Thank you for Joining Us! The Meeting Will Begin Shortly. 1 - - PowerPoint PPT Presentation

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

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Patient Advisory Committee (PAC) Facility Representative Orientation

Wednesday, February 27, 2019

Meeting Reminders

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• 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

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Participant Attendance Check-In

Agenda Topics

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

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Network Background

Sarah Keehner, RN, BSN, CNN Quality Improvement Director

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18 ESRD Networks

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

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State ESRD Patient Census # of Dialysis Facilities # of Transplant 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

Network Demographics Who is Impacted by Network Activities?

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Network 1 Staff

Brittney Jackson, LMSW, MBA Patient Services Director 203-285-1213 bjackson@nw1.esrd.net Merari Rosario, MHA Community Outreach Coordinator 203-285-1223 mrosario@nw1.esrd.net

1952 Whitney Avenue, 2nd Floor, Hamden, CT 06517 Phone: (203) 387-9932 Fax: (203) 389-9902

Network Staff Patient Services Department

• p. 11

Sarah Keehner, RN, BSN, CNN Quality Improvement Director 203-285-1214 skeehner@nw1.esrd.net Nadine Caruthers, LPN Quality Improvement Coordinator 203-285-1224 ncaruthers@nw1.esrd.net

1952 Whitney Avenue, 2nd Floor, Hamden, CT 06517 Phone: (203) 387-9932 Fax: (203) 389-9902

Network Staff Quality Improvement Department

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ESRD Statement of Work (SOW)

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

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

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Questions? Comments?

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Patient Advisory Committee (PAC)

Merari Rosario, MHA Community Outreach Coordinator

Patient Advisory Committee Mission

• To identify and act upon issues of

concern to ESRD patients, thereby improving their quality of life

Patient Advisory Committee Structure and Function

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• 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

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

Patient Advisory Committee 2019 Goals

• p. 21
• 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

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

• Registration required
• Certificate of completion

provided

• p. 22

https://esrdlms.ipro.org

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National Coordinating Center (NCC) Events

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)
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Questions? Comments?

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Facility Performance

Sarah Keehner, RN, BSN, CNN Quality Improvement Director

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

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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

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Questions? Comments?

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Emergency Preparedness

Merari Rosario, MHA Community Outreach Coordinator

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

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

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
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Patient and Family Engagement (PFE)

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

Technical Assistance Plan How Can Patients Help Support Activities?

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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

Questions? Comments?

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Quality Improvement Activities (QIAs)

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Bloodstream Infection Reduction

Nadine Caruthers, LPN Quality Improvement Coordinator

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

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Patient Safety How Can Patients Help Support Activities?

• p. 41

Patient can assist facilities in infection prevention in may ways! Facilities are encouraged to include patients in:

• Hand hygiene audits
• Patient can observe staff and other patient
• Peer to Peer education
• Assist in a infection prevent hand hygiene demonstration
• Review education resource with other patient in the facility
• Providing feedback to facility leadership
• Join a month Quality Assurance/ Performance Improvement

Meeting (QAPI)

• Providing feedback to Network staff

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Long-Term Catheter Reduction

Patient Safety Long Term Catheter (LTC) Reduction

Goal is for facilities with high BSI rates to reduce catheter use by 2% by September 2019

• Facility data is provided by CROWNWeb

Facilities responsibilities include:

• Assisting patient with making appointment with

vascular surgeon

• Proper catheter care to reduce the chance of

infection

• Patient education on vascular access options
• p. 43

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Home Dialysis

Utilization of Home Dialysis Increasing the use of Home Dialysis

Goal is to increase the number of patients who start a home modality by 2% by October 2019

• Data for this project is form

CROWNWeb.

Facilities responsibilities include:

• Patient and staff education
• Track patient using CMS step data
• Hosting Lobby day
• Find a new facility for patient who

want to start a home modality if they can not stay at their current facility

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Utilization of Home Dialysis Increasing the use of Home Dialysis

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Patient can assist facilities in educating other patients Facilities are encouraged to include patients in:

• Peer to Peer education
• Join a work group to create resource materials
• Providing feedback to facility leadership
• Join a month Quality Assurance/ Performance

Improvement Meeting (QAPI)

• Discuss issues that are keeping patient from choosing

a home modality

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Improving Transplant Coordination

Improving Transplant Coordination Increasing Patient on the Waitlist

Goal is to increase the number of patients on the transplant waitlist by 2% by October 2019

• United Network for Organ Sharing

(UNOS) Data will tell us the number of patient who get on the transplant waitlist

Facilities responsibilities include:

• Patient and staff education
• Communicating with transplant centers
• Helping patients organize doctor

appointments

• Tracking patient progression

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Improving Transplant Coordination Six (6) Step to Success

Track and report to CMS the number of patients in each of 6 steps each month:

1. Patient interest in transplant 2. Referral call to transplant center 3. First visit to transplant center 4. Transplant center work-up 5. Successful transplant candidate 6. On waiting list or evaluate potential living donor

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Improving Transplant Coordination How Can Patients Help Support Activities?

• Help us create recourses for patients
• Encourage other patients within your

unit to explore their options, and ask questions

• Help host a lobby day and talk about

transplant process and options

• Communicate with the network and let

us know what educational materials and recourses your unit is giving to you

• Be a leader, role model, and peer

mentor

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Questions? Comments?

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Population Health Focused Pilot QIA (PHFPQ)

Merari Rosario, MHA Community Outreach Coordinator

Population Health Focused Pilot QIA (PHFPQ) Vocational Rehabilitation (VR)

Goal is to increase referrals to VR agencies by 10%.

• Facilities report patient status data CROWNWeb)

Facilities responsibilities include:

• Assessing current referral process in the dialysis

facility

• Evaluating changes in life events that could

change receptiveness to VR

• Collaborate with vocational rehabilitation agencies

to advocate on behalf of ESRD patients

• p. 53

Population Health Focused Pilot QIA (PHFPQ) How Can Patients Help Support Activities?

• Increase awareness of VR and help to change the dialysis facility

culture

• Share VR resources and goal setting tools with other patients
• p. 54

Questions? Comments?

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Meeting Summary Important Take Away Items

• The Network is excited to partner with patients in their healthcare
• Patients play an important role in the success of QIAs

– The Network will be calling on PAC Facility Representatives to help develop patient-centered resources

• Patients should be aware of facility responsibilities for providing

good quality of care

– The Network will be calling on PAC Facility Representatives for feedback on local activities

• p. 56

Thank you for Joining Us! We are looking forward to working with all of you.

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Presentation Template Draft for Review

April 6, 2017

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Corporate Headquarters 1979 Marcus Avenue Lake Success, NY 11042-1002 www.ipro.org

For more information:

Sarah Keehner, RN, BSN, CNN Brittney Jackson, LMSW, MBA Quality Improvement Director Patient Services Director (203) 285-1214 (203) 285-1213 skeehner@nw1.esrd.net bjackson@nw1.esrd.net Nadine Caruthers, LPN Merari Rosario, MHA Quality Improvement Coordinator Community Outreach Coordinator 203-285-1224 203-285-1223 ncaruthers@nw1.esrd.net mrosario@nw1.esrd.net