IPRO ESRD Network of the South Atlantic Patient Advisory ......Role of the Network ... who volunteer...

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Transcript of IPRO ESRD Network of the South Atlantic Patient Advisory ......Role of the Network ... who volunteer...

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IPRO ESRD Network of the

South Atlantic Patient Advisory Committee

(PAC) Facility Representative

Orientation Call

• The webinar will begin momentarily!

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Patient Advisory Committee (PAC)

Facility Representative Orientation

Monday, March 21st 2019

Housekeeping Rules

p. 3

All lines are currently muted except for the presenter.

There will be breaks and lines will be unmuted for open discussion and questions:

• Mute your own phone if you are not speaking to eliminate background noise

• Be prepared for sharing and actively participating in the open discussion

• Be mindful of others and allow one person at a time to speak.

• Be forthcoming in discussing obstacles and barriers in achieving PAC goals

• Stay open-minded to strategizing new ideas or recommendations

• Share your thoughts and suggestions!

Housekeeping Rules

p. 4

You can submit questions and comments via chat or Q&A at any time

Let’s Practice!

What are you doing for national kidney month?

Agenda Topics

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• Network Overview

• Patient Advisory Committee (PAC) Overview

• Quality Improvement – Why is it important?

• How YOU can be the difference!

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Network

Background

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ESRD Networks

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ESRD Network Structure

Centers for Medicare & Medicaid Services (CMS)

• Sets goals to improve the care of patients in ESRD

18 ESRD Networks

• Works with facilities and patients in their region to

design programs to help reach regional and

national improvement goals

ESRD National Coordinating Center

• Works with ESRD Networks, CMS, and Patient

Subject Matter experts to support the goals and

share information on a national level

Centers for Medicare & Medicaid Services

18 ESRD Networks

ESRD National Coordinating Center

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233 Facilities

18,310 Patients

5 Transplant Ctrs

155 Facilities

10,219 Patients

1 Transplant Ctrs

368 Facilities

21,403 Patients

4 Transplant Ctrs

IPRO ESRD Network 6 Service Area

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Role of the Network

• Improve quality of care for ESRD patients

• Provide assistance to ESRD patients and providers

• Encourage patient engagement

• Evaluate and resolve patient grievances

• Collect data to measure quality of care

• Support emergency preparedness and disaster

response

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Network Staff Patient Services Department

Chanell McCain

Patient Services Director

Jenna Huff

Community Outreach

Coordinator

Network Staff Quality Improvement Department

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Alexandra Cruz

Quality

Improvement

Coordinator

Loretta Ezell

Quality

Improvement

Director

Michelle Lewis

Quality

Improvement

Coordinator

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Patient Advisory

Committee (PAC)

Chanell McCain

Patient Services Director

Jenna Huff

Community Outreach Coordinator

Patient Advisory Committee (PAC)

The PAC is an organized group of patients and/or family members

who volunteer their time to represent the Network in their dialysis or

transplant facility, and also represent their facility to the Network

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Tier 1 PAC Member Roles and

Responsibilities

Individuals who are interested in learning about

becoming better advocates for their care.

Ideal for those who are interested in learning more

about ESRD and the ESRD Network.

They will be encouraged to:

• Take an active role as a member of their healthcare team

• Educate themselves about renal disease and treatment options

• Take advantage of additional training to increase their level of

involvement with the Network.

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Tier 2: PAC Facility Representatives

Roles and Responsibilities

Works with their facility and the Network to focus on key areas

that are important to improve the health and safety of kidney

patients at their facility.

Provides a link between patients and facility staff to encourage

other patients to take an active role in their healthcare by:

• Share information provided by the Network or facility with other patients

• Provide the patient perspective by participating in quality improvement

activities and share your feedback with facility leadership

• Collect ideas from other patients on ways to educate and support

patients, providing this information to the facility and the Network

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Tier 3: PAC Advisors Roles and

Responsibilities:

Support PAC Facility Representatives and are available

to answer questions and give advice as needed.

They may also function as Network board

representatives or members of national patient groups to:

• Provide the patient perspective in local and national QI projects

• Coordinate social or educational functions aimed at increasing

awareness of ESRD

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Quality Improvement

Why is it important?

Loretta Ezell

Quality Improvement Director

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What are quality measures and why are

they important?

CMS defines Quality Measures as:

Tools that help us measure or quantify healthcare processes,

outcomes, patient perceptions, and organizational structure and/or

systems that are associated with the ability to provide high-quality

health care and/or that relate to one or more quality goals for health

care.

