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Thank you for Joining Us! The Meeting Will Begin Shortly. 1 Patient Advisory Committee (PAC) Facility Representative Orientation Wednesday, February 27, 2019 2 Meeting Reminders Please mute your phone when not speaking to avoid


  1. Thank you for Joining Us! The Meeting Will Begin Shortly. 1

  2. Patient Advisory Committee (PAC) Facility Representative Orientation Wednesday, February 27, 2019 2

  3. Meeting Reminders • Please mute your phone when not speaking to avoid background noise • Be present and engaged • Be prepared for active participation and open discussion • Be mindful of muting your phone when not speaking 3

  4. Participant Attendance Check-In 4

  5. Agenda Topics • Network Background • National Coordinating Center (NCC) Events • Patient Advisory Committee (PAC) • Emergency Preparedness • Facility Performance • Patient and Family Engagement (PFE) • Quality Improvement Activities (QIAs) 5

  6. Network Background Sarah Keehner, RN, BSN, CNN Quality Improvement Director 6

  7. 18 ESRD Networks 7

  8. What Does the Network Do? • Assists facilities in improving quality of care • Provide assistance to patients and providers • Encourage patient engagement • Evaluates and resolves patient grievances • Support emergency preparedness and disaster response p. 8

  9. Network Demographics Who is Impacted by Network Activities? ESRD Patient # of Dialysis # of Transplant State Census Facilities Facilities Connecticut 4,358 51 2 Maine 1,109 19 1 Massachusetts 6,975 87 9 New Hampshire 1,069 20 1 Rhode Island 1,143 17 1 Vermont 351 8 1 TOTAL 15,005 202 15 Data Source: CROWNWeb 9 9

  10. Network 1 Staff 10

  11. Network Staff Patient Services Department Merari Rosario, MHA Brittney Jackson, LMSW, MBA Community Outreach Coordinator Patient Services Director 203-285-1223 203-285-1213 mrosario@nw1.esrd.net bjackson@nw1.esrd.net 1952 Whitney Avenue, 2 nd Floor, Hamden, CT 06517 Phone: (203) 387-9932 Fax: (203) 389-9902 p. 11

  12. Network Staff Quality Improvement Department Nadine Caruthers, LPN Sarah Keehner, RN, BSN, CNN Quality Improvement Coordinator Quality Improvement Director 203-285-1224 203-285-1214 ncaruthers@nw1.esrd.net skeehner@nw1.esrd.net 1952 Whitney Avenue, 2 nd Floor, Hamden, CT 06517 Phone: (203) 387-9932 Fax: (203) 389-9902 p. 12

  13. ESRD Statement of Work (SOW) 13

  14. ESRD Statement of Work December 2018 - November 2019 Background & Purpose • Assigns tasks to be completed by each of the 18 ESRD Networks • Was developed in 1986 as part of the Social Security Act and the Omnibus Budget Reconciliation Act • Projects are designed to support national quality improvement goals • Tasks in this SOW are intended to align Network activities with Centers for Medicare & Medicaid Services (CMS) goals p. 14

  15. ESRD Statement of Work December 2018 - November 2019 CMS Goals 1. Empower patients and doctors to make decisions about their health care 2. Usher in a new era of state flexibility and local leadership 3. Support innovative approaches to improve quality, accessibility, and affordability 4. Improve the CMS customer experience p. 15

  16. Questions? Comments? p. 16

  17. Patient Advisory Committee (PAC) Merari Rosario, MHA Community Outreach Coordinator 17

  18. Patient Advisory Committee Mission • To identify and act upon issues of concern to ESRD patients, thereby improving their quality of life

  19. Patient Advisory Committee Structure and Function • PAC representatives are ESRD patients or family members, who volunteer their time as a subject matter expert (SME) to: – Promote communication between patients and staff – Inform patients about the ESRD Network – Serve as a link between patients and the ESRD Network • Chairperson: John Visone p. 19

  20. Patient Advisory Committee Structure and Function PAC Activities • Recruitment activities – Site Visits – Conference Calls – Referrals • Patient and Family Engagement – Lobby days – Peer Mentoring • Collaboration – Collaborating with Leadership at the facility level – National Coordinating Center (NCC) Collaboration p. 20

