Category: Dialysis

[siteorigin_widget class="SiteOrigin_Widget_Headline_Widget"][/siteorigin_widget] It’s safe to say that the COVID-19 pandemic has required all of us to make adjustments in how we live, interact with one another, and care for ourselves. While we all feel the impact of the coronavirus—through our social lives, our budgets and our work-life balance—people who live with chronic conditions, such as chronic kidney disease (CKD), have had to make unique changes to their daily routines to ensure they stay healthy and continue receiving treatment. The different stages of chronic kidney disease require different levels of care, and as a health care provider, you can help patients develop a plan of action that is both safe and effective. One way providers of CKD patients have been able to save money and stress during the pandemic is by…

[siteorigin_widget class="SiteOrigin_Widget_Headline_Widget"][/siteorigin_widget] In this critical time with COVID-19 spread, everyone needs to be proactive in preventing illness. Older adults, particularly those with chronic conditions are identified by CDC as the vulnerable population to be affected by the virus. ESRD patients are at extremely high risk for this infection due to frequent exposure as they receive dialysis, low immunity associated with ESRD, and lack of knowledge or adequate practice of infection prevention lifestyle. Therefore, it is the responsibility of the dialysis providers to keep your patients safe and healthy. Some of the ways to manage your patients’ care and deflect Emergency Room visits include: • Waiting room: o Encourage your patient to arrive to dialysis clinic on time and avoid having them wait in the waiting room. This will minimize the…

[siteorigin_widget class="SiteOrigin_Widget_Headline_Widget"][/siteorigin_widget] Dealing with distressed patients may be difficult, especially if you’re new to the job. Although it’s understandable why they feel and act the way they do, managing it — along with a slew of other problems the profession brings — is still difficult for any healthcare professional in today's industry landscape. Unfortunately this is going to become more of a common occurrence due to doctor shortages in the US. One reason for this is the increasing number of senior patients which has meant that healthcare institutes are stretched, and this problem will get only worse in the future. Statistics gathered by Maryville University reveal an impending physician shortage of approximately 100,000 by 2025, as well as an increasingly complex healthcare system and rising quality demands from patients and…

[siteorigin_widget class="SiteOrigin_Widget_Headline_Widget"][/siteorigin_widget] The healthcare industry has some of the highest employee turnover rates in the country. Dialysis businesses, specifically, saw even higher turnover rates at greater than 30%. This rate affects operational costs and causes low patient satisfaction and due to longer working hours and lower pay, the rates have unfortunately increased. Monthly Turnover Rate = (Number of Separations During the Month / Average Number of Employees During the Month) x 100 Here are a few ways employers can decrease turnover rates: Spot disengaged employees, work closely with them to improve engagement in their respective roles. Disengaged employees are not only at risk of leaving the company, they could also be disruptive to other staff members.  Tip: Daily huddles could be one of the ways to engage your staff Celebrate…

7 Things You Should Know About ESRD QIP 2019 The Centers for Medicare & Medicaid Services (CMS) manages the End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP) to promote high-quality services in outpatient dialysis facilities. A portion of Medicare payments are directly linked to facilities’ performance on quality of care measures determined by CMS. When a facility’s overall score on applicable measures does not meet established standards, Medicare payment is reduced by 0.5% to 2%, based on the score. To receive a QIP score the facility must treat at least 11 eligible patients and be certified by CMS before June 30 2017. Here are 7 facts you must know about ESRD QIP Score QIP program continues to evolve through the years and common change you notice each year is the…

[siteorigin_widget class="SiteOrigin_Widget_Headline_Widget"][/siteorigin_widget]A Simple Patient-Centered Checklist for your Dialysis Clinic! Has your dialysis clinic established a system of trust with your patients? Lack of trust is a major barrier to patient-centered care. So, if your answer is no or even unsure, here are some ways you could keep your patients happy and decrease grievances: Practice sound follow through:  Hear a patient complaint? Look into it immediately and find the root cause! Develop rounding script as well by encouraging staff to ask 3 to 4 questions that can efficiently elicit patient concerns. When you develop an action plan, make sure the new process will prevent same concerns in the future Invest in a paid or volunteer ‘communication coach’: A communication coach is someone who will (a) focus on patients’ needs, and (b)…

