This ESRD facility monthly newsletter highlights the latest ESRD insights and resources. Our goal is to provide you with a resource that makes it easy for you to stay on top of trends and support you in providing the best possible care for those you work with and serve.
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In This Issue:
- News You Can Use
- Health Equity
- Behavioral Health
- Home Dialysis
- Hospital Admissions, Readmissions and Emergency Visits
- Transplant
- Vaccinations
- Patient and Family Engagement
- EQRS
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“The heat in August is like a warm hug from the sun, except it’s more like a smothering blanket.” - Unknown
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News You Can Use
As we (mercifully) move closer toward cooler weather, seasonal storms always become a concern. Now is a good time to familiarize yourself with your facility’s disaster plan, ensuring you know how to reach your local Emergency Management Agency and who to work with in the event of a disaster. For assistance with your disaster plan, contact the Network at NW8info@allianthealth.org or NW14info@allianthealth.org.
In addition, the Kidney Community Emergency Coalition (KCER) website has multiple disaster resources for facility staff and patients. The KCER Prep Rally campaign also has resources for engaging in-center patients in emergency preparedness. Information for managing home dialysis patients during a disaster can be found in Chapter 4 of the newly revised Home Dialysis Toolkit created by the Forum of ESRD Networks.
In addition, the Kidney Community Emergency Coalition (KCER) website has multiple disaster resources for facility staff and patients. The KCER Prep Rally campaign also has resources for engaging in-center patients in emergency preparedness. Information for managing home dialysis patients during a disaster can be found in Chapter 4 of the newly revised Home Dialysis Toolkit created by the Forum of ESRD Networks.
On a similar note, we also encourage you to review your facility's active shooter response plan. Facilities that do not have a plan or want more information can check out the hour-long Federal Emergency Management Agency training titled Active Shooter Prevention: You Can Make a Difference. This training will help you to:
- Recognize indicators that someone is on a pathway to violence, including the role that stressors play and the importance of addressing concerning behaviors.
- Identify potential concerning behaviors, how to recognize them, and when to take appropriate action.
- Identify common pre-attack indicators demonstrated by active shooters and how to recognize them.
- Identify empathy and compassion techniques to reduce the likelihood of an event escalating into an active shooter incident.
- Identify situations where professional help could be used to prevent an incident from escalating into a violent situation.
- Identify traits of a connected and supportive work environment.
- Recognize the characteristics of productive conflict and destructive conflict.
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Health Equity
Findhelp.org helps connect people who need socioeconomic assistance with resources. Individuals enter their zip code to find programs in their area, including assistance for food, housing (including resources to pay for utility bills), furniture and appliances, transportation, legal and more.
With summer comes high utility bills, especially in the South. A list of resources to help patients pay for utility costs is below:
Alabama:
Alabama Department of Economic and Community Affairs (ADECA)
Community Services Programs of West Alabama, Inc. (CSP)
Mississippi:
Mississippi Public Service Commission (MPSC)
Mississippi Low Income Home Energy Assistance Program (LIHEAP)
Tennessee:
Tennessee Housing Development Agency (LIHEAP)
Texas:
Texas Comprehensive Energy Assistance Program (CEAP)
Texas Utility Help Program (TUHP)
Texas Department of Housing and Community Affairs (LIHWAP)
With summer comes high utility bills, especially in the South. A list of resources to help patients pay for utility costs is below:
Alabama:
Alabama Department of Economic and Community Affairs (ADECA)
Community Services Programs of West Alabama, Inc. (CSP)
Mississippi:
Mississippi Public Service Commission (MPSC)
Mississippi Low Income Home Energy Assistance Program (LIHEAP)
Tennessee:
Tennessee Housing Development Agency (LIHEAP)
Texas:
Texas Comprehensive Energy Assistance Program (CEAP)
Texas Utility Help Program (TUHP)
Texas Department of Housing and Community Affairs (LIHWAP)
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Behavioral Health
Brain fog, or decline in cognitive functioning, can be very challenging for patients on dialysis. Research has shown higher rates of brain fog in standard hemodialysis patients than in the general population. Cognitive changes can lead to depression or other mental health problems. It is important to identify patients who are starting to show signs of cognitive decline and work with their primary care physician to screen them during their annual Medicare wellness visit.
Behavioral Health Contacts:
Network 8: ericka.webb@allianthealth.org
Network 14: cassandra.hanna@allianthealth.org
Network 8: ericka.webb@allianthealth.org
Network 14: cassandra.hanna@allianthealth.org
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Home Dialysis
Reports show that clinics with a Home Ambassador are transitioning more patients to home dialysis than clinics without one. A Home Ambassador can help your clinic overcome many barriers. If you need assistance identifying a candidate for Home Ambassador, please reach out.