  21. Patient Advisory Committee 2019 Goals • Increase training for PAC members • Increase awareness about PAC and the Network • PAC Representatives to continue participating in regional and national conference calls • Encourage regularly scheduled meetings with staff and patients • Increase PAC membership on the closed Facebook group • Solicit articles for PAC Speaks, patient newsletter, about a personal experience p. 21

  22. Peer-to-Peer Mentoring E-University Background • Online learning system that provides training for ESRD patients and professionals that align with CMS goals • Training empowers patients to engage their peers in their healthcare https://esrdlms.ipro.org • Registration required • Certificate of completion provided p. 22

  23. National Coordinating Center (NCC) Events 23

  24. National Coordinating Center (NCC) Learning and Action Networks (LAN) National Patient and Family Engagement Learning and Action Networks (NPFE-LAN) Affinity Groups • Patient Experience of Care • Bloodstream Infections (BSI) • Home Modalities • Patient and Family Engagement (PFE) • Transplant Coordination • Population Health Focused Pilot QIA (PHFPQ) p. 24

  25. Questions? Comments? p. 25

  26. Facility Performance Sarah Keehner, RN, BSN, CNN Quality Improvement Director 26

  27. Quality Incentive Program (QIP) What is the QIP? Quality Incentive Program • The QIP is a “pay -for performance” program • Facilities receive financial reimbursement based on their QIP Score Facility’s QIP Performance Score Certificate must be posted in a “visible location” in the facility p. 27

  28. Quality Incentive Program (QIP) Dialysis Facility Compare DFC Website is a Medicare run website that allows patient to compare dialysis facility in the same area p. 28

  29. Questions? Comments? p. 29

  30. Emergency Preparedness Merari Rosario, MHA Community Outreach Coordinator 30

  31. Emergency Preparedness What Should Facilities Do? Facility Responsibilities • Review facility disaster plan • Update patient information • Provide patients with backup facility • Provide patients with copy of most recent dialysis orders • Emergency dialyze schedule • Coordinate transportation • Ensure an effective communication plan p. 31

  32. Emergency Preparedness What Should Patients Know and Do? Patient Responsibilities • Learn evacuation zone your home • Learn your dialysis facility’s emergency policies • Update your emergency contact information at the facility • Gather emergency supplies • Obtain emergency diet for dialysis patients • Plan for back-up transportation to dialysis p. 32

  33. Emergency Preparedness What Should Patients Know and Do? Patient Responsibilities • Get a list of dialysis facilities and hospitals in the area • Ask your social worker about “special shelters” • Write down toll-free numbers to call for dialysis after the event (if your facility is closed) • Listen to local TV and radio for “dialysis updates” • Peritoneal dialysis patients supplies • Transplant patients medicine need p. 33

  34. Patient and Family Engagement (PFE) 34

  35. Technical Assistance Plan Increasing Patient and Family Engagement Goals for Facilities • Support groups/new patient adjustment groups • Incorporate patient, family and caregiver participation into the Quality Assurance Performance Improvement (QAPI) Program and governing body of the facility • Develop policy and procedures related to patient, family and caregiver participation in the patient’s care p. 35

  36. Technical Assistance Plan How Can Patients Help Support Activities? Patient can assist facilities in patient and family engagement in may ways! • Work with staff to determine patient interest in support group • Educate/Inform other patients about the support group • Work with staff to determine possible topics for the meetings • Share tools and resources • Request to participate in monthly QAPI meetings at the facility • Provide suggestions and/or concerns to the staff for review • Educate yourself and encourage others to take an active role in their care p. 36

  37. Questions? Comments? p. 37

  38. Quality Improvement Activities (QIAs) 38

  39. Bloodstream Infection Reduction Nadine Caruthers, LPN Quality Improvement Coordinator 39

  40. Patient Safety Bloodstream Infection (BSI) Reduction Goal is to reduce the bloodstream infection by 20% from last year. • Facilities self report data in a National Healthcare Safety Network (NHSN) Facilities responsibilities include : • Patient and staff education • Monthly reporting of BSI • Conduct monthly audit • Utilize all Centers for Disease Control and Prevention (CDC) core intervention • Include patients in Network activities 40

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