[siteorigin_widget class="SiteOrigin_Widget_Headline_Widget"][/siteorigin_widget]Is Your Dialysis Clinic ESRD Survey-Ready? In order to receive Medicare reimbursement, dialysis facilities must comply with ESRD facility certification requirements. State agencies survey all Medicare-certified facilities for ESRD Conditions for Coverage compliance to ensure that the facility provides quality care to all patients. Being ESRD Survey-Ready means that all functions of your dialysis facility are performing day-to-day activities while maintaining compliance standards and a high quality of care for the patients. Because of changing trends and extensive ESRD survey requirements, preparing properly for the survey could seem like a daunting task for your dialysis team. Understand and apply these helpful tips in order to eradicate doubts and create an effective survey: Create a culture of safety by defining specific behaviors that the dialysis team and patients can practice…

7 Most Likely Reasons for Hospitalizations Among Dialysis Patients According to U.S Renal Data System, End-Stage Renal Disease (ESRD) patients are admitted to the hospital on average nearly twice a year and about 35% of these patients have a re-hospitalization within 30 days following discharge1. This is twice as high as for the patients of same age without ESRD (15%)1. It was also reported that ESRD patients spend on average 11 days in the hospital per year resulting in missing about 5 treatments. Unnecessary hospitalization results in not only a financial burden for the clinic and health system but also poor quality of life for the patients. Some of the reasons for these hospitalizations include: New dialysis patients starting with catheter as dialysis access and/or with fluid overload Poor self-care…

[siteorigin_widget class="SiteOrigin_Widget_Headline_Widget"][/siteorigin_widget]3 Ways to Improve Patient Experience Through ICH CAHPS People receiving in-center hemodialysis (ICH) spend large portions of their time in Medicare-certified dialysis facilities. When patients are involved in their care, the outcomes are far better than when providers make most of the care decisions. Because of this, CMS deemed it important to measure patient experiences through the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) In-Center Hemodialysis Survey. This CMS mandated program that dialysis facilities must implement to survey patients twice a year through a third party vendor has 62 questions and patients can choose to take the survey by phone or on paper. The ICH CAHPS enables patients’ experiences to be given a priority and promotes patient-centered care at dialysis clinics by providing direction to administrators and…

[siteorigin_widget class="SiteOrigin_Widget_Headline_Widget"][/siteorigin_widget] In our value-based American healthcare environment, it is pertinent to focus some attention on our indigent population, or otherwise known as “uninsured and/or low-income”. Approximately 10.2% of the U.S population (non-elderly between the ages of 0 to 64 years) is uninsured. Financial status of patients is integrally entwined with issues that directly affect patient health outcomes. Therefore it is our responsibility as healthcare providers to provide appropriate care for the uninsured or financially challenged patients. Providers are faced with three main choices when caring for indigent populations, they can:   Refer to public clinic or other government funded health system Skip a few tests or therapies as a way of cost containment Offer reduced fee service or waive the charges This article will outline what the first option…

[siteorigin_widget class="SiteOrigin_Widget_Headline_Widget"][/siteorigin_widget] Quality management and performance improvement initiatives, especially in the current value-based environment, are a critical feature of the healthcare landscape. The main functions of a quality manager are: to comply with best practices, reduce costs, gain a competitive advantage, and maintain high-quality standards. Organizations essentially have two options when it comes to quality management: Hiring quality management consultants (outsourcing) Hiring an in-house quality manager Which is a better option? Before answering that, one must address the differences in the working abilities of an in-house quality manager vs a contract based quality consultant. In-house Quality Manager Outsourced Quality Management Services ●      Costly to keep on payroll and to provide benefits that permanent employees receive ●      Monetary investment = unquestioned obedience and loyalty to your company ●      Easily accept work…