Simply put, this means that systems are put in place to ensure:

The Right Care for Every Patient Every Time.

p. 20

• Reducing the number of patients who have a blood stream

infections

• Reduce the number of patients using a long term catheter access

• Increase patient awareness about home treatment options

• Increase patient awareness of transplant treatment options

• Increase patient awareness of vocational rehab resources to assist

with returning to work

CMS Quality Improvement Focus Areas for 2019

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How Coaches help Patients Get

Involved

Patient Engagement

Activity

QAPI, Support Group, Peer Mentorship

Program

Share information with other patients and their family/caregiver

Patient Facility Representative

Project Lead

Patient Health Coach

Provide feedback to facility leadership

Working Together to Improve Quality

Improved patient experience of care & quality of life

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Increase Rates of Patients Dialyzing at

Home Criteria:

• Identify 30% of dialysis facilities to participate (231

Facilities)

Network/Facility Goal:

• Demonstrate a 2 percentage point improvement in the

natural trend of patients using a home modality

National Goal:

• By 2023 increase the number of ESRD patients dialyzing at

home to 16% from the 2016 national average of 12%

12.0% 16.0% 5 Year

Goal

2

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Current Dialysis Treatments types in the United States

88% In-Center Dialysis

10% Peritoneal Dialysis

2% Home Hemodialysis

2016 Chronic Kidney Disease (CKD) Centers for Medicare & Medicaid Services (CMS).

The

current

national

average of

patients

dialyzing

at home is

only 12%

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Home Dialysis Facts

• It is a requirement by Medicare that

ESRD patients receive treatment

option education at least once per

year.

• When surveyed 32% of patients

responded they were not informed or

educated on all treatment options.

• Treatment options include:

• In-Center Hemodialysis

• Home Treatment – Peritoneal

Dialysis

• Home Treatment – Home

Hemodialysis

• Transplant

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Increase Rates of Patients on Transplant

Waitlist

Criteria:

• Identify 30% of dialysis facilities to participate (231 Facilities)

Network/Facility Goal:

• Demonstrate a 2 percentage point improvement in the natural trend

of patients on the waitlist or being evaluated for living donor

National Goal:

• By 2023 increase the number of ESRD patients on the transplant

waitlist to 30% from the 2016 national average of 18.5%

18.5% 30% 5 Year

Goal

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Transplant Statistics

750,000 people affected by ESRD in the US

100,000 ESRD patients on waitlist

UCSF- The Kidney Project -2016

20,161 ESRD patients transplanted

The current

national

average of

patients on

the transplant

waitlist is only

18.5%

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Kidney Transplant Options

The benefits of transplantation extend to ESRD patients regardless of age,

gender, or ethnicity, or conditions like diabetes and hypertension.

Transplant Centers have different criteria for determining waitlist eligibility

Benefits

• Improved health and quality of life.

• Greater freedom (no dialysis treatments)

• Increased energy levels

• Fewer diet restrictions

Considerations

• Surgery recovery

• Possible kidney rejection

• Anti-rejection medication needed to maintain transplanted kidney

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Reducing the rates Blood Stream Infections

Criteria:

• Identify 50% of dialysis facilities to participate (376 Facilities)

Network/Facility Goal:

• Demonstrate a 20% or greater reduction in the rates of blood

stream infections

National Goal:

• By 2023 reduce the rates of blood stream infections in dialysis

patients by 50% that occurred in 2016

50%

Reduction

5 Year

Goal

Reducing Blood Stream Infections

• Infections are the second leading

cause of death in patients with ESRD

• The majority of blood stream

infections are catheter related BSIs

• Reducing BSIs reduces

hospitalization and improves quality

of life

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Reducing the rates Long Term Catheters

Criteria:

• Identify 20% of dialysis facilities with the highest infection

rates to participate

Network/Facility Goal:

• Demonstrate a 2% or greater reduction in the rates of long

term catheters

National Goal:

• By 2023 achieve less than 10% of long term catheter

accesses in dialysis patients

10.6% <10% 5 Year

Goal

p. 31

Advantages and Disadvantages of Vascular

Access Types

Choosing a vascular access is

important, it is a Lifeline for a Lifetime

Benefits BSI and Long Term

Catheter Reduction

The benefits of BSI and Long term catheter reduction

include:

BSI Reduction

• Reduced hospitalizations

• Improved quality of life

LTC Reduction

• Fewer catheter related infections

• Better dialysis clearance

• Freedom to shower and swim

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3

3

Population Health Focused Pilot QIA (PHFPQ) Vocational Rehabilitation

ESRD Beneficiaries between the

ages of 18 and 54 may be eligible to

receive free services including:

• Job training

• Career counseling

• Vocational rehabilitation

• Job placement

• Ongoing support services

necessary to achieve a work goal

Questions? Comments?

p. 34

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Patient Facility

Representatives

How you can make a

difference!

Chanell McCain

Patient Services Director

Jenna Huff

Community Outreach Coordinator

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Facility participation in Quality

Improvement:

Your facility is participating in an ESRD Network Quality Improvement

project in one of these areas

To reach their quality improvement goal and the improvement goals at a

national level, we must partner with patients like you!

Your facility has committed to engaging patients and has identified you as

their representative to work together in one of the following focus areas:

• Patient Peer Mentorship

• Creating a Patient Support Group

• Incorporating Patient Representation in the facility

Quality Assurance Performance Improvement (QAPI)

meetings

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Working together to improve quality

Patient Engagement

Strategy

Patient Facility Representative

Project Lead

Patient Health Coach

Share Information with other Patients

Provide feedback to facility leadership

p. 38

Patient Peer Mentorship Program

Peer mentoring provides

support and increases the

confidence that many new

patients need, and offers

patients access to someone

who has been through

the similar experiences and

can understand their concerns

one on one.

p. 39

Training Modules

• Mentoring to Support Choices

• Talking Effectively with Another

Patient

• Discussing Home Dialysis as an

Option

• Discussing Transplant as an

option

• Helping Peers Plan for a

Vascular Access

E-University

• Online training platform

Peer Mentor Training Program

p. 40

Training courses are designed to

help patients to:

Learn how to become a

leader at the facility and the importance of

patient engagement.