Home Dialysis Contact: mandy.lubbeck@allianthealth.org
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Hospital Admissions, Readmissions and ER Visits
There are numerous drivers for hospitalizations, re-admissions and ED visits. We found that many high-performing dialysis clinics successfully reduced hospitalizations, re-admissions and ED visits by building relationships and working as a team to accomplish common goals. It seems elementary, but it is easy to overlook meaningful relationships when trying to get caught up with everyday work.
Strong partnerships will help your clinic provide patients with the highest level of care and avoid unnecessary hospitalizations, ED visits and readmissions. The ESRD NCC Change package, linked below, covers this topic in detail.
One particular hospitalization driver we are concerned about is admissions related to vascular access complications. Because there are many causes of access dysfunction, we want to stress the importance of vascular access monitoring and timely intervention. Please consider vascular access monitoring as a topic for your next staff meeting, especially if you have new staff that may need to become more familiar with this. If you do not have internal policies or resources for this, reach out to the contacts below.
Strong partnerships will help your clinic provide patients with the highest level of care and avoid unnecessary hospitalizations, ED visits and readmissions. The ESRD NCC Change package, linked below, covers this topic in detail.
One particular hospitalization driver we are concerned about is admissions related to vascular access complications. Because there are many causes of access dysfunction, we want to stress the importance of vascular access monitoring and timely intervention. Please consider vascular access monitoring as a topic for your next staff meeting, especially if you have new staff that may need to become more familiar with this. If you do not have internal policies or resources for this, reach out to the contacts below.
Hospitalization Contacts:
Network 8: kristi.durham@allianthealth.org
Network 14: koby.guthrie@allianthealth.org
Network 8: kristi.durham@allianthealth.org
Network 14: koby.guthrie@allianthealth.org
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Transplant
The Transplant Change Package, created by the ESRD National Coordinating Center (NCC), has action change ideas to help dialysis facilities increase the number of patients on the transplant waitlist. The change ideas can help facilities drive performance improvement by implementing the five primary drivers and secondary drivers as the actions and interventions that impact the primary drivers. Check out the new updates and additions for implementation within your facility.
Transplant Contact: arlandra.taylor@allianthealth.org
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Vaccinations
The ESRD NCC’s Vaccination Change Package is composed of key change ideas from top-performing facilities and is intended to support dialysis facilities in increasing the number of patients receiving COVID-19, influenza and pneumococcal vaccinations. Review the updated vaccination change package and choose ideas to improve vaccination rates in your facility.
Vaccination Contacts:
Network 8:kristi.durham@allianthealth.org
Network 14: koby.guthrie@allianthealth.org
Network 8:kristi.durham@allianthealth.org
Network 14: koby.guthrie@allianthealth.org
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Patient and Family Engagement (PFE)
Quality Assurance and Process Improvement (QAPI)
CMS expects facilities to include patients in monthly QAPI meetings. This meeting may go by different names depending on your dialysis organization, including TQM, FHM or QAI. Please note: QAPI is a separate meeting from the monthly plan of care meeting held with patients to discuss their personal health outcomes.
What does this involvement look like at your facility? Identify a patient who is interested in their care and explain what QAPI is. Invite the patient to attend the meeting in person, via conference call or via submission of written comments/suggestions for meeting attendees to review and address. If the patient chooses to participate via written format, be sure to provide feedback in a timely manner. You can also give the patient a discussion topic. For example, have a patient who has gone through the transplant referral process discuss their experience and offer pointers to other patients or have a home patient share ideas on how to encourage more patients to do a home modality.
What are the benefits?
CMS expects facilities to include patients in monthly QAPI meetings. This meeting may go by different names depending on your dialysis organization, including TQM, FHM or QAI. Please note: QAPI is a separate meeting from the monthly plan of care meeting held with patients to discuss their personal health outcomes.
What does this involvement look like at your facility? Identify a patient who is interested in their care and explain what QAPI is. Invite the patient to attend the meeting in person, via conference call or via submission of written comments/suggestions for meeting attendees to review and address. If the patient chooses to participate via written format, be sure to provide feedback in a timely manner. You can also give the patient a discussion topic. For example, have a patient who has gone through the transplant referral process discuss their experience and offer pointers to other patients or have a home patient share ideas on how to encourage more patients to do a home modality.
What are the benefits?
