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The national Fistula First Breakthrough Initiative (FFBI) represents a joint effort between ESRD Networks, CMS, and the Institute for Healthcare Improvement (IHI). The purpose of the project is to improve quality in the area of vascular access, specifically by increasing the proportion of patients who dialyze via AV fistula (AVF). A preponderance of medical literature exists, and will not be reiterated here, providing convincing evidence that the AVF is the preferred access based on low complication rates, longevity, and low costs. Further, the National Kidney Foundation K-DOQI Practice Guidelines establish a goal that at least 50% of incident and at least 40% of prevalent hemodialysis patients should dialyze by AVF. Fistula proponents maintain that a much higher rate can be achieved, which has in fact been demonstrated in some areas.
The CMS target for AVFs is 66%.
As of April 2008, with 100% of facilities reporting,
Network 5's AV fistula rate was 46%!
We achieved our CMS goal for March 2008--
3 months ahead of schedule!
View a list of facilities with over 40% AV fistulas
SUCCESS STORIES!
Learn how some facilities are increasing their fistula rates.
If your facility is in Virginia, West Virginia, Maryland, or Washington, DC, we can help you improve your rates! Download an order form or contact us to obtain the following materials. If you are located outside of the Network 5 area, please contact the ESRD Network for your state for Fistula First materials.
Physicians
Fistula First Project Book
Facility Staff
In-Service Training Module #4: Fistula First (available in hard copy upon request)
Cannulation Protocol for New Fistulas Use these guidelines to establish your own facility protocol.
Patients
Planning Ahead for a Fistula, a comprehensive list of patient resources for vascular access (compiled as part of the Fistula First Breakthrough Initiative)
Information Card for Patients (3 1/2" x 8 1/2" card for patients about advantages of an AV Fistula)
Dialysis Patients Speak: A Conversation about the Importance of AV Fistulas
(DVD & VHS)
Your Access to Success (DVD & VHS)
Vascular Access for Hemodialysis (VHS only)
Surgeons
Creating AV Fistulae in All Eligible Hemodialysis Patients (DVD only)
Additional Resources
National Fistula First Breakthrough Initiative website
For detailed information about the Fistula First Project in Network 5, click on the documents below:
Documents on this page are presented in Adobe PDF format. To view the documents,
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