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Based on the 2007 CPM data collection sample (data from 4th quarter 2006), the measured Percent Patients with AVG and Stenosis Monitoring for Network 5 was 66%, compared with a national average of 69%. Although it is well accepted that the best vascular access that can be offered to patients is a native arteriovenous fistula (AVF), a significant percentage of patients in Network 5 continue to dialyze via AVG. In fact, the Network average in March 2008 for AVG was 26.2%. This, in combination with the average to below average Network performance on Percent Patients with AVG and Stenosis Monitoring , presents a significant opportunity for quality improvement. In addition, improved graft surveillance may assist in identifying patients who are suitable for secondary AVF placement in accordance with the Fistula First Change Concepts.
This initiative aims to increase the Network-level CPM measure of Percent Patients with AVG and Stenosis Monitoring by at least 5% by March 2009. This is being accomplished through a Network-wide communication campaign to educate facilities about the detection of access dysfunction through K-DOQI recommended surveillance activities and by partneri ng with medium to high-volume facilities with high rates of AVG utilization among adult prevalent in-center HD patients. In conjunction with this initiative, t he Network is assiting facilities in identifying needs for system improvements and offering technical assistance to stimulate changes designed to impact AVG stenosis monitoring/surveillance.
Stenosis Monitoring WebEx Training Session - September 2008
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