Renal Network Three

Goals

1. Develop criteria and standards relating to the quality and appropriateness of patient care.
2. Conduct on-site reviews of facilities and providers, as necessary, utilizing standards of care established by the Network.
3. Identify facilities not meeting Network goals, assist facilities to develop appropriate plans for correction, and report to the Secretary (CMS) facilities and providers that are not providing appropriate medical care.
4. Improve collaboration with providers to ensure achievement of the goals through the most efficient and effective means possible,
   1. Facilities will maintain expected levels of performance in national clinical performance indicators:
      
      

      Indicator	Goal
      Anemia management Hgb 10-12g/dL	55%
      Dialysis adequacy URR ≥65%	92%
      Dialysis adequacy Kt/V>1.2	96%
      Mean albumin >4.0/3.7g/dL	36%
      Mean TSAT >20%	87%
      Mean Ferritin 100-800 ng/mL	66.7%
      Adjusted calcium 8.4-10.2 mg/dL	83%
      Mean phosphorus 3.5-5.5 mg/dL	55%
      Fistula rate prevalent patients	66%
      Catheter reduction	2%
      Fistula rate incident patients	50%
      AV stenosis monitoring	100%
      Catheters >90 days	<10%

      
       
   2. Facilities will assign specific staff who have the responsibility for home designee, transplant designee and vascular access coordinator functions

Improve the independence, quality of life, and rehabilitation(to the extent possible) of individuals with ESRD through transplantation, use of self-care modalities, as medically appropriate, through the end of life;

1. Encourage the participation of patients, providers of services, and ESRD facilities in vocational rehabilitation programs.
2. Evaluate procedures used by facilities and providers to assess the appropriateness of patient treatment type.
   1. Facilities will post in prominent place posters describing treatment modalities provided by QIRN3.
   2. Facilities will provide treatment schedules that allow patients to work or refer to another facility with this ability.
   3. Facilities will post in prominent place QIRN3’s patient rights and responsibilities statement and distribute annually paper copies.

Improve patient perception of care and experience of care and resolve patient complaints and grievances; and,

1. Encourage the use of those treatment settings most compatible with the successful rehabilitation of the patient.
2. Implement procedures for evaluating and resolving patient grievances.
   1. Each facility will post in prominent place QIRN3’s grievance policy and distribute annually paper copies.
   2. Each facility will fully document all involuntary discharges and notify QIRN3 of each occurrence.

Improve the collection, reliability, timeliness, and use of data to measure processes of care and outcomes; maintain patient registry; and to support the goals of the ESRD Network Program.

1. Collect, validate and analyze data for the preparation of reports and assuring the maintenance of a national ESRD registry.
2. Submit an annual report to the Secretary.
   1. Each facility will monitor forms submission and maintain the required timeliness and accuracy rates of 90%.
   2. Each facility will promptly address data discrepancies identified by QIRN3.