be asked to take part in the Take the First Step Campaign to aid those female patients to take the first step and be referred to a transplant center.

Definitions to aid this Quality Improvement Project:

CMS has defined transplant referral as:

“Any first-time referral for a patient (i.e., the patient has not already been referred or been placed on a transplant waitlist), and for which either a dialysis facility or transplant center provides an indication that the patient has been referred. Patients who have had transplant failures are considered as re-starting the referral process anew, and would be eligible for “first-time” referrals.”

Eligible for Transplant Referral is defined as: 

"In consultation with transplant centers, ALL patients are eligible for transplant referral.  The transplant centers will assess the patient and make the final decision about transplant appropriateness."

Referral is defined as:

"Initial contact has been made by the facility on behalf of the patient to a transplant center by means of fax, letter, email or phone call." 

For more information about the transplant referral  project, visit our Take the First Step campaign page. You can also view a presentation on this project

* American Journal of Nephrology. 2005 Sep-Oct;25(5):474-83. Epub 2005 Aug 26.
**Data calculated from ESRD Network 4 facility sample size.