Project Guidelines

Facilities Involved in 2017 LTC Reduction QIA

Project Agreements/Contracts due back to the Network by January 31, 2017

ESRD Networks are tasked by the Centers for Medicare & Medicaid Services (CMS) to support your facility’s goals in providing safe, effective, efficient, patient-centered, timely, and equitable care. Increasing the number of patients receiving dialysis via arteriovenous fistulas (AVF) and reducing long-term catheter (LTC) use for dialysis access is key to providing optimum care for your patients.  A dialysis patient is identified as having a LTC when he or she has been dialyzed with a catheter for 90 days or longer, regardless of whether the catheter has been replaced. We want to help you to continue to deliver excellent care to your patients and to meet these important goals.  These efforts: Result in improved patient care; Minimize loss of revenue due to hospitalizations related to catheter complications; Help ensure that your facility receives maximum reimbursement through the Quality Incentive Program; Improve your facility’s rating on the Dialysis Facility Compare website.

  • Each hemodialysis facility’s LTC rate should be less than or equal to 10%. (Network QIA Focus)
  • Each hemodialysis facility’s AVF rate should be equal to or greater than 68% If your facility has a LTC rate above 10% as of September 2015 you are required to participate in the Network’s Vascular Access Quality Improvement Activity, which runs throughout the year, with an end date for this year’s activity of September of 2016.The requirements for this project are detailed in the Vascular Access Project Guides under each ESRD Network specific area.  The Network will support your efforts and follow your progress throughout the project period.

AIM: To decrease rates of long-term catheters (LTC) use (catheters in use for equal to or less than 90%) among prevalent patients by 2%

Baseline: First and second quarter of 2016 (January through June 2016) to re-measure in September 2017 based on first and second quarter of 2017 (December 2016 through May 2017)

Goal and Timeline: The goal of this project is to decrease the Long Term catheter rates in the target facilities by 2% with an optimal goal of less than or equal to a 10% LTC rate in each clinic.

Tools and Resources

Algorithm Management of Patients with Central Venous Catheters - Provided by the Network

Catheter Reduction Tool - Long Term Catheter Rate (LTC) Monthly Progress Measure

Facility List 2017 - Facilities involved in the 2017 LTC Reduction QIA

FFCL - Access Planning Manual - Life for a Lifetime Planning for Your Vascular Access Manual - Created by the ESRD NCC

Patient Appointment Tracker - Provided by Network to be used as a resource

Provider CVC Progress Tracker - Provided by Network to be used as a resource

Notification Letter - 2017 VA QIA is provided by the network to facilities involved in project

Patient Ambassador Job Description - Description of Patient Ambassador role in the LTC QIA

Patient Choice Form - Created by Network to be completed by patient

Project Inclusion Letter and Timeline - Provided by the network to assist provider with the 2017 timeline

Project Guide - VAQIA project Guide Created by the Network

The Right to Access Poster - Created by NW to be posted in the facility. Poster also available in Spanish. Contact Network for materials.

Vascular Access Data Cleanup in CROWNWeb - Data obtained from CW to assist providers

NNI VA Monitoring and Surveillance - Article from Nephrology News and Issues

Initiative Contacts:

Sarah Keehner, RN, BSN, CNN
Quality Improvement Director