[siteorigin_widget class="SiteOrigin_Widget_Headline_Widget"][/siteorigin_widget]4 Ways to Train Staff on Mental Health Competency When Lisa began dialysis, she thought it was the end of the road. She experienced depression while going through her medical journey without her or her healthcare providers ever identifying it as such. According to the Centers for Medicare & Medicaid Services (CMS), one in six Americans experiences a mental health issue any given year. However many people, like Lisa and her healthcare providers, are not well informed on this highly prevalent issue that occurs in 25% of older adults who suffer from one or more chronic health conditions. This can lead to an exacerbation of both the chronic health condition and quality of life, putting healthcare providers at a loss. Staff, who are properly trained in mental health know…

[siteorigin_widget class="SiteOrigin_Widget_Headline_Widget"][/siteorigin_widget] Introduce yourself and your role while caring for dialysis patients at each encounter until the patient knows you Face your patient while speaking, as oppose to the dialysis machine or your note pad. Address with their name frequently to keep them engaged in the conversation While talking or instructing on health related subject, make sure that your body language is projecting the same message. For instance, don’t frown as you say “You look good today!” Address your patient’s needs first and then talk about your agenda about the dialysis treatment. This helps with getting their full attention and in receptive mode Put every request from the patient in writing, whether it is dialysis related or not, so that you understand it correctly and follow through to completion Minimize…

[siteorigin_widget class="SiteOrigin_Widget_Headline_Widget"][/siteorigin_widget] Infections are second leading cause of death and leading cause of hospitalizations in ESRD patients costing about $15,000 per admission (USRDS, 2018). A dialysis catheter puts patient at 7-fold increase in risk of infection versus a permanent access. According to CDC, every fourth Blood Stream infection may result in death. As a result of the above, quality of life is drastically decreased for the patients and their families. Furthermore, Infection is costly to the clinic in the form of missed treatments, increased staff hours, and lower QIP score. Why are Dialysis Patients At Risk For Infections? Dialysis process requiring the use of needles and catheters, provides direct access to blood and thereby increases the chance of infection. Weakened patient immunity and exposure to highly infectious places such as…

[siteorigin_widget class="SiteOrigin_Widget_Headline_Widget"][/siteorigin_widget] Daily huddles are effective in patient care and has been practiced in hospitals and other healthcare systems to provide good quality patient care. It helps the team communicate more efficiently and be involved in all things that matter in caring for the patients. It also promotes teamwork among the first-line staff and the leadership. With that being said here are some tips on how to conduct daily hurdles that are effective and efficient. 1. Keep them short, preferably 15 minutes or less. You lose the attention of your people with longer meetings or long discussions. 2. Set the time to discuss per patient or per topic. For example, allot five minutes to discuss hospitalizations for that day and five minutes for no-shows. 3. Keep the agenda consistent so…

[siteorigin_widget class="SiteOrigin_Widget_Headline_Widget"][/siteorigin_widget] Medical errors are the third leading cause of death in United States1. These adverse events are costly to your center and deadly to your patients. Most common reasons for medical errors are poor communication, inadequate training, taking short cuts on job, and multitasking. In a survey of dialysis professionals2, 43% reported a patient being given the wrong medicine or medicine at the wrong time, and 63% reported a patient not receiving a medication at all. Here are 10 ways to prevent medical errors: Survey your patients and staff for any errors they witnessed. List the reported errors and talk with your team for possible ways to correct them Follow Policies and Procedures manual – Take time to read policies concerning patient care and understand the proper way of…

