Mid-Atlantic Renal Coalition (MARC) - ESRD Network 5

Medical Review Board Statement of Philosophy and Expectations

MARC Mission  .  .  .  MARC's mission is to lead improvement in the delivery of quality of care for people with chronic kidney disease, valuing each member of the renal community and their role in achieving this goal.

MARC Vision  .  .  .  MARC will be a recognized leader in developing quality improvement methods used by the Renal Community to improve outcomes for patients with kidney disease.

MRB Mission  .  .  .  The Network 5 Medical Review Board will strive to support the mission of the Mid-Atlantic Renal Coalition and fulfill its mandated responsibilities by using a dynamic quality improvement model.

MRB Functions  .  .  .  The Medical Review Board serves as the focal point for all quality activities conducted within Network 5, and its goal is to assist providers in improving patient care.  The functions and responsibilities of the Medical Review Board, mandated by the Center for Medicare and Medicaid Services (CMS, formerly the Health Care Financing Administration) and clarified by the Forum of ESRD Networks, are highlighted below. 

• Provide oversight for the quality of care provided to ESRD beneficiaries
  
   
• Monitor and evaluate quality programs
  
   
• Collect, analyze and report data
  
   
• Coordinate the patient grievance process
  
   
• Take action on individual instances or patterns of care that pose danger to patients, or are not congruent with accepted community and professional standards (Actions may include: corrective action plans, site visits, referral to the Secretary, State Agency, Professional Review organization, and/or the recommendation of sanctions.)

MRB Philosophy  .  .  .  The Network 5 Medical Review Board believes it can best fulfill its mission by striking a balance between identifying best practices, recognizing excellent performance, assisting average providers in improving performance, and taking punitive action only when necessary if recalcitrant providers repeatedly fail to attempt improvement.  The MRB focuses on improving the performance of all providers, thus "raising the bar" and "shifting the mean to the right."

MRB Expectations  .  .  .  The Medical Review Board does not develop criteria and standards or practice guidelines.  It has, however, established a set of minimum expectations for all ESRD providers operating within Network 5, and these are listed below.  All dialysis and transplant providers should:

1. Comply with the ESRD Program Conditions of coverage (42 CFR, §405.2100-§405.2184);
   
    
2. Comply with all applicable state and local laws and regulations;
   
    
3. Comply with applicable AAMI/ANSI standards (e.g., water quality and reuse);
   
    
4. Follow the guidance/recommendations offered by professional organizations through their position statements (e.g., Renal Physicians Association, National Kidney Foundation, American Society for Transplantation, and American Nephrology Nurses Association position statements).
   
    
5. Observe K-DOQI Practice Guidelines; and, keep up-to-date with evidence based medicine and information technology
   
    
6. Strive to achieve Network 5 goals and objectives;
   
    
7. Participate in Network activities, such as quality improvement projects, including timely submission of data and responses to MRB queries;
   
    
8. Have an operational quality improvement program with active physician involvement (operational defined as engaging in unit-specific, internally driven quality improvement projects.)

Approved by the MRB 10/4/01, Endorsed by BOD 10/18/01