- Adds diverse perspectives and ideas
- Provides an opportunity for discussion about facility processes
- Ensures patient communication and education
- Guarantees the patient’s voice is heard
Patient and Family Engagement Contacts:
Network 8: casey.rich@allianthealth.org
Network 14: debbie.odaniel@allianthealth.org
Network 8: casey.rich@allianthealth.org
Network 14: debbie.odaniel@allianthealth.org
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EQRS
Do you need assistance with an EQRS issue? There are several avenues available for EQRS support. If you work for a large dialysis organization (FMC, DaVita, DCI or US Renal Care), your organization provides educational resources (check your organization’s intranet) and has national teams that provide support for EQRS.
Primary support for EQRS is provided by CCSQ. The CCSQ Service Center has advanced expertise in CMS health care quality initiatives, policies and information systems, including EQRS. You can submit a ticket online. Start here. Then, click the Create Ticket button and fill out the requested information. You can also call or email the CCSQ Support Help Desk.
EQRS Support:
qnetsupport-esrd@cms.hhs.gov
1-(866)-288-8912 (TRS: 711)
Contact this service center for assistance with the following issues:
Occasionally, you will have an EQRS issue that can only be addressed by the ESRD Network. The best way to obtain support from the ESRD Network is to submit a Service Ticket request.
Please provide the requested information about your support need. If you’re unable to admit a patient and get the error message “Cannot admit the patient due to a possible duplicate. Contact your Network,” your service request should be “Cannot Admit Due to Possible Duplicate / Near Match.” Once you select that, additional information will be requested to resolve the ticket. This information can now be submitted online due to the upgraded security of the application that supports Network Service tickets.
To schedule an appointment with the Information Management support team (Robert Bain or Sade Castro), click here. There are several appointment types available. The most common is EQRS Focused Assistance.
Many questions can be answered by documents found on the EQRS website. Visit https://eqrs.cms.gov to view and download various helpful guides.
Finally, you can reach Sade Castro or Robert Bain by email. For a specific question about a patient, please submit a service ticket or schedule an appointment. For general questions, email may be a good choice. Please note that email communication with the ESRD Network is subject to CMS Information Security Policies and Procedures. If you email patient-specific information to the ESRD Network, we are required to report it to CMS as a potential HIPAA violation. The only identifier that we can accept is the patient’s EQRS Patient ID (also known as CROWN UPI or UPI). Do not include the patient’s name, DOB, SSN, or MBI in an email to the ESRD Network.
Primary support for EQRS is provided by CCSQ. The CCSQ Service Center has advanced expertise in CMS health care quality initiatives, policies and information systems, including EQRS. You can submit a ticket online. Start here. Then, click the Create Ticket button and fill out the requested information. You can also call or email the CCSQ Support Help Desk.
EQRS Support:
qnetsupport-esrd@cms.hhs.gov
1-(866)-288-8912 (TRS: 711)
Contact this service center for assistance with the following issues:
- HARP Account Management
- Troubleshooting patient files and forms (2728/2746 and 2744)
- Clinical data,
- QIP Reports/Certificates
- Manage File Transfer (MFT)
Occasionally, you will have an EQRS issue that can only be addressed by the ESRD Network. The best way to obtain support from the ESRD Network is to submit a Service Ticket request.
Please provide the requested information about your support need. If you’re unable to admit a patient and get the error message “Cannot admit the patient due to a possible duplicate. Contact your Network,” your service request should be “Cannot Admit Due to Possible Duplicate / Near Match.” Once you select that, additional information will be requested to resolve the ticket. This information can now be submitted online due to the upgraded security of the application that supports Network Service tickets.
To schedule an appointment with the Information Management support team (Robert Bain or Sade Castro), click here. There are several appointment types available. The most common is EQRS Focused Assistance.
Many questions can be answered by documents found on the EQRS website. Visit https://eqrs.cms.gov to view and download various helpful guides.
Finally, you can reach Sade Castro or Robert Bain by email. For a specific question about a patient, please submit a service ticket or schedule an appointment. For general questions, email may be a good choice. Please note that email communication with the ESRD Network is subject to CMS Information Security Policies and Procedures. If you email patient-specific information to the ESRD Network, we are required to report it to CMS as a potential HIPAA violation. The only identifier that we can accept is the patient’s EQRS Patient ID (also known as CROWN UPI or UPI). Do not include the patient’s name, DOB, SSN, or MBI in an email to the ESRD Network.
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Our mailing address is:
Alliant Health Solutions
400 Perimeter Center Ter NE
Suite 250
Atlanta, GA 30346
Our mailing address is:
Alliant Health Solutions
400 Perimeter Center Ter NE
Suite 250
Atlanta, GA 30346