Access educational

resources on kidney care

choices.

Understand how with

communicate with peers and

keeping information confidential.

Understand peer mentoring and how their role as a peer

will make a difference.

Patient and Family Support Groups

An opportunity for people with kidney disease

to meet on a regular basis to:

• Share common concerns and issues

• Provide support and encouragement

• Learn about kidney disease research,

treatment options and services

• Discuss coping skills due to the effects of

kidney disease

• Empower each other to take an active role in

managing their care

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Popular Topics for Kidney Support

Group Meetings

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• Modality Choices

• Minimizing Problems of Long Term Dialysis

• Going Back to Work

• Coping with the Renal Diet

• Learning How Others Have Successfully Lived with ESRD

• Communicating with Your Physician

• Planning vacations

• Holiday Recipes

• Travel

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Quality Assurance and Performance

Improvement (QAPI)

QAPI is a data-driven, proactive approach

to improving the quality of life, care, and

services for patients in your facility.

Involves members at all levels of the

organization to:

• identify opportunities for improvement

• address gaps in systems or processes

• develop and implement an improvement or

corrective plan

• continuously monitor effectiveness of

interventions.

Patient or Family Member

Medical Director

Nephrologist

Social Worker

Special Project Leads

Dietician

Registered Nurse

Getting involved in QAPI

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Patients have unique skills and perspectives

that other members of the team do not….

Ideal QAPI Patient Facility Representatives

are those who can:

• Demonstrate interest in partnering with the

facility and providing constructive feedback

• Work well with staff and other patients

• Are able to share insights about their

experiences in ways that others can learn

from.

• Listen well and respect the opinions of

others.

• Are comfortable speaking with leadership.

Explains the patient

role in QAPI

Common Goal: Share information

with others at your facility

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• Become familiar with educational

resources provided by your facility

or available from the ESRD

Network

• Share this information with others

at your facility

• Encourage others to be active in

their healthcare and talk with their

healthcare team about their options

Questions? Comments?

p. 46

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Next Steps

Chanell McCain

Patient Services Director

Jenna Huff

Community Outreach Coordinator

How do I get started?

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• Review the Patient Advisory

Committee Welcome Booklet

• Meet with your facility quality

improvement project lead,

social worker, or patient health

coach

• Discuss your focus area and

ways that you may be able to

partner with the facility to

achieve focus area goals

How do I get started?

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• Work with your facility to create

an education station

• Education Station Tips:

• Reserve a space in the lobby

• Develop a mobile resource cart

• Use colorful, eye catching

materials

• Display patient success stories

throughout the unit

• Use balloons, flags or signs to

draw attention to your space

Ridgeland Dialysis

Share your success and challenges

with the ESRD Network

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The ESRD Network will contact you either by phone,

text or email depending on your preference and ask

you to respond about your participation in activities at

your facility and to invite you to follow up meetings.

The phone number will be: 1-800-524-7139

The text number will be: 1-866-708-4369

The email address will be: info@nw6.esrd.net

Mark Your Calendar for future calls!

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The Patient Advisory Committee meets every other month to

exchange ideas, discuss challenges and learn about our

progress in achieving our state, regional, and national goals.

List of PAC Meeting Dates:

Wednesday, May 15th from 5:00-6:00pm

Wednesday, July 17th from 5:00-6:00pm

Wednesday, September 18th from 5:00-6:00pm

• Please make sure you have signed the patient confidentiality form. We

must have this on file to invite you to future meetings.

p. 52

ESRD Network of the South Atlantic (Network 6) Staff

Shannon Wright Executive Director swright@nw6.esrd.net Emily Watson Administrative Coordinator ewatson@nw6.esrd.net Loretta Ezell Quality Improvement Director lezell@nw6.esrd.net Michelle Lewis Quality Improvement Coordinator mlewis@nw6.esrd.net Alex Cruz Quality Improvement Coordinator acruz@nw6.esrd.net

Chanell McCain Patient Services Director cmccain@nw6.esrd.net Jenna Huff Community Outreach Coordinator jhuff@nw6.esrd.net Jaya Bhargava Operations Director jbhargava@nw1.esrd.net Ben Williams Data Analyst bwilliams@nw6.esrd.net Jasmine Taborn Data Coordinator jtaborn@nw6.esrd.net

Questions? Comments?

p. 53

Presentation Template

Draft for Review

April 6, 2017

p. 1

Corporate Headquarters

1979 Marcus Avenue

Lake Success, NY 11042-1002

www.ipro.org

For more

information:

Website: https://network6.esrd.ipro.org/

Email Address: info@nw6.esrd.net

Patient Toll Free Number: 800-524-7139