You are here: Home >
The goals and recommendations listed below were adopted by the MARC Board of Directors to focus Network 5 activities during 2007-2009. In addition to the areas addressed below, the Medical Review Board will examine other quality indicators (such as patient grievances, hospitalization, mortality, etc.), and conduct improvement initiatives as indicated.
Click here to download a PDF version of the 2007-2009 Goals and Recommendations.
Adequacy
Conflict Resolution
Disaster Preparedness
Facility Quality Program
Patient Safety
Preventive Care
Transplantation
Vascular Access
End of Life
Goals
1. Adequate Dialysis for Adult Patients
2. Anemia Management for Adult Patients
3. Vascular Access for Adult Patients
Recommendations
1. Adequacy
2. Conflict Resolution
3. Disaster Preparedness
4. Facility Quality Program
- Quality improvement activities at the facility level enhance the facility’s ability to provide high quality care, and, to meet and/or exceed Network 5 goals. All Network 5 providers are urged to
-Have an operational quality improvement program with active physician involvement; and,
-Engage in unit-specific, internally driven, quality improvement projects.5. Patient Safety
6. Preventive Care
- Dialysis facilities are urged to embrace a “culture of safety” and initiate specific measures to enhance safety such as maintain an updated patient medication list, use a standardized abbreviation list,use stickers to warn of allergies and/or anticoagulation therapy (in addition to treatment-related heparin),post a list of “drugs to avoid in ESRD patients” in the dialysis unit, and track adverse effects/incidents.
7. Transplantation
- All ESRD patients should be vaccinated against influenza, hepatitis B, and pneumococcal pneumonia, in accordance with ACIP and CDC recommendations.
- All ESRD providers should offer annual influenza vaccination.
- At least 90% of medical caregivers should receive HBV vaccination, or have HBV antibodies.
- Adult and adolescent patients should be evaluated for dyslipidemias at least annually in accordance with K-DOQI Practice Guidelines.
- Smoking cessation materials should be offered to all ESRD patients who use tobacco.
8. Vascular Access
- All facilities should monitor the transplant status of patients to ensure that <5% have no transplant status established.
- 100% of dialysis facilities should have a written policy defining delivery of transplant information to all patients, including: when transplant information will be presented to new patients, what tools (brochures, video) are used, and who conducts annual follow-up education/contact with patient.
- 100% of dialysis facilities should designate one staff member to serve as the transplant liaison to oversee transplant education, evaluation referrals, submission of laboratory samples, and patient status changes.
- 100% of Network 5 transplant centers will provide written kidney transplant inclusion and exclusion criteria to dialysis facilities referring patients for transplant evaluation or transplant centers will post a link to this information on the MARC website.
9. End of Life
- Facilities should employ a prospective monitoring program for A-V accesses (grafts and fistula), which utilizes intra-access flow, and/or static venous pressures, and/or dynamic venous pressures.
- All facilities should have a written policy addressing referral to a surgeon for vascular access.
- 100% of facilities should have a written policy addressing advance directives and health care proxy.
Board of Directors Approval January 2008
Documents on this page are presented in Adobe PDF format. To view the documents,
download the latest version of Adobe Acrobat Reader for free.
