Quality Insights Renal Network 4 
A Periodic Newsletter from Quality Insights Renal Network 4 | www.qirn4.org
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QIRN 4 Staff
Executive Director
Quality Improvement Director
Quality Improvement Coordinator
Patient Services Director
Patient Services Coordinator
Data Manager
Administrative Assistant
October 9, 2014 
Greetings from QIRN 4
Quality Insights Renal Network 4 (QIRN 4) is committed to providing valuable resources that help improve the quality of renal care in Pennsylvania and Delaware. 
We encourage you to visit our Web site for the most up-to-date information or to contact us with questions, comments or suggestions. 
IMPORTANT NOTE:This bi-weekly e-newsletter will serve as our primary method of communicating important news and updates. 
Your QIRN 4 Team
Mark Your Calendars: Upcoming Events
Cannulation Crossroads (Eastern PA)
October 16, 2014
Giant Super Food Store
315 York Road
Willow Grove, PA 19090


Knowing the Signs of Flu and Ebola
Everyone has been focused on the Ebola Virus with the onset of recent events. The United States Department of Health and Human Services has encouraged all health care workers to become knowledgeable about Ebola so they can be better informed and be in a better position to educate patients. Below are a few resources we hope you'll find helpful. 

Signs and Symptoms of Ebola

Ebola Prevention

How do I protect myself against Ebola?

We should remind everyone that there are currently no cases of Ebola within or near our Network area (Delaware and Pennsylvania) and we can use this time to educate ourselves as well as our patients, so that we can be prepared should more cases emerge in the future.

However, since both flu and Ebola can look very similar in the initial stages, we would like to encourage all facility staff and their patients to get the flu vaccine. 

Signs, Symptoms and Prevention of the Flu

Things We Can Do Now to Protect Ourselves from All Infections:
  • Frequent hand washing or use of alcohol-based hand sanitizer when hand washing is not feasible or available.
  • Avoiding direct contact with blood and/or body fluids of any person, particularly if the person is sick.
  • Seek medical care immediately if you develop a fever (temperature of 101.5F/38.6C). 
New NCC Website and FFCL Access Planning Manual Available
The ESRD Network Coordinating Center (NCC) is pleased to announce the launch of its new and enhanced ESRD NCC website at www.esrdncc.org.  The site is a national resource hub that will provide intuitive access to resources, tools and information in support of the ESRD Network Program and the ESRD community. It includes news feeds, social media, embedded videos and other new elements.

A new patient area, "Navigating the ESRD Journey," is a resource library inspired by ESRD patients who have worked with with the NCC to identify and create resources that they believe will help others who are learning to live with this illness. The resources are organized in the form of a journey. As more resources are added through the National Patient/Family Engagement Learning and Action Network's (N-PFE LAN) work, each step on the path will guide a patient's or caregiver's understanding of ESRD and ultimately engage them in their care.

Overview of New Resources

One of the steps in the ESRD Journey is Your Vascular Access, focused on vascular access planning and monitoring. It includes a new resource for patients and professionals developed by the Fistula First Catheter Last Workgroup Coalition. Lifeline for a Lifetime: Planning for Your Vascular Access is a step-by-step guide to help patients plan for a vascular access. It can either be reviewed on line or printed as a manual for use in the care setting. Educating patients on the steps involved in preparing a fistula or graft for hemodialysis will help them be part of the care team in planning for a lifeline that will last their lifetime. Please share this guide with your patients and your community.

Download the manual here.  

The ESRD Network Coordinating Center and the Fistula First Catheter Last Workgroup Coalition thank the ESRD Networks, provider community, and renal experts for their invaluable work which helped to develop the vascular access tools.

Please email questions to ncc@ncc.esrd.net.

Prior Authorization of Repetitive Scheduled Non-Emergent Ambulance Transport
The Centers for Medicare & Medicaid Services (CMS) will begin implementing a prior authorization demonstration program  for repetitive scheduled non-emergent ambulance transport in New Jersey, Pennsylvania, and South Carolina. CMS will test whether prior authorization helps reduce expenditures, while maintaining or improving quality of care. CMS believes using a prior authorization process will help ensure services are provided in compliance with applicable Medicare coverage, coding, and payment rules before services are rendered and claims are paid.  

Prior authorization will not create new clinical documentation requirements. Instead, it will require the same information necessary to support Medicare payment, just earlier in the process.  Prior authorization allows providers and suppliers to address issues with claims prior to rending services and to avoid an appeal process. This will help ensure that all relevant coverage, coding, and clinical documentation requirements are met before the service is rendered to the beneficiary and before the claim is submitted for payment.

NHSN Migration from SDN to SAMS
The Centers for Disease Control and Prevention (CDC) has been migrating away from the issuance of digital certificates to access the National Healthcare Safety Network (NHSN) and will no longer issue any NEW digital certificates. Instead users will obtain access to NHSN by using Secure Access Management Service (SAMS).  If you still have a digital certificate you may continue to use it to access NSHN as you always have.  However, prior to your certificate expiring, you will be invited to apply for SAMS credentials.  This process differs significantly from the certificate renewal process.  When you do get your SAMS invitation, you are urged to act promptly as the process for SAMS is slightly longer than the process for receiving a digital certificate.  Please be especially aware of expiring digital certificates that fall close to CMS reporting deadlines.  All users are required to be migrated to SAMS, and SDN will no longer be available as of April 15, 2015.

Emergency Preparedness Updates
Submit Your Disaster Preparedness Articles
Our focus at QIRN 4 is to "Be Disaster Aware, Take Action to Prepare." If you have any disaster preparedness articles or links, please e-mail your information to dknight@nw4.esrd.net so it may be posted in our bi-weekly newsletter. 

Fire Prevention Week Resources 
This week is Fire Prevention Week. Kidney Community Emergency Response (KCER) is sharing resources on escape planning and electrical safety (in English and Spanish) from the National Fire Protection Association (NFPA). These resources are also available on the KCER website.  
Fire Prevention Week Trivia: Did you know?

In 1920, President Woodrow Wilson issued the first National Fire Prevention Day proclamation, and since 1922, Fire Prevention Week has been observed on the Sunday through Saturday period in which October 9 falls. According to the National Archives and Records Administration's Library Information Center, Fire Prevention Week is the longest running public health and safety observance on record. The President of the United States has signed a proclamation proclaiming a national observance during that week every year since 1925.

Patient Representative Involvement in QAPI Meetings
CMS believes patient participation in Quality Assurance and Performance Improvement (QAPI) is a key component in ESRD Patient Engagement. Your dialysis facility's patient representatives should be invited to participate in QAPI. Below are some guidelines for administrators and patient representatives to consider regarding patient involvement in administrative meetings. Also posted below is a patient representative quality meeting notes outline that patient representatives are welcome to use when attending administrative meetings.

Patient Representative QAPI Guidelines

Patient Representative Quality Meeting Notes 


Featured Continuing Education Opportunities
Got 15 Minutes? Participate in the NFK Kidney Talks on Membranous Nephropathy
Check out these free CME/CE presentations in 3 short, visually-engaging videos. Each video is approved for 0.25 AMA PRA Category 1 Credits™/ Prescribed Credit.

These 3 NKF Kidney Talks programs will help you:
  • Review current research and clinical findings regarding the pathogenesis of membranous nephropathy
  • Examine novel and effective tools for diagnosing and monitoring membranous nephropathy, thus providing guidance for the best treatment course
  • Identify the most current therapeutic options for membranous nephropathy, thus promoting individualized patient care
Register today.


NCC National Release: "Your Life, Your Choice: Stories from Kidney Transplant Patients and Donors"
The ESRD NCC is pleased to announce the national release of "Your Life, Your Choice: Stories from Kidney Transplant Patients and Donors", a new resource added online to the "Navigating Your ESRD Journey" portion of the ESRD NCC website (www.esrdncc.org).

Produced in collaboration with ESRD Networks 1, 2, 4, 6, 8, 15, and 17, who worked on the AIM 2 innovation project targeting increased transplant referral rates, this booklet contains the stories of real kidney transplant recipients and donors in their own words. It was created to inspire hope for ESRD patients, their family members, and care partners, and to encourage ESRD patients to explore all treatment modalities, including kidney transplant.

The booklet is available on the ESRD NCC website under the "Patients" tab, and may be downloaded in PDF format or linked to here. Hearing other patients talk about their experiences can reassure and comfort patients about their own experiences, motivating them to be informed and engaged, and to actively participate in their care.

The NCC would like to express appreciation to the AIM 2 Collaborative Networks for bringing this project to life and the patients and donors who graciously shared their stories. We look forward to future opportunities to collaborate with the ESRD Network community to help bring forth their valuable work at a national level.

Please email questions to Jeanine Pilgrim, ESRD NCC National Coordinator, Patient/Family Engagement Project Manager at jpilgrim@ncc.esrd.net or (516) 209-5365.


CROWNWeb October 2014 Newsletter Now Available
The October 2014 edition of the CROWNWeb Newsletter is now online.  The CROWNWeb Newsletter focuses on user-specific topics, such as training, account management, use of the CROWNWeb system, and tips and tricks, as well as key technical aspects of CROWNWeb.

This month's edition features updated information on monthly clinical month closures starting in 2015, as well as information on CROWNWeb and the upcoming ICD-10 transition.  Other stories include:
  • Completing the CMS-2728 in CROWNWeb 4.5
  • Working with Past Due CMS Forms
  • Treatment Records: Adding vs. Editing
CROWNWeb Newsletter
Click the link above, then click the OCT 2014 button for the CROWNWeb newsletter. Newsletters display in Adobe PDF format.
Note:  Beginning with this month's (October 2014) edition, the CROWNWeb Newsletter and the former CRAFT Newsletter have been consolidated into a single CROWNWeb newsletter. 


ESRD NCC Information Exchange
The ESRD NCC provides centralized coordination and support for the Medicare ESRD Network program. Each month, the ESRD NCC distributes an e-newsletter, known as the Information Exchange, that compiles the most important information from numerous ListServs and publications related to renal health. 

To sign up to receive this informative newsletter, please contact the ESRD NCC at ncc@ncc.esrd.net or visit the ESRD NCC Web site. You can also check the QIRN 4 website for updates that include material from the Information Exchange.


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Quality Insights Renal Network 4
 630 Freedom Business Center, Suite 116
King of Prussia, PA 19406
800-548-9205 (patients only) 
610-783-0374 (fax)
This material was prepared by Quality Insights Renal Network 4 under contract with the Centers for Medicare & Medicaid Services (CMS). The contents do not necessarily reflect CMS policy. 
Publication No. ESRD4-100814

Copyright 2014. All Rights Reserved.