A Periodic Newsletter from Quality Insights Renal Network 3 | www.qirn3.org
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February 2016 
Greetings from QIRN3
Welcome to the February 2016 issue of the Quality Insights Renal Network 3 (QIRN3) e-newsletter. Check out information about the new EnGAGE 2016 program, OPTN/UNOS policies and bylaws, the ICH CAHPS survey manual, guidelines for opting out of administering the survey, educational opportunities, resources and much more.   
 
As always, we encourage you to visit our website for the most up-to-date information or to contact us with questions, comments or suggestions. 

We wish you a wonderful holiday season. 
QIRN3 Presents EnGAGE 2016
Quality Insights Renal Network 3 (QIRN3) makes an ongoing effort to assist dialysis facilities in the development of Patient-Centered Care models that promote patient, family and staff engagement. In support of the development of a patient-centered care culture, QIRN3 is pleased to present EnGAGE 2016.

Facilities that enroll and complete this program are recognized by QIRN3 during the Network's Annual Meeting with a certificate of achievement for their exemplary work. In addition, all dialysis facilities that complete the program will be included on QIRN3's website and recognized in this newsletter.

The completion date for the EnGAGE program is
September 16, 2016Learn more about participation

CMS Seeks Public Comments on Hospitalization, Mortality Measures
The Centers for Medicare & Medicaid Services (CMS) has contracted with the University of Michigan Kidney Epidemiology and Cost Center (UM-KECC) to evaluate the potential of including prevalent comorbidities in the SMR and SHR risk adjustment models. Measure specifications for two measures have been posted on the CMS site for public comment. The public comment period begins February 8 and closes on February 22.

The following documents are posted on the CMS public comment page for comment:
  • Standardized Mortality Ratio Measure Information Form
  • Standardized Mortality Ratio Measure Justification Form
  • Standardized Hospitalization Ratio Measure Information Form
  • Standardized Hospitalization Ratio Measure Justification Form
Project-Specific Instructions:
  • Do not include personal health information in your comments.
  • If you are providing comments on behalf of an organization, include the organization's name and your contact information.
  • If you are commenting as an individual, submit identifying or contact information.
  • Please indicate which measure (s) you are providing comments on.
  • Please send all comments to [email protected] no later than February 22.
Implementing the Extraordinary Circumstances Exception in the ESRD QIP
In 2014, CMS finalized (79 FR 66189) that, for PY 2017 and beyond, it would exempt a facility from all ESRD QIP requirements during the time that the facility was forced to close temporarily due to a natural disaster or other extraordinary circumstances beyond the facility's control. In order to receive consideration for such an exception, the facility would need to submit a CMS Disaster Extension/Exception Request Form through www.qualitynet.org within 90 calendar days of the date of the disaster or extraordinary circumstance.

As of January 2016, the ECE request form is still under review for compliance with the Paperwork Reduction Act and until further notice it is not available for use by ESRD facilities. CMS has implemented a process for use by facilities requesting an exemption until the form is available on www.qualitynet.org. Read the CROWN memo.

CMS to Add Three New Quality Measures in CY2016 QIP to Dialysis Facility Compare Website 
Starting in October 2016, the Centers for Medicare & Medicaid Services (CMS) will add the three new quality measures included in the Calendar Year 2016 Quality Incentive Program (QIP) to the Dialysis Facility Compare website. Those measures are:
  • Bloodstream Infection in Hemodialysis Outpatients
  • CAHPS (Consumer Assessment of Healthcare Providers) In-Center Hemodialysis Survey
  • Pediatric Peritoneal Dialysis Adequacy: Achievement of Target Kt/V
Learn more. Visit the Dialysis Facility Compare website.

CMS Extends Compliance Date for Posting PY 2016 PSCs 
CMS has updated the date by which facilities must post their ESRD Quality Incentive Program (QIP) Performance Score Certificates (PSC) in both English and Spanish for Payment Year (PY) 2016. During the PY 2019 Final Rule National Provider Call on January 19, 2016, CMS set the deadline at February 1, 2016, for facilities to post their PSCs in a prominent patient area. Subsequently, CMS has learned that facilities may have experienced obstacles in accessing their accounts on www.qualitynet.org and retrieving their reporting documents. In light of those developments, CMS has updated the deadline for facilities to post their PSCs to February 22. Facilities should retain an electronic copy of their reporting documents for reference throughout the year in the event that the posted hard copies need to be replaced due to damage or other unforeseen events.