Six ways to optimize processes and improve patient outcomes Health is affected by five domains - genetics, social circumstances, environmental exposures, behavioral patterns, and health care. Yet, when we care for our patients, we consider only what meets the eye. This is because our healthcare delivery is organized around clinicians’ skillset rather than around patients’ needs. To improve the quality of service and efficiency of care delivery, we need to be customer oriented, just as the American businesses today. Drs. Porter and Lee said that “Reorganizing around the needs of groups of patients with particular needs, in the same way businesses reorganized around particular customers’ needs, is the future of healthcare.” The six steps to meet the needs of your patients and improve clinical and operational outcomes include: Recognize the needs…

-Decrease Missed Treatments For decades, the healthcare industry has been using Six Sigma method to improve patient safety and operational efficiency, while decreasing costs and increasing revenue. Missed dialysis treatments, a common problem among dialysis patients, is expensive for the facility and potentially fatal for the patients. The most common reasons for patients missing a treatment or reducing their time on dialysis are: health issues, boredom from the routine, transportation issues and schedule conflicts. With this in mind, here is how you could apply the Six Sigma DMAIC (Define, Measure, Analyze, Improve and Control) quality improvement model to tackle these issues and ensure patients are present for their treatments: Define: Assemble a team to define the problem – why are your patients missing treatment? Determine the patients’ reasons or concerns.…

- Hemodialysis or Peritoneal Dialysis? In-center hemodialysis remains the leading dialysis choice among patients in the U.S. However, research suggests that if a higher percentage of these patients were on peritoneal dialysis, they would benefit from lower infection rates, better survival rates and improved quality of life, especially in the first four months of treatment. The cost of care per patient decreases with peritoneal dialysis, most significantly due to staffing needs. According to USRDS Annual Data Report, the cost savings of peritoneal dialysis treatment, when compared to hemodialysis, is 13 to 30%, based on the volume and services provided at the center. In spite of these benefits for the center and patient, over 90% of the patients are receiving hemodialysis as treatment of choice. Here are some of the reasons…

[siteorigin_widget class="SiteOrigin_Widget_Headline_Widget"][/siteorigin_widget] A simple checklist in patient satisfaction for dialysis patients A survey of small sample of dialysis professionals in 2016 identified that trust between the patient and provider was a major barrier to patient centered care. Staff inattentiveness and lack of staff sensitivity (poor customer service skills) was perceived as another major reason for patient dissatisfaction with their care provider. Here are some ways you could keep your patients satisfied and improve your CAHPS score: Practice sound follow through- investigate every patient grievance to find the root causes and then put processes in place to prevent such concerns in the future Invest in a paid or volunteer ‘communication coach’- appoint someone at the center to be the point person who (a) spends some time every day or week to…

[siteorigin_widget class="SiteOrigin_Widget_Headline_Widget"][/siteorigin_widget] Tips for dialysis facility administrators to plan a successful ESRD Survey To receive Medicare reimbursement, dialysis facilities must comply with ESRD facility certification requirements. State agencies survey all Medicare certified facilities for compliance with standards including ESRD Conditions for Coverage, and to ensure that the facility provides quality care to all patients. Being ESRD Survey-Ready means that all functions of your dialysis facility are performing day-to-day activities while maintaining compliance and a high quality care for the patients. Preparing for the survey could create anxiety for the dialysis team, but it does not have to be a daunting task despite changing trends and ESRD survey requirements. Here a few things you could do to be Survey-Ready: Create a culture of safety by defining specific behaviors that the dialysis…

[siteorigin_widget class="SiteOrigin_Widget_Headline_Widget"][/siteorigin_widget] Quality Management (QM) and Performance Improvement initiatives have always been a part of healthcare, but have become increasingly important as we shift to a value-based environment. A good QM team will ensure that your facility complies with best practices, reduces costs, gains a competitive advantage, and maintains high quality standards. As an administrator, you may be wondering if it is more efficient to rely on an in-house quality manager or an external QM consultant. Does the choice depend on the size, culture, or operations of my business? Is the answer the same for every organization? While cost is an obvious factor, there are pros and cons to both maintaining internal staff and outsourcing. Further, it is possible to outsource some portions of QM without outsourcing the whole thing.…