IPRO ESRD Networks are tasked by the Centers for Medicare and Medicaid Services (CMS) to work with facilities to increase the use home therapies.
Home dialysis modalities are underutilized in the USA with only 8% of the dialysis patients undergoing renal replacement therapy at home versus 92% being treated with center hemodialysis.
As a result, the following AIM with a 5-year target has been set to guide national health promotion and management to improve the health of all people in the United States living with ESRD: by 2023, to increase the number of ESRD patients dialyzing at home to 16% from the 2016 national average of 12%. (The 2016 New England average was 7.1%)
The intent of the Home Dialysis QIA is to promote referral to home dialysis modalities, identify and mitigate the barriers to timely referral, and determine the steps patients and providers can take to improve referral patterns. The Networks shall increase the number of patients on a home modality by participating in the ESRD NCC Home Dialysis LAN, and assisting dialysis facilities in the implementation of interventions to support patients through the process of training to dialyze at home.
Thinking outside the box—identifying patients for home dialysis; written by: Brigitte Schiller, Hayley Munroe, and Andrea Neitzer
Goal: 10 percentage point increase in home therapies training over baseline.
Timeline: Facilities are selected and notified of their participation in January. The Network will work with the facilities to implement interventions. Facilities will be notified in October if they have met the goal to graduate or will continue in the project during the next year. Facilities not meeting goal should continue to implement interventions and strategies regardless of the measurement period to maximize their ability to graduate in future years.
Facility Selection: 30% of all Network Service area chronic out patients dialysis facilities that treat in-center hemodialysis patients. (stand alone home therapy facilities are excluded)
Baseline Data: The QIA baseline data was provided by the ESRD National Coordinating Center (NCC) from the facility submitted information available in CROWNWeb.
Re-Measurement Data: Data for this QIA will be extracted from facility monthly CROWNWeb data, and will be provided to the Network by the ESRD National Coordinating Center (NCC.)
Tools and Resources:
- Home Therapies QIA Kick-Off Webinar
Review project timelines, report root causes to low home therapies training, and review project interventions for 2018. Recording; Slides
- My Choice Home Hemodialysis (HD)
- My Choice Home Peritoneal (PD)
- Kidney Health Disparities
- Facilities in the QIA