CROWNWeb's OCT Offers Training on CMS-2744
The Outreach, Communications, and Training Team (OCT) for CROWNWeb will provide CMS-2744 training on Wednesday, March 2, 2016 at 2:00 PM. During this webinar session, attendees will gain an understanding of the purpose of the CMS-2744 form and how it impacts facilities, how to complete the CMS-2744, and how to utilize CMS-2744 reports to resolve errors. Attendees can register here. Timeline for the CMS-2744 Annual Facility Survey:

Task
Deadline
Generating the 2744February 15
Submitting the balanced 2744 with any comments to the Network
April 1

Network Resources


Decrease in BSI/ARBSI is Achievable and Sustainable
A new Centers for Disease Control and Prevention (CDC) study shows that decreases to certain bloodstream infection (BSI) rates can be maintained through the use and implementation of CDC dialysis BSI prevention tools. The new study reported a 44 percent drop in access-related bloodstream infections (ARBSIs) and estimated more than 60 percent of expected ARBSIs may have been prevented over the 4-year period among dialysis patients treated at facilities using the CDC's Core Interventions for Dialysis BSI Prevention as part of a collaborative project. This study followed up with 17 outpatient dialysis facilities that implemented CDC BSI prevention tools as part of a CDC-initiated infection prevention collaborative.

CDC's 2013 study of the collaborative reported drops in overall BSI and ARBSI during the first 15 months of the intervention period. The present study tracked the progress of these clinics for an additional 33 months into the intervention, referenced as the later intervention period. Reductions in ARBSI rates continued at dialysis facilities during the later intervention period even after formal collaborative efforts and intensive technical assistance from CDC ended. These findings show that reduction in infection rates is both achievable and sustainable up to four years following adoption of the CDC Core Interventions. No changes in BSI rates were detected in this study.

NHSN Outpatient Dialysis Center Practices Survey is Released
The NHSN Outpatient Dialysis Center Practices Survey (required for Dialysis Event reporting) has been released. Many questions in the 2016 survey pertain to the first week of February; therefore, NHSN users are encouraged to begin the survey on or after February 1. The survey cannot be submitted to NHSN until after the first week of February. It is strongly recommended that the survey is completed by someone who works in the center and is familiar with current practices within the center. Complete the survey based on the actual practices at the center, not necessarily the center policy, if there are differences. Thank you for your attention to this matter. Please contact the NHSN helpdesk for questions and enter "Dialysis" in the subject line.

CDC Releases Recommendations for Reducing Hepatitis C Transmission during Hemodialysis Treatments
The CDC released recommendations for reducing transmission of the Hepatitis C virus (HCV) during in-center hemodialysis treatment. According to CDC, HCV starts as an acute infection, and approximately 75-85 percent of people who become infected develop a lifelong, chronic infection which can lead to severe liver disease and liver cancer. Curative therapy is now available, even for some patients with end-stage renal disease. Because HCV is transmitted through percutaneous blood exposure and can survive in the environment for extended periods of time, lapses in infection control practices at dialysis facilities could expose patients to HCV. You can review the fact sheet about the release of the CDC recommendations here, as well as the CDC Health Advisory that was released on January 27. 

OPTN/UNOS Requests Public Comment on Policy and Bylaw Proposals
The Organ Procurement and Transplantation Network (OPTN)/ United Network for Organ Sharing (UNOS) has offered nine proposals, developed by its committees, for public comment. When the public comment period ends on March 25, each sponsoring committee will review the feedback it received and consider modifications to the original proposals. The OPTN/UNOS Board of Directors may then review and vote on these proposals at its meeting on June 6 and 7. Please provide your comments on these proposals. You may also continue to send general feedback to [email protected]. Please submit all comments no later than March 25. For general questions about the proposals, please contact your Regional Administrator at (804) 782-4800.

OPTN/UNOS welcome your feedback on these proposals and other aspects of the public comment process as it continues to improve the way that it communicates with the community. Thank you in advance for your careful review and feedback on these proposals.

ICH CAHPS Survey Administration and Specifications Manual, Version 4.0, is Now Available
The In-center Hemodialysis CAHPS (ICH CAHPS) Survey Administration and Specifications Manual, Version 4.0 is now available. The protocols and guidelines described in Version 4.0 of this manual are effective immediately and supersede those described in previous versions of the manual. An electronic version of the manual in both MS Word and PDF is now available on the ICH CAHPS Survey website

Options for Facilities Declaring Non-Participation: Deadline is February 28
In-center hemodialysis (ICH) facilities that do not plan to administer the ICH CAHPS Survey must complete and submit via the ICH CAHPS website a Facility Non-Participation Form to indicate that they will not be administering the ICH CAHPS Survey in calendar year (CY) 2016. The Facility Non-Participation Form is valid for one year only; facilities that submitted the form in CY2015 must submit the form for CY2016 and each year thereafter if they do not plan to administer the survey for a specific year. Any dialysis facility (CCN) that qualifies as a non-participant and decides not to administer the ICH CAHPS Survey during a specific calendar year now can choose one of two options.

Education Opportunities
NKF Adds New Topics to Professional Education Resource Center (PERC)
The NKF has added new topics to its Professional Education Resource Center (PERC). This resource center is designed for professionals committed to continuing their education and improving patient outcomes by offering online CME/CE courses. There are a variety of activities on carefully selected topics given by renowned faculty. New courses will continue to roll out. Courses are free to NKF members and non-members pay a per-course fee. Find additional information.

Medscape Education Offers Comprehensive Management of CKD-MBD: Hands-On Case Studies Medscape Education now has a CME/CE opportunity on the topic of Comprehensive Management of CKD-MBD: Hands-On Case Studies. The goal of this activity is to improve the management and treatment of patients with CKD-MBD and to assist healthcare providers in tailoring treatment for individual patients.

AHRQ Offers Continuing Education and Continuing Medical Education Opportunities
The Agency for Healthcare Research and Quality (AHRQ) offers continuing education (CE) and continuing medical education (CME) videos and articles on a range of health care topics including patient safety and patient-centered outcomes research findings. The CE/CME activities summarize reviews of evidence on the effectiveness and safety of treatments and strategies for improving patient care. Some of the available topics include:
 
  • Menopausal Symptoms: Comparative Effectiveness of Therapies
  • Pharmacotherapy for Adults with Alcohol-Use Disorders in Outpatient Setting
  • Treatment Strategies for Patients with Peripheral Artery Disease
  • Child Obesity Prevention Programs: Comparative Effectiveness
     
  • Treating Insomnia in Adults
These resources provide health care providers with skills and information to support individual decision making and patient management. The activities are available at no cost for CE/CME credit. Learn more.
ESRD Resources
AAKP Offers FREE HealthLine Conference Calls
The American Association of Kidney Patients (AAKP) presents monthly FREE HealthLine conference calls for patients. Encourage your patients to join the upcoming call:

February 24: "The Importance of Exercise for All Stages of Kidney Disease"
March 10: "Mastering Social Media as a Patient Advocate"

Find more information about these calls, and how to register. For recordings of previous HealthLine calls, visit the AAKP website

New Booklet on Palliative Care for Children is Available
The NIH National Institute of Nursing Research provides a booklet for families regarding supportive medical and non-medical care for children suffering from a chronic disease such as CKD, called Palliative Care for Children: Support for the Whole Family When Your Child Is Living with a Serious Illness. Download a copy

NKF Develops New Website for Hispanic/Latino Cultural Concerns
The National Kidney Foundation (NKF) has created a new website addressing cultural concerns that Hispanic/Latino patients, donors, family, and friends may have about kidney transplantation, including cultural misconceptions, treatment options, steps to become a living donor, risks and benefits of donation, financial issues, and immigrant issues.  The website is available in both English and Spanish.

Living Donor Financial Assistance is Available
The National Living Donor Assistance Center (NLDAC) is a federally funded program that provides financial assistance for living donors to travel to the transplant center for their evaluation, surgical procedure, and medical follow-up appointments.  Approved applicants receive a controlled value card to pay for their travel, lodging, and food up to a total of $6,000.  Eligibility is based on the recipient's household income.  For more information, call (888) 870-5002 or visit the website.

Find Important Social Security Forms Here
The Social Security Administration's website has many forms you can download, print and fill out. Available forms include applications for disability benefits and child's insurance benefits, enrolling in Medicare, appealing a medical decision and requesting a waiver on an overpayment. Of course, you can also apply for benefits and take care of other Social Security business online. For more information, read Disability.gov's Guide to Disability Benefits or call 1-800-772-1213 (TTY: 1-800-325-0778) or your local Social Security office.

Check out the ESRD NCC Information Exchange 
The ESRD Network Coordinating Center (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 [email protected] or visit the ESRD NCC website.

Upcoming Events
March 10 is World Kidney Day 
Contact your local National Kidney Foundation (NKF) office for events related to World Kidney Day. Check out the official World Kidney Day website for additional ideas and information.

Registration Open for NKF 2016 Spring Clinical Meetings 
The National Kidney Foundation (NKF) 2016 Spring Clinical Meetings offer an extraordinary networking and learning opportunity for kidney healthcare professionals. Participants will enjoy a cutting-edge program presenting the newest developments related to all aspects of nephrology practice. Taught by internationally acclaimed faculty, the program features specialized courses, interactive workshops and lively debates. The meetings will take place April 27 - May 1, 2016 at the Hynes Convention Center in Boston, MA.

NANT Annual Symposium is Scheduled for March 21-24
The National Association of Nephrology Technicians (NANT) Annual Symposium provides up to four days of dialysis technician-focused education. Technicians who participate in all four days can earn 25 contact hours. View complete information.

47th ANNA National Symposium Will Be Held in May
ANNA will be hosting its 47th National Symposium May 1 - 4 at the Marriott Louisville and Kentucky International Convention Center in Louisville, KY. The symposium provides opportunities for nephrology nurses to expand their knowledge, enhance clinical skills, and widen professional networks. For more information, visit www.annasymposium.org

AAKP Hosts National Patient Meeting
AAKP is pleased to announce its 2016 National Patient Meeting will be held in Nashville, TN, September 23-25. AAKP is looking forward to returning to Tennessee to build on the excitement, success, and education of last year's meeting. Registration will open soon.

   Quality Insights Renal Network 3
 109 South Main Street, Suite 21
Cranbury, NJ 08512
609-490-0310
888-877-8400 (patients